Debunk & Disorderly - R to Z

Final instalment. They really went to town when deciding on disorders that start with the letter 'S'.
One has to remember that the following are all deemed as mental illnesses and all are, apparently 'treatable' with either talk or drugs.

Pay heed to the letter 'U'. It would appear that when you don't meet the full criteria, your prescriber gets a helping hand from those wacky APA Task Force members.

More sexual problems make the list of disorders again and also those who struggle with reading are also deemed to be 'abnormal'. Infants and children are targeted in this next block of disorders too.

Remember how the DSM once said homosexuality was a disorder but they later backtracked and removed it? APA Task Force members are now targeting transvestites.

Also, note how problems caused by medications are now deemed as disorders.

Which of the following disorders do you think is the most absurd?



R

RAD
reactive attachment disorder - a rare but serious condition in which an infant or young child doesn't establish healthy attachments

RD
relational disorder - persistent and painful patterns of feelings, behaviors, and perceptions among two or more people in an important personal relationship, such a husband and wife, or a parent and children

RD (2)
rumination disorder - an eating disorder in which a person -- usually an infant or young child -- brings back up and re-chews partially digested food that has already been swallowed. In most cases, the re-chewed food is then swallowed again; but occasionally, the child will spit it out

RD (3)
rett's disorder - a rare non-inherited genetic postnatal neurological disorder that occurs almost exclusively in girls and leads to severe impairments, affecting nearly every aspect of the child's life: their ability to speak, walk, eat, and even breathe easily

RD (4)
reading disorder - occurs when a person has trouble with any part of the reading process

S

SAD (1)
seasonal affective disorder - a mood disorder characterized by depression that occurs at the same time every year

SAD (2)
separation anxiety disorder - excessive worry and fear about being apart from family members or individuals to whom a child is most attached. Children with separation anxiety disorder fear being lost from their family or fear something bad happening to a family member if they are separated from them

SAD (3)
social anxiety disorder - a chronic mental health condition in which social interactions cause irrational anxiety

SAD (4)
sleep arousal disorder - common in children. Arousal does not mean that the child wakes-up. The “arousal” is a partial arousal usually from “deep” sleep also called “slow-wave sleep”. Most commonly the child transitions from deep sleep to a mixture of very light sleep and/or partial wakefulness. This stage shift will commonly lead to a confusional state or a “confusional arousal

SAD (5)
sexual aversion disorder - one of two sexual desire disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and is defined as a "persistent or recurrent extreme aversion to, and avoidance of, all or almost all, genital sexual contact with a sexual partner

SCD
social (pragmatic) communication disorder - SCD encompasses problems with social interaction, social understanding and pragmatics. Pragmatics refers to using language in proper context

SD
schizophreniform disorder - a mental disorder diagnosed when symptoms of schizophrenia are present for a significant portion of the time within a one-month period, but signs of disruption are not present for the full six months required for the diagnosis of schizophrenia

SSD
somatic symptom disorder - a form of mental illness that causes one or more bodily symptoms, including pain. ... The symptoms can involve one or more different organs and body systems, such as: Pain. Neurologic problems. Gastrointestinal complaints

SDNos
somatoform disorder NOS - a psychiatric diagnosis used for conditions that do not meet the full criteria for the other somatoform disorders, but have physical symptoms that are misinterpreted or exaggerated with resultant impairment

SHAUD
sedative, hypnotic, or anxiolytic use disorder - a condition characterized by the harmful consequences of repeated use of sedative-like drugs, a pattern of compulsive use of sedative-like drugs, and (sometimes) physiological dependence on sedative-like drugs (i.e., tolerance and/or withdrawal)

SLD
specific learning disorder -  a disorder that interferes with a student's ability to listen, think, speak, write, spell, or do mathematical calculations. Students with a specific learning disability may struggle with reading, writing, or math

SMISD
substance or medication-induced sleep disorder - the official diagnostic name for insomnia and other sleep problems which are caused by the use of alcohol, drugs, or taking certain medications

SMIMMND
substance/medication-induced major or mild neurocognitive disorder - mild neurocognitive disorder due to substance/medication use and major neurocognitive disorder due to substance/medication use are the diagnostic names for two alcohol- or drug-induced major neurocognitive disorders― "major" obviously being the more severe form

SMD
stereotypic movement disorder - a motor disorder with onset in childhood involving repetitive, nonfunctional motor behavior (e.g., hand waving or head banging), that markedly interferes with normal activities or results in bodily injury

SUD
substance use disorder - occurs when a person's use of alcohol or another substance (drug) leads to health issues or problems at work, school, or home

SUD (2)
stimulant use disorder - include stimulant intoxication, stimulant withdrawal, and stimulant use disorder. They result from abuse of a class of medications known as stimulants, which include a wide range of drugs such as amphetamines, methamphetamine, and cocaine

SPD
schizoid personality disorder - a personality disorder characterized by a lack of interest in social relationships, a tendency towards a solitary or sheltered lifestyle, secretiveness, emotional coldness, detachment, and apathy

SPD (2)
shared psychotic disorder - a rare delusional disorder shared by 2 or, occasionally, more people with close emotional ties. ... Two people share the same delusion or delusional system and support one another in this belief. They have an unusually close relationship

SPD (3)
specific phobia disorder - a type of anxiety disorder defined as an extreme, irrational fear of or aversion to something

SSD
speech sound disorder - a communication disorder in which children have persistent difficulty saying words or sounds correctly

SRAD
substance-related and addictive disorder - a craving for, the development of a tolerance to, and difficulties in controlling the use of a particular substance or a set of substances, as well as withdrawal syndromes upon abrupt cessation of substance use

SMS
sexual masochism disorder - the condition of experiencing recurring and intense sexual arousal in response to enduring moderate or extreme pain, suffering, or humiliation

SSD
sexual sadism disorder - the condition of experiencing sexual arousal in response to the extreme pain, suffering or humiliation of others

SSRD
somatic symptom and related disorder - mental health disorders characterized by an intense focus on physical (somatic) symptoms that causes significant distress and/or interferes with daily functioning

STD
sleep terror disorder - episodes of screaming, intense fear and flailing while still asleep. Also known as night terrors, sleep terrors often are paired with sleepwalking. Like sleepwalking, sleep terrors are considered a parasomnia — an undesired occurrence during sleep

SWD
sleep-wake disorder - occur when the body's internal clock does not work properly or is out of sync with the surrounding environment

SWD (2)
sleepwalking disorder - a behavior disorder that originates during deep sleep and results in walking or performing other complex behaviors while asleep. It is much more common in children than adults and is more likely to occur if a person is sleep deprived

SZA
schizoaffective disorder - a chronic mental health condition characterized primarily by symptoms of schizophrenia, such as hallucinations or delusions, and symptoms of a mood disorder, such as mania and depression

T

TD
tic disorder - defined as repeated, sudden, rapid, nonrhythmic muscle movements including sounds or vocalizations. Tourette syndrome is diagnosed when people have had both motor and vocal tics for > 1 yr

TD (2)
transvestic disorder - cross-dressing, or dressing in the clothes of the opposite gender, to become sexually aroused. It must occur over a period of at least 6 months

TD (3)
tourette's disorder - a neurological disorder characterized by repetitive, stereotyped, involuntary movements and vocalizations called tics

TUD
tobacco use disorder - the most common substance use disorder in the United States. ... Nicotine is the primary addictive substance in tobacco; however other chemicals likely increase the addiction risk. Tobacco use appears to have an addictive / dependence potential at least equal to that of other drugs

U

UAD
unspecified anxiety disorder - used when there are anxiety-like symptoms that cause significant distress or impaired functioning. However, there is insufficient information to determine what particular type of Anxiety Disorder may be present

UDD
unspecified depressive disorder - category applies to presentations in which symptoms characteristic of a depressive disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the depressive disorders diagnostic class

UOCRD
unspecified obsessive-compulsive and related disorder - presentations characterized by OCD features that cause significant distress or impairment, but which do not meet the full criteria

USD
undifferentiated somatoform disorder - occurs when a person has physical complaints for more than six months that cannot be attributed to a medical condition

V

VD
voyeurism disorder - this disorder refers to (for over a period of at least 6 months) having recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving the act of observing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity


Bob Fiddaman

Previously

A to C

D to F

G to L

Debunk & Disorderly - M to P

The widening of the net continues. Previous posts at the foot of this post.


M

MDD
major depressive disorder - a mental health disorder characterized by persistently depressed mood or loss of interest in activities

MFMD
major frontotemporal neurocognitive disorder -  uncommon disorder that primarily affect the frontal and temporal lobes of the brain — the areas generally associated with personality, behavior and language

MHSDD
male hypoactive sexual desire disorder - considered a sexual dysfunction and is characterized as a lack or absence of sexual fantasies and desire for sexual activity

MND
major neurocognitive disorder - a decline in mental ability severe enough to interfere with independence and daily life

MNDWLB
major neurocognitive disorder with lewy bodies - the second most common type of degenerative dementia following Alzheimer's disease (AD). DLB is clinically and pathologically related to Parkinson's disease (PD) and PD dementia, and the three disorders can be viewed as existing on a spectrum of Lewy body disease.

MNDPD
major neurocognitive disorder due to parkinson’s disease
See MNDWLB

MVND
major vascular neurocognitive disorder - Vascular neurocognitive disorder is a common form of dementia. It is diagnosed in between 15-30% of all people who are diagnosed with dementia. Other names for this disorder include vascular dementia, vascular cognitive impairment and multi-infarct dementia

N

NES
night eating syndrome - a condition that combines overeating at night with sleep problems

ND
nightmare disorder - also known as dream anxiety disorder, is a sleep disorder characterized by frequent nightmares

NDD
neurodevelopmental disorders -  a group of disorders in which the development of the central nervous system is disturbed. This can include developmental brain dysfunction, which can manifest as neuropsychiatric problems or impaired motor function, learning, language or non-verbal communication

NPD
narcissistic personality disorder -  a personality disorder with a long-term pattern of abnormal behavior characterized by exaggerated feelings of self-importance, excessive need for admiration, and a lack of empathy

O

OCD
obsessive-compulsive disorder - a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over

OCPD
obsessive-compulsive personality disorder - despite having similar names and symptoms, OCD and OCPD are distinct forms of mental illness that have unique and specific characteristics. The main difference is that OCD is designated in the DSM within its own category called Obsessive-Compulsive and related disorders, while OCPD is considered a personality disorder.

ODD
oppositional defiant disorder - a type of behavior disorder. It is mostly diagnosed in childhood. Children with ODD are uncooperative, defiant, and hostile toward peers, parents, teachers, and other authority figures

OUD
opioid use disorder - patients presenting with an opioid use disorder may appear acutely intoxicated, in opioid withdrawal, or show no acute effects related to their opioid use

P

PAD
persisting amnestic disorder - the amnestic disorders are a group of disorders that involve loss of memories previously established, loss of the ability to create new memories or loss of the ability to learn new information

PBD
pediatric bipolar disorder - one of the more contentious issues in children’s mental health involves pediatric bipolar disorder (BD).  We now know that when BD presents in children, it tends to be a severe form of the illness.  But children who have been diagnosed with pediatric bipolar disorder (BD) may, in fact, have different illnesses requiring different treatments.

PCBD
persistent complex bereavement disorder - a disorder for those who are significantly and functionally impaired by prolonged grief symptoms for at least one month after six months of bereavement

PD
phobic disorder - intense, persistent, and recurrent fears of certain objects (such as snakes, spiders, or blood) or situations (like heights, speaking in front of a group, and public places). These things may trigger a panic attack. Social phobia and agoraphobia are examples of phobic disorders

PD (2)
pica disorder - an eating disorder that involves eating items that are not typically thought of as food and that do not contain significant nutritional value, such as hair, dirt, and paint chips

PDD
persistent depressive disorder - a low mood occurring for at least two years, along with at least two other symptoms of depression.

PDD (2)
pervasive developmental disorder - a group of disorders characterized by delays in the development of socialization and communication skills. Parents may note symptoms as early as infancy, although the typical age of onset is before 3 years of age.

PDD (3)
premenstrual dysphoric disorder - a health problem that is similar to premenstrual syndrome (PMS) but is more serious. PMDD causes severe irritability, depression, or anxiety in the week or two before your period starts

PPD
paranoid personality disorder -  one of a group of conditions called "Cluster A" personality disorders which involve odd or eccentric ways of thinking. People with PPD also suffer from paranoia, an unrelenting mistrust and suspicion of others, even when there is no reason to be suspicious

PTED
post-traumatic embitterment disorder - a pathological reaction to drastic life events and has the tendency not to stop. The trigger is an extraordinary although common negative life event as for example divorce, dismissal, personal insult or vilification

PTSD
post-traumatic stress disorder - a disorder in which a person has difficulty recovering after experiencing or witnessing a terrifying event

PUD
phencyclidine use disorder - this disorder is given to people who are experiencing problems as a result of using a group of substances called phencyclidines, or substances which are pharmacologically similar to them, such as ketamine


To be continued...


Bob Fiddaman


Previously

A to C

D to F

G to L

Debunk & Disorderly - G to L

Continuing on from my previous two posts.

All the following are 'mental health disorders', or are claimed to be mental health disorders by the Task Force of the DSM 5.



G

GAD
generalized anxiety disorder - severe, ongoing anxiety that interferes with daily activities

GD
gambling disorder - a persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress

GID
gender identity disorder (gender dysphoria) - an individual exhibits marked and persistent identification with the opposite sex and persistent discomfort (dysphoria) with his or her own sex or sense of inappropriateness in the gender role of that sex


H

HD
hoarding disorder - a persistent difficulty discarding or parting with possessions because of a perceived need to save them

HD (2)
hypersomnolence disorder - characterized by recurrent episodes of excessive daytime sleepiness or prolonged nighttime sleep

HPD
histrionic personality disorder - defined by the American Psychiatric Association as a personality disorder characterized by a pattern of excessive attention-seeking emotions, usually beginning in early adulthood, including inappropriately seductive behavior and an excessive need for approval

HPD (2)
hair-pulling disorder - a mental disorder classified under Obsessive-Compulsive and Related Disorders and involves recurrent, irresistible urges to pull hair from the scalp, eyebrows, eyelids, and other areas of the body

HPPD
hallucinogen persisting perception disorder - a disorder in which a person has flashbacks of visual hallucinations or distortions experienced during a previous hallucinogenic drug experience


I

IAD
internet addiction disorder -  also known as problematic internet use or pathological internet ..... A subcategory of IAD, Internet gaming disorder is listed in DSM-5 as a condition that requires more research in order to be considered as a full disorder

ICDNoS
impulse-control disorder NOS - individuals who fall under Impulse-Control Disorder NOS do not meet any of the criteria for the above disorders or any of the other impulse control disorders in the DSM-IV-TR. (eg. substance abuse, paraphilias). Some common impulse-control disorders in this category include impulsive sexual behaviors, pathological skin picking, self-mutilation, and compulsive shopping. Those with sexual impulses often are promiscuous, show compulsive masturbation, show a compulsive use phone sex lines and/or pornography, and often show pornography dependence

IED
intermittent explosive disorder - a behavioral disorder characterized by explosive outbursts of anger and violence, often to the point of rage, that are disproportionate to the situation at hand

ID
insomnia disorder - a sleep disorder that is characterized by difficulty falling and/or staying asleep

IGD
internet gaming disorder - most common in male adolescents 12 to 20 years of age. According to studies it is thought that Internet Gaming Disorder is more prevalent in Asian countries than in North America and Europe. Internet Gaming Disorder is a “Condition for Further Study” in the DSM-5 (APA 2013).  This means that it is not an "official" disorder in the DSM, but one on which the American Psychiatric Association request additional research.

IUD
inhalant use disorder -  a problem that can develop when people deliberately breathe in the fumes of various substances


L

LD
language disorder - an individual's expressive language may be severely impaired, while his receptive language is hardly impaired at all. More specifically, according to the DSM-5, deficits in comprehension or production can include the following: Reduced vocabulary (word knowledge and use)


To be continued...

Bob Fiddaman

A to C

D to F

Debunk & Disorderly - D to F

Continuing from yesterday. Pay particular attention to the 'disorders' beginning with the letter 'F'.

Do members of the APA Task Force watch porn movies before raising their, ahem... hands?

D


DCD
developmental coordination disorder -  a motor skills disorder that affects five to six percent of all school-aged children

DD
delusional disorder - a generally rare mental illness in which the patient presents delusions, but with no accompanying prominent hallucinations, thought disorder, mood disorder

DDD
depersonalization/derealization disorder - involves a persistent or recurring feeling of being detached from one's body or mental processes

DID
dissociative identity disorder - a disorder characterized by the presence of two or more distinct personality states

DMDD
disruptive mood dysregulation disorder - a childhood condition of extreme irritability, anger, and frequent, intense temper outbursts

DICCD
disruptive, impulse-control, and conduct disorder -  combines oppositional defiant disorder (ODD), conduct disorder (CD), and disruptive behavior disorder not otherwise specified (DBDNOS) with disorders in the “Impulse-Control Disorders Not Otherwise Specified” chapter


E

ED
excoriation disorder - a mental illness related to obsessive-compulsive disorder. It is characterized by repeated picking at one's own skin

ED (2)
exhibitionistic disorder - a condition marked by the urge, fantasy, or act of exposing one's genitals to non-consenting people, particularly strangers

EDNOS
eating disorder not otherwise specified - applied when an individual’s symptoms cause significant distress but do not fit neatly within the strict criteria for anorexia, bulimia, avoidant/restrictive food intake disorder or binge eating disorder

F

FD
factitious disorder - a mental disorder in which a person acts as if he or she has a physical or mental illness when, in fact, he or she has consciously created the symptoms (Important question here)

FD (2)
frotteuristic disorder - the act of touching or rubbing one's genitals up against another person in a sexual manner without their consent

FD (3)
fetishistic disorder -  characterized as a condition in which there is a persistent and repetitive use of or dependence on nonliving objects (such as undergarments or high-heeled shoes) or a highly specific focus on a body part (most often nongenital, such as feet) to reach sexual arousal

FHSDD
female hypoactive sexual desire disorder - a deficiency or absence of sexual fantasies and desire for sexual activity that causes marked distress or interpersonal difficulty

FSAD
female sexual arousal disorder - a disorder characterized by a persistent or recurrent inability to attain sexual arousal or to maintain arousal until the completion of a sexual activity

FOD
female orgasmic disorder - refers to difficulty reaching orgasm. It may take a woman with FOD longer to have an orgasm


To be continued...

G - L


Bob Fiddaman

Debunk & Disorderly - A to C

debunk - to expose the sham
disorder - abnormal physical or mental condition

I've been reading the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) and it struck me that disorder is such a vile word. The DSM 5 mentions the word no less than 1,377 times with references to various illnesses and subsets of illnesses, the majority of which are just downright laughable. Then again, most know how these illnesses are arrived at, and for those that don't, here's a good place to start. In brief, in the 1800s  seven categories of mental health were distinguished: mania, melancholia, monomania, paresis, dementia, dipsomania, and epilepsy. By 1952 the first edition of the DSM was written. Fast forward to the year 2000 and work began on the fifth version. It's a bit like a movie franchise that keeps churning out follow-ups. Jaws, Jaws II, Jaws III etc.

I don't know who came up with the title of the book (manual) but it clearly shows how people with problems in their life are seen by the American Psychiatric Association, who create task forces to update each version of the DSM. They do this by a show of hands. For example, all the problems below were voted into existence. No tests were carried out, just discussion. The list below isn't all of the 'disorders' that have been voted on and some are subtypes of 'disorders' already in place. Be sure to click on each disorder for a description of what it means, or what the APA task force wants you to believe it means.

Most of the 'disorders' can and should be debunked as nothing but the imagination of white privileged gentlemen who want to impress their peers, moreover, want to keep the sham going. One has to bear in mind that all the 'disorders' below are alleged mental problems and all, according to the field of psychiatry, are manageable with 'treatment.' There's an awful amount of brain pellets ready to be prescribed, folks. Contrast the 7 disorders that were agreed upon in the 1800s with the modern-day (DSM-5) list below. For example, there are now 10 'disorders', but those are just the ones that begin with the letter 'A'. You and/or someone you know may just be abnormal.

--

A

AD
adjustment disorder - the presence of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s)

ADD
attention deficit disorder - a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development

ADHD
attention deficit hyperactivity disorder
(See ADD)

ARFID
avoidant/restrictive food intake disorder - an eating or feeding disturbance (e.g., apparent lack of interest in eating or food; avoidance based on the sensory characteristics of food

ASD
autism spectrum disorder - persistent deficits in social communication and social interaction across multiple contexts

ASD
acute stress disorder - the diagnosis of ASD can only be considered from 3 days to one month following a traumatic event (commonly referred to as the acute phase).

ASPD
antisocial personality disorder - a person with ASPD may present "with psychopathic features" if he or she exhibits "a lack of anxiety or fear and a bold, efficacious interpersonal style

ATSUD
amphetamine-type substance use disorder - a person who takes a substance in larger amounts and/or over a longer period than the patient intended.

AUD
alcohol use disorder - alcohol abuse and alcohol dependence, into a single disorder called alcohol use disorder (AUD) with mild, moderate, and severe sub-classifications.

AvPD
avoidant personality disorder - a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation

B

BD
bipolar disorder - a lifelong illness. Episodes of mania and depression eventually can occur again if you don't get treatment

BD1
bipolar disorder I - involves periods of severe mood episodes from mania to depression.

BD2
bipolar disorder II - a milder form of mood elevation, involving milder episodes of hypomania that alternate with periods of severe depression

BDD
body dysmorphic disorder - a relatively common mental health condition in which a person experiences excessive anxiety about a perceived defect in their physical appearance

BED
binge eating disorder - a treatable eating disorder characterized by recurrent episodes of eating large quantities of food

BPD
borderline personality disorder - a mental health disorder that impacts the way you think and feel about yourself and others

BPD (2)
brief psychotic disorder - an uncommon psychiatric condition characterized by sudden and temporary periods of psychotic behavior

BP-NOS
bipolar disorder not otherwise specified - may be used when symptoms are consistent with bipolar disorder but fall short of a definitive diagnosis

C

CD
cognitive disorder - a category of mental health disorders that primarily affect cognitive abilities

CD (2)
conduct disorder - a serious behavioral and emotional disorder that can occur in children and teens

CIAD
caffeine-induced anxiety disorder -  a psychiatric disorder linked to the aggravation and maintenance of anxiety disorders, and the initiation of panic or anxiety attacks in those who are already predisposed to such phenomena

CISD
caffeine-induced sleep disorder - a psychiatric disorder that results from overconsumption of the stimulant caffeine

CRSD
circadian rhythm sleep disorder - a family of sleep disorders which affect the timing of sleep.

COFD
childhood-onset fluency disorder -  stuttering — also called stammering or childhood-onset fluency disorder — is a speech disorder that involves frequent and significant problems with normal fluency and flow of speech

CUD
cannabis use disorder - problematic marijuana use

CUD (2)
cocaine use disorder - problematic cocaine use

To be continued...


Bob Fiddaman


D-F

G-L

Donald Trump - The Role of Psychiatry

I'm not into politics, particularly American politics. I've often laughed at the whole election process over there. Obscene amounts of money thrown at huge campaigns, even rock stars get in on the act in efforts to persuade their fans who to vote for. Here in the UK it's very low key. On the odd occasion, we may see a minor scuffle outside a polling station on a damp and dreary Thursday ~ It's nothing compared to the firework displays and live bands performing for our American counterparts.

So, if I'm not into politics why am I using my free time on a Sunday to write a blog about Donald Trump?

Well, I'm finding him very interesting. I can't weigh him up though. I know he has a disdain for journalists and I know he tweets a lot. His tweets are causing concern for many as are his speeches, so much so that a number of mental health professionals are claiming that Trump’s speeches and actions make him incapable of serving safely as president. They claim that Trump is showing 'grave emotional instability.'

In a letter to the New York Times, no less than 35 health care professionals, led by Lance Dodes, M.D., claim that:

(Donald Trump's) actions demonstrate an inability to tolerate views different from his own, leading to rage reactions. His words and behavior suggest a profound inability to empathize. Individuals with these traits distort reality to suit their psychological state.

Let's take a look at this closer by using the Merck Manual of personality disorders.

According to the 35 health care professionals, Trump is showing:

- grave emotional instability - Another term for this, I guess, could be 'emotionally detached.'
- profound inability to empathize -

Schizotypal personality disorder
People with schizotypal personality disorder are emotionally detached. In addition, they have odd ways of thinking, perceiving, and communicating similar to those of people with schizophrenia. Odd ways of thinking may include magical thinking and paranoid ideas. In magical thinking, people believe that their thoughts or actions can control something or someone. For example, people may believe that they can harm others by thinking angry thoughts. People with paranoid ideas tend to be suspicious and mistrustful and wrongfully think other people have hostile motives or intend to harm them. Schizotypal personality disorder may be treated with antipsychotic drugs.

Fair to say that Trump, if the 35 professionals assessment of him is correct, would meet the criteria for someone having Schizotypal personality disorder.

But wait, there's more from the Merck Manual:

Antisocial personality disorder
Many people with antisocial personality disorder become frustrated easily and tolerate frustration poorly. As a result, they act impulsively and irresponsibly, sometimes committing criminal acts. In these cases, they act without considering the negative consequences of their behavior and the problems or harm they cause others. There are no medications specifically approved by the Food and Drug Administration to treat antisocial personality disorder. Doctors may prescribe medications for conditions sometimes associated with antisocial personality disorder, such as anxiety or depression, or for symptoms of aggression

Furthermore:

Narcissistic personality disorder
This type is characterized by an inflated view of self-worth (called grandiosity). People with this disorder expect to be treated with deference and may exploit others because they think their superiority justifies it. Their relationships are characterized by a need for admiration, and they often think that others are jealous of or envy them. These people are sensitive to the reactions of others but only as far as the reactions relate to themselves. They are extremely sensitive to failure, defeat, and negative reactions from others, including criticism. Such reactions from others can trigger sudden rages or depression (including suicidal thoughts or actions). There are no medications specifically used to treat narcissistic personality disorder. However, if you have symptoms of depression, anxiety or other conditions, medications such as antidepressants or anti-anxiety drugs may be helpful.

Moving across to the Diagnostic Statistical Manual of Mental Disorders, we see Trump also meets the criteria (If the 35 health care professionals are to be believed) for:

Obsessive-Compulsive Personality Disorder
Empathy: Difficulty understanding and appreciating the ideas, feelings, or behaviors of others. In most cases, medication for this disorder is not indicated unless the individuals is also suffering from another psychiatric disorder. However, newer medications such as Prozac, an SSRI, have been approved for the treatment of obsessive-compulsive disorder and may provide some relief to individuals with the related personality disorder.

In fact, according to the 35 health care professionals, Trump also meets the criteria for Avoidant Personality Disorder and Borderline Personality Disorder, both can be treated with psychiatric medications.

So, my question to these 35 health care professionals is simple, however, I don't expect an answer.

If Trump was your patient would you prescribe him any of the medications listed above and let him continue in office?

I highly suspect the answer would be a defiant 'No' - not because they don't want him to continue in office, not because they believe that Trump is beyond repair either. Neither of these health care professionals would prescribe any psychiatric drug to Trump because of this one Tweet:

Military solutions are now fully in place,locked and loaded,should North Korea act unwisely. Hopefully Kim Jong Un will find another path!

— Donald J. Trump (@realDonaldTrump) August 11, 2017

Why would any psychiatrist or doctor prescribe an antipsychotic or SSRI to someone who throws out a gauntlet like this?

Which brings me nicely to the recent Panorama programme, 'A Prescription For Murder.'

James Holmes, despite telling his psychiatrist he had murderous thoughts, was prescribed the SSRI sertraline, known better by its brand name of Zoloft in the US and Lustral in the UK. Holmes, after taking sertraline for 6 weeks carried out those murderous thoughts regardless. Much was said in the defence of SSRIs prior to and after the airing of the Panorama programme. Those same critics who chastised Panorama are now in a wonderful position. Why not let them decide if a psychiatric drug, which they believe does not induce murderous thoughts, should be administered to President Donald J. Trump?

If they are so cocksure that the benefits of these types of medications outweigh the serious risks they can pose then I'm sure they will pull out their prescription pads and write him a prescription for some medication.

Given what we know about these meds, and what we have been saying for many years about these meds, this is one occasion where psychiatry can prove us all wrong.

I double-dare you all.

Bob Fiddaman

Children Facing Long-Term Health Risks!

Fox News investigates why children are being prescribed powerful psychiatric medicine.

Pediatric shrinks who prescribe these mind-numbing drugs should be utterly ashamed of themselves.




MyFoxAustin | KTBC | Fox 7 Austin | News Weather Sports



Why?

Here's a study I carried out myself a few years ago.


Psychiatric Medication or Play Therapy?

Psychiatric Medication or Play Therapy? For me it's a no-brainer but for millions of unsuspecting parents play therapy is just not an option. Why?

Play therapy has, over the years, steadily grown in popularity among clinicians. It has, however, not been accepted by the scientific community and, more often than not, has been criticized for a lack of evidence showing efficacy to support it's use on a bigger scale. Consequently, its not been offered to parents as an alternative to drugging their children into submission.

So, what is play therapy?


It's roots go back a long way. We've all experienced it at some point in our lives, it's just being a kid. Exploring the world, expressing yourself and interacting with other kids and adults while having fun.

Think about it for a second. What was the one thing we all craved as children at school? Double history, double maths, geography? - We all wanted to hear that bell - PLAY TIME!

Famous philosopher, Plato, once had this to say about play, "you can discover more about a person in an hour of play than in a year of conversation.".

In the eighteenth century Genevan philosopher, Jean-Jacques Rousseau, wrote in his novel, Émile: or, On Education, how important it was to observe play as a vehicle to learn about and understand children.

Most notably it was Friedrich Fröbel, a German teacher, who laid the foundation for modern education based on the recognition that children have unique needs and capabilities who summed up the value of play by saying "Play is the highest level of child development . . . It gives . . . joy, freedom, contentment, inner and outer rest, peace with the world . . . The plays of childhood are the germinal leaves of all later life."

So, in Plato, Rousseau and Fröbel, we have a pretty clear understanding of how play therapy is an important tool in understanding children and their needs. All three are regularly quoted in today's world. Sadly their work and thoughts on how we should all treat children have been eclipsed by the heavy marketing of child disorders and psychiatric medication.

I'd like to step forward in time and offer you three key opinion leaders in the field of mental health, Moreover, I'd like to quote them.

First off, Emeritus Professor John Werry, a child psychiatrist  “as far as we know” giving SSRIs to babies would not harm them. “But one doesn't like to give growing and developing kids medications that affect basic bio-cyclic processes because it just doesn't seem like a good idea unless the kid is really in severe difficulty.” He adds, it would be rare to prescribe antidepressants before the teenage years, and that the youngest child he had prescribed one to was a boy with autism aged 8 or 9, but that was “very exceptional”.[1]

"...the ministry had no concerns about the number of children being prescribed medication for ADHD" - Dr Pat Tuohy, Chief Advisor - Child and Youth Health at Ministry of Health New Zealand [2]

Speaking on why children should be given antidepressants, Andrew Cotgrove, Clinical Director and Consultant in Adolescent Psychiatry at Pine Lodge Young People's Centre, Chester England, said, "We should not deny depressed children one of the few evidence-based available treatments"  [3]

Compare the quotes of Plato, Rousseau and Fröbel with Werry, Tuohy and Cotgrove. What can you see?

Is it just me or do the latter three appear less compelling and enduring than the former?

So, this post is about psychiatric medication vs play therapy. It's about giving an option to parents who think that medication is the only possible treatment for children with behavioural problems and/or depressive signs. It's also a post that may interest counsellors, teachers and others who often refer children to mental health services.

In 2005, The Efficacy of Play Therapy With Children: A Meta-Analytic Review of Treatment Outcomes, was published in the Professional Psychology: Research and Practice [4]

The authors used a combination of online and offline search procedures to exhaust all resources in locating both unpublished and published play therapy outcome studies. The University of North Texas was a primary offline resource, particularly for unpublished studies.

Across the 93 studies, a total of 3,248 boys and girls with diverse presenting issues participated in a play therapy intervention. The 93 studies occurred between 1953–2000.

What the authors found after analyzing the 93 studies was that "play therapy outcome studies support the efficacy of this intervention with children suffering from various emotional and behavioral difficulties."

The meta-analysis concluded the following, "This meta-analysis has significant implications for those who provide mental health services to children and families. These findings should be used to not only educate managed care companies but also to educate and work with parents, government, schools, and the medical and legal communities to provide children with the most beneficial treatments."

So, given that there is an effective non-medical treatment out there for children with diverse presenting issues, or ADHD, as psychiatry would label it, why do we constantly hear stories about children being hooked on Ritalin, killing themselves on Prozac, Zoloft, Celexa and Paxil, gaining weight on Seroquel?

It would be easy for me to suggest that it was just about the money and the way pharmaceutical companies promote their wares. It was also be way too easy for me to suggest that published papers by key opinion leaders [paid by pharmaceutical companies] influence the majority of prescribing healthcare professionals.

But perhaps there are hidden dangers with Play Therapy not reported in the literature, that stop it being the intervention of choice for medical and mental health professionals?

With this in mind I decided to contact Carol Laubscher of Integrated Learning Therapy, a New Zealand based play therapy centre. I asked her:

1. What effect does play therapy have on a child's developing brain?

2. Has any child under your care ever become addicted to play therapy?

3. Has any child during the course of receiving play therapy from you ever attempted to self-harm?

4. Has any child during the course of receiving play therapy from you ever attempted suicide?

5. Has any child during the course of receiving play therapy from you ever gained weight as a result of the therapy?


On the issue of play therapy and how it effects a child's developing brain Carol told me:

"As play therapy works to reconfigure a child's attachment model, it has a huge effect neurologically, releasing the brain from anxiety and reorganising neural pathways."

Carol answered 'no' to questions 2 - 5.

I also contacted Dr Sue Bratton, co-author of The Efficacy of Play Therapy With Children: A Meta-Analytic Review of Treatment Outcomes, and asked if any adverse events were reported in the 93 studies that were analyzed. Dr Bratton told me that there were no adverse events reported. On the issue of how child therapy effects a child's brain she told me:

"In all children, play is essential to healthy brain development (If you want details about the neuroscience of play and brain development, I can give you many good resources: Bruce Perry, MD, PhD and Stuart Brown, MD are two examples).  For children who have had early adverse and traumatic experience, the brain’s development is impacted in such a way that the child’s holistic development is thwarted. Play, in the context of relationship, is crucial to the child’s brain developing new neural pathways that promote healthy brain functioning (again, this is a very simplistic explanation, please see Perry or Bonnie Badenoch’s Brainwise Therapist (2008)."

Dr. Bratton is a professor in Counseling and Director of the Center for Play Therapy at the University of North Texas

Using play therapy in children before medication is even considered should, one would think, be top of any healthcare professional's list. Alas, the odds are stacked against children in favour of psychiatric medication. This is due to a number of factors.

Pharmaceutical companies spend billions on marketing psychiatric medication. If a specific drug is not deemed by the regulatory authorities to be safe or effective for children, pharma will then hire child psychiatrists to run clinical trials, this, to show the regulators, other healthcare professionals and media that these drugs aren't dangerous in this target population.

Front groups that purport to fly the mental health flag are, in fact, nothing more than agents, pimps for the pharmaceutical industry. Examples of these front groups can be seen in the the four articles I highlighted back in 2007 entitled, 'GlaxoSmithKline, Money Trail Down Under'. [5], [6], [7], [8]

Psychiatrists that are well respected among their peers are also targeted by the pharmaceutical industry, often paid huge sums of money to promote the use of antidepressants in children and adolescents.

A and B list celebrities must also carry the shoulder of blame. Quite often they are used as advocates for antidepressant type medications, be they famous sports personalities, Hollywood film stars or TV and radio talk show hosts. These people have huge fan bases, many of their fans hang on to every word they say. In many instances they promote psychiatric medication with financial support from the pharmaceutical industry.

Play therapists are individual practitioners. Neither they, nor their professional associations have multi-million dollar marketing arms which are able to buy doctors, celebrities or journalists to promote their product. Nor are they able to create or take-over patient advocacy groups with the sole purpose of promoting their work and building revenues.

The God factor also comes into play. If you, as a parent, do your own research on the drug your child has been prescribed and you bring your concerns to the prescribing doctor's table you will, more often than not, be dismissed as either not knowing what you are talking about or be accused of reading too many internet conspiracies.

The Play Therapists I have encountered are convinced of the benefits and importance of the work they do but not of their own omnipotence as so many psychiatrists are and are unlikely to promote themselves in quite the way psychiatrists such as Dr Beiderman do in the following famous testimony on his qualifications in a case against pharmaceutical company  Johnson & Johnson.

In a deposition between Dr. Biederman and lawyers for the states, he was asked what rank he held at Harvard. “Full professor,” he answered.

“What’s after that?” asked a lawyer, Fletch Trammell.

“God,” Dr. Biederman responded.

“Did you say God?” Mr. Trammell asked.

“Yeah,” Dr. Biederman said.

Hard to believe huh? With the modern wonders of the internet we can see Biederman in action here.

PRESS PLAY

When the competition has that much clout it's hardly surprising that play therapy, despite its proven efficacy, is rarely used by healthcare professionals.

Then there is cost and convenience. It's so much cheaper and easier for a parent to choose psychiatric medication for their child than it is to enroll them in play therapy sessions. Global governments subsidize prescription medication, this makes taking drugs even cheaper. They do not subsidise Play Therapy which makes it both relatively expensive and unavailable.

If your child is distressed, disruptive, anti-social and unhappy, as a parent you need a short term solution but also to weigh the long term risks and benefits of the available interventions.

The following chart shows the relative risk of stimulant medication such as ritalin and play therapy on longer term outcomes for kids.

Every day parents are taking that risk when they dispense their prescription at the pharmacy on behalf of their children.

If a kid is being a kid then let them continue to be a kid. Psychiatric medication as first-line treatment is absurd when the option of play therapy exists.

If further evidence were needed regarding the importance of play then The Importance of Play in Promoting Healthy Child Development and Maintaining Strong Parent-Child Bonds[10] published in the Official Journal of Pediatrics, clearly sends out a stark message, a message that is somewhat contradicted.

"Play is a cherished part of childhood that offers children important developmental benefits and parents the opportunity to fully engage with their children. However, multiple forces are interacting to effectively reduce many children’s ability to reap the benefits of play. As we strive to create the optimal developmental milieu for children, it remains imperative that play be included along with academic and social-enrichment opportunities and that safe environments be made available to all children. Additional research is needed to explore the appropriate balance of play, academic enrichment, and organized activities for children with different temperaments and social, emotional, intellectual, and environmental needs."

All seems good until you delve deeper into the published article...

"Pediatricians should refer to appropriate mental health professionals when children or their parents show signs of excessive stress, anxiety, or depression."

It's almost like an add-on, a disclaimer - such is the stranglehold psychiatry has on the modern day. Unless we recognise that Play Therapists are mental health professionals and their therapy addresses stress, anxiety and depression by nurturing rather than damaging children's growing brains.

When weighing up the benefits of psychiatric medication against the risks, one should always remember that there are many adverse reactions reported, some so severe that children have died because the prescribed medication induced their suicide...you cannot get a more adverse reaction than death.

Brain damage has also been linked to children taking these powerful drugs. In 2009,'Differential regulation of psychostimulant-induced gene expression of brain derived neurotrophic factor and the immediate-early gene Arc in the juvenile and adult brain' was published in European Journal Of Neuroscience. [11] The authors concluded:

"The psycho-stimulant drugs Methylphenidate (Ritalin) and Amphetamine are widely used in children for the treatment of ADHD, but recent data suggest that exposure to these agents in early life could be detrimental to brain development."

Ritalin is widely used in children with behavioural problems.

In another study, Stimulant Induced Psychosis, published in the Child and Adolescent Mental Health Journal in 2009 [12] the authors concluded that:

"Our findings highlight potential issues in the care of children treated with stimulant medication. Throughout the United Kingdom practices differ; many localities have specialist ADHD clinics, which include Paediatric services or Child and Adolescent Mental Health Services. The practice of shared care with the General Practitioner is amongst NICE recommendations. We feel it is important for all professionals involved in the use of stimulant medication to have mental health training, particularly in the careful screening and identification of psychotic symptoms which could easily be mistaken as a deterioration in the symptoms of ADHD and result in an increase in the dose of stimulant prescribed, potentially having serious implications."


Play therapy, however, report no adverse reactions.

Still not convinced yet?

Perhaps the following article will sway your opinion. It was published in the Ethical Human Psychology and Psychiatry journal last year. 'The Risks Associated With Stimulant Medication Use in Child and Adolescent Populations Diagnosed With Attention- Deficit/Hyperactivity Disorder' [13] was written by Jeanne M. Stolzer, PhD of the University of Nebraska-Kearney.

In her summation Stolzer writes:


"ADHD-type behaviors are nothing new. They have been documented across cultures, across time, and across mammalian species (Stolzer, 2005). The fact of the matter is that children have always been fidgety, highly active, inattentive, spontaneous, and prone to engage in behaviors that exacerbate adults. What has been compendiously altered is our collective perception of what constitutes normal-range child behaviors. The simple and reductionistic medical model refuses to acknowledge bioevolutionary based traits, financial incentives to label children with ADHD, inappropriate educational systems, the influence of the pharmaceutical industry, nature deprivation, and alterations in cultural perceptions of childhood. The medical model remains adamant that ADHD behaviors are pathological and can be attributed to a chemical imbalance within the child’s brain in spite of the fact that no empirical evidence exists to substantiate this hypothesis. We have two choices. We can cling to a hypothesis which has no scientific credence, and continue to prescribe dangerous and addictive stimulant medication to millions of children who have been diagnosed with a mythical disease—or we can demand an end to this lunacy."


If, after reading all of the above evidence, you still think medicating children and adolescents is safe and effective then you'll just add to my despair - I can deal with that via some adult play... normally my guitar.

As I said in the beginning of this post, "For me it's a no-brainer."


There are no seven wonders of the world in the eyes of a child. There are seven million.
~ Walt Streightiff

Bob Fiddaman


[1] Babies Given Antidepressants In New Zealand [Link]
[2] NZ urged to shift stress on drugs as first option [Link]
[3] To Give Or Not To Give Antidepressants To Young People [Link]
[4] The Efficacy of Play Therapy With Children: A Meta-Analytic Review of Treatment Outcomes - Sue C. Bratton, Dee Ray, Tammy Rhine, Leslie Jones - Professional Psychology: Research and Practice - 2005, Vol. 36, No. 4, 376–390
[5] GlaxoSmithKline Money Trail Down Under Part 1 [Link]
[6] GlaxoSmithKline Money Trail Down Under Part 2 [Link] 
[7] GlaxoSmithKline Money Trail Down Under Part 3 [Link]
[8] GlaxoSmithKline Money Trail Down Under Part 4 - Enter Dr Martin Keller [Link]
[9] Knowles v. Minister for Defence [2002] IEHC 39 (22 February 2002)
[10] PEDIATRICS Vol. 119 No. 1 January 1, 2007 pp. 182 -191 (doi: 10.1542/peds.2006-2697)
[11] Differential regulation of psychostimulant-induced gene expression of brain derived neurotrophic factor and the immediate-early gene Arc in the juvenile and adult brain - European Journal Of Neuroscience [serial online]. February 2009;29(3):465-476.
[12] Stimulant Induced Psychosis - Child and Adolescent Mental Health Volume 14, No. 1, 2009, pp. 20–23
[13] The Risks Associated With Stimulant Medication Use in Child and Adolescent Populations Diagnosed With Attention- Deficit/Hyperactivity Disorder - Ethical Human Psychology and Psychiatry, Volume 14, Number 1, 2012

CHART REFERENCES

[1] Shatha Shibib & Nevyne Chalhoub Stimulant Induced Psychosis Child and Adolescent Mental Health Volume 14, No. 1, 2009, pp. 20–23
[2] Banerjee P. Differential regulation of psychostimulant-induced gene expression of brain derived neurotrophic factor and the immediate-early gene Arc in the juvenile and adult brain. European Journal Of Neuroscience [serial online]. February 2009;29(3):465-476. 
[3] Lambert N. The Contribution of Childhood ADHD, Conduct Problems, and Stimulant Treatment to Adolescent and Adult Tobacco and Psychoactive Substance Abuse. Ethical Human Psychology & Psychiatry [serial online]. Winter2005 2005;7(3):197-221.
[4] Jeanne, M. S. (2012). The risks associated with stimulant medication use in child and adolescent populations diagnosed with attention- Deficit/Hyperactivity disorder. Ethical Human Psychology and Psychiatry, 14(1), 5-14. 
[5] Samuels, Franco, Wan, & Sorof, 2006
[6] Gould, M., Walsh, B., Munfakh, J., Kleinman, M., Duan, N., Olfson, M., et al. (2009). Sudden death and the use of stimulant medications in youth. American Journal of Psychiatry, 166(9), 992-1001
[7] Stein, M. (2009). Psychiatric reactions to ADHD medications. Pediatric and Adolescent Medicine, 123, 111–120.

Pharmaceutical Ads Should be Allowed on British TV's

There are only two countries in the world that are allowed to air ads for prescription drugs, namely New Zealand and the good old US of A. This is called direct-to-consumer advertising, or DTC for short.

I'm calling for the British government to allow the same type of ads on British TV screens.

So, have I gone and signed a deal with the Devil, taken a kickback from the Pharmafia?

Nup.

I'll explain.

In the US it is the job of the FDA to regulate direct-to-consumer advertising, any ad that falls short of their rules and regulations is either not aired or taken back to the editing room.

In the UK that job, if ads were aired, would be down to the British drug regulator, the MHRA. Anyone familiar with our toothless drug watchdog will know that they have, time and time again, given antidepressants a clean bill of health where adults are concerned. They normally refer to the Committee on Safety of Medicines [CSM] when asked about the safety of antidepressants in this population. Bizarrely Prozac can be given to children and teens in the UK whereas in the US it's not recommended.

Advertising a prescription drug on television used to be a lucrative tool for the pharmaceutical industry. In the US, for example, Paxil was heavily promoted as the pill to cure shyness. However, this lucrative tool has now become the Achilles heel for the marketing departments of the pharmafia.

Now, they are legally obliged to list the side effects of the particular drugs they are advertising on US TV screens.

Here's an example of a recent ad for Latuda [lurasidone] - a new atypical antipsychotic for the treatment of "bipolar depression" and developed by Dainippon Sumitomo Pharma and marketed by Sunovion in the USA.

How would the British public react to this ad if it were aired halfway through Coronation Street or the X-Factor?

Personally, I think it would be a wake-up call to all those British folk who think the pharmaceutical industry are whiter than white.

Did you hear the list of side-effects mentioned in the 90 second ad above?

The first 20 seconds of the ad describes the product and what it is indicated for.

Let's just take a look at what happens after the 20 second mark.

Latuda is not for everyone.

Call your doctor if you have unusual changes in moods, behaviours or thoughts of suicide. Antidepressants can increase these in children, teens and young adults. 

Elderly dementia patients taking Latuda have an increased risk of death or stroke. 

Call you doctor if you have fever, stiff muscles and confusion as these may be signs of a life-threatening reaction...or if you have uncontrollable muscle movements as these may become permanent.

High blood sugar has been reported with Latuda and medicines like it and in some cases extreme high blood sugar can lead to coma or death.

Other risks include decreases in white blood cells which can be fatal, dizziness upon standing, seizures, increased cholesterol, weight gain, increased prolactin levels, impairment in judgement or trouble swallowing.

Avoid grapefruit and grapefruit juice whilst taking Latuda.

Use caution when driving or operating machinery.

The side effects narrated by the softly spoken woman end at 1.15. The final 15 seconds asks the viewer [you, the consumer] to ask your doctor for Latuda and that "bipolar depression" is treatable.

I find it remarkable that the marketing team in this ad have added the following narrative, "Call your doctor if you have unusual changes in moods, behaviours or thoughts of suicide. Antidepressants can increase these in children, teens and young adults."

Latuda is not recommended for children or teens yet they felt the need to throw up the warning. This is because they know that Latuda will more than likely be prescribed off-label to this age group, they know because they will probably promote it in such a way when their reps visit the doctors in their workplaces.

The ad, to me at least, is more about the illness than the product. What they are trying to do here is make "bipolar depression" sound as if it is life-threatening if left untreated, they are trying to convince the consumer that this condition is as bad as a cancerous growth on the lung. This is designed to make you, the consumer, think that the risks stated are worth it.

Bipolar depression is the name given to the depression experienced in those who have bipolar disorder [in other words, they experience depression as well as manic or hypomanic episodes]...at least, that's what we are told.

Now, the reason I believe that we, here in the UK, should allow such ads on our TV screens is simple.

People already on these types of drugs probably haven't read the patient information leaflet that accompanies these drugs, even if they have it's hardly as powerful as the spoken word.

Airing ads like the above on British TV screens would serve a purpose. It would show how dangerous these drugs are. It wouldn't just be bloggers like myself telling you how dangerous they are, it would be the actual pharmaceutical company who manufacture the drug.

Can you imagine if Carlsberg listed that you should call your doctor if you had thoughts of suicide or if drinking their beer could cause an increased risk in strokes for elderly dementia patients?

Imagine if Carlsberg told us...

"Call you doctor if you have fever, stiff muscles and confusion as these may be signs of a life-threatening reaction...or if you have uncontrollable muscle movements as these may become permanent.

"High blood sugar has been reported with Carlsberg and beers like it and in some cases extreme high blood sugar can lead to coma or death."

Would we still be clambering down the aisles at our local supermarket for the 'buy one, get one free' packs of Carlsberg?

Of course not.

So, why do people still ask their doctor for the drugs advertised on US TV?

It's simple, they are told that they have a condition. What they are not told is that the condition came about as a result of heavy marketing and DSM madness. The DSM is the Diagnostic Statistical Manual of Mental Disorders, a book that lists mental diseases [labels] - they are as ludicrous as the pills used to treat them.

I'm not suggesting for one minute that people don't suffer bouts of depression, they do. But the ad above, and ads like it, are not aimed at those people. The ad is aimed at the consumer who would have been convinced that his or her depression is more serious than your average depression.

I'm all for the MHRA sanctioning these types of ads. It will make the British public ask questions. It will also highlight how dangerous these types of drugs are... and how those that market them probably should be labelled with a mental disorder themselves.

Bob Fiddaman.

Psychiatric Medication or Play Therapy?

Psychiatric Medication or Play Therapy? For me it's a no-brainer but for millions of unsuspecting parents play therapy is just not an option. Why?

Play therapy has, over the years, steadily grown in popularity among clinicians. It has, however, not been accepted by the scientific community and, more often than not, has been criticized for a lack of evidence showing efficacy to support it's use on a bigger scale. Consequently, its not been offered to parents as an alternative to drugging their children into submission.

So, what is play therapy?


It's roots go back a long way. We've all experienced it at some point in our lives, it's just being a kid. Exploring the world, expressing yourself and interacting with other kids and adults while having fun.

Think about it for a second. What was the one thing we all craved as children at school? Double history, double maths, geography? - We all wanted to hear that bell - PLAY TIME!

Famous philosopher, Plato, once had this to say about play, "you can discover more about a person in an hour of play than in a year of conversation.".

In the eighteenth century Genevan philosopher, Jean-Jacques Rousseau, wrote in his novel, Émile: or, On Education, how important it was to observe play as a vehicle to learn about and understand children.

Most notably it was Friedrich Fröbel, a German teacher, who laid the foundation for modern education based on the recognition that children have unique needs and capabilities who summed up the value of play by saying "Play is the highest level of child development . . . It gives . . . joy, freedom, contentment, inner and outer rest, peace with the world . . . The plays of childhood are the germinal leaves of all later life."

So, in Plato, Rousseau and Fröbel, we have a pretty clear understanding of how play therapy is an important tool in understanding children and their needs. All three are regularly quoted in today's world. Sadly their work and thoughts on how we should all treat children have been eclipsed by the heavy marketing of child disorders and psychiatric medication.

I'd like to step forward in time and offer you three key opinion leaders in the field of mental health, Moreover, I'd like to quote them.

First off, Emeritus Professor John Werry, a child psychiatrist  “as far as we know” giving SSRIs to babies would not harm them. “But one doesn't like to give growing and developing kids medications that affect basic bio-cyclic processes because it just doesn't seem like a good idea unless the kid is really in severe difficulty.” He adds, it would be rare to prescribe antidepressants before the teenage years, and that the youngest child he had prescribed one to was a boy with autism aged 8 or 9, but that was “very exceptional”.[1]

"...the ministry had no concerns about the number of children being prescribed medication for ADHD" - Dr Pat Tuohy, Chief Advisor - Child and Youth Health at Ministry of Health New Zealand [2]

Speaking on why children should be given antidepressants, Andrew Cotgrove, Clinical Director and Consultant in Adolescent Psychiatry at Pine Lodge Young People's Centre, Chester England, said, "We should not deny depressed children one of the few evidence-based available treatments"  [3]

Compare the quotes of Plato, Rousseau and Fröbel with Werry, Tuohy and Cotgrove. What can you see?

Is it just me or do the latter three appear less compelling and enduring than the former?

So, this post is about psychiatric medication vs play therapy. It's about giving an option to parents who think that medication is the only possible treatment for children with behavioural problems and/or depressive signs. It's also a post that may interest counsellors, teachers and others who often refer children to mental health services.

In 2005, The Efficacy of Play Therapy With Children: A Meta-Analytic Review of Treatment Outcomes, was published in the Professional Psychology: Research and Practice [4]

The authors used a combination of online and offline search procedures to exhaust all resources in locating both unpublished and published play therapy outcome studies. The University of North Texas was a primary offline resource, particularly for unpublished studies.

Across the 93 studies, a total of 3,248 boys and girls with diverse presenting issues participated in a play therapy intervention. The 93 studies occurred between 1953–2000.

What the authors found after analyzing the 93 studies was that "play therapy outcome studies support the efficacy of this intervention with children suffering from various emotional and behavioral difficulties."

The meta-analysis concluded the following, "This meta-analysis has significant implications for those who provide mental health services to children and families. These findings should be used to not only educate managed care companies but also to educate and work with parents, government, schools, and the medical and legal communities to provide children with the most beneficial treatments."

So, given that there is an effective non-medical treatment out there for children with diverse presenting issues, or ADHD, as psychiatry would label it, why do we constantly hear stories about children being hooked on Ritalin, killing themselves on Prozac, Zoloft, Celexa and Paxil, gaining weight on Seroquel?

It would be easy for me to suggest that it was just about the money and the way pharmaceutical companies promote their wares. It was also be way too easy for me to suggest that published papers by key opinion leaders [paid by pharmaceutical companies] influence the majority of prescribing healthcare professionals.

But perhaps there are hidden dangers with Play Therapy not reported in the literature, that stop it being the intervention of choice for medical and mental health professionals?

With this in mind I decided to contact Carol Laubscher of Integrated Learning Therapy, a New Zealand based play therapy centre. I asked her:

1. What effect does play therapy have on a child's developing brain?

2. Has any child under your care ever become addicted to play therapy?

3. Has any child during the course of receiving play therapy from you ever attempted to self-harm?

4. Has any child during the course of receiving play therapy from you ever attempted suicide?

5. Has any child during the course of receiving play therapy from you ever gained weight as a result of the therapy?


On the issue of play therapy and how it effects a child's developing brain Carol told me:

"As play therapy works to reconfigure a child's attachment model, it has a huge effect neurologically, releasing the brain from anxiety and reorganising neural pathways."

Carol answered 'no' to questions 2 - 5.

I also contacted Dr Sue Bratton, co-author of The Efficacy of Play Therapy With Children: A Meta-Analytic Review of Treatment Outcomes, and asked if any adverse events were reported in the 93 studies that were analyzed. Dr Bratton told me that there were no adverse events reported. On the issue of how child therapy effects a child's brain she told me:

"In all children, play is essential to healthy brain development (If you want details about the neuroscience of play and brain development, I can give you many good resources: Bruce Perry, MD, PhD and Stuart Brown, MD are two examples).  For children who have had early adverse and traumatic experience, the brain’s development is impacted in such a way that the child’s holistic development is thwarted. Play, in the context of relationship, is crucial to the child’s brain developing new neural pathways that promote healthy brain functioning (again, this is a very simplistic explanation, please see Perry or Bonnie Badenoch’s Brainwise Therapist (2008)."

Dr. Bratton is a professor in Counseling and Director of the Center for Play Therapy at the University of North Texas

Using play therapy in children before medication is even considered should, one would think, be top of any healthcare professional's list. Alas, the odds are stacked against children in favour of psychiatric medication. This is due to a number of factors.

Pharmaceutical companies spend billions on marketing psychiatric medication. If a specific drug is not deemed by the regulatory authorities to be safe or effective for children, pharma will then hire child psychiatrists to run clinical trials, this, to show the regulators, other healthcare professionals and media that these drugs aren't dangerous in this target population.

Front groups that purport to fly the mental health flag are, in fact, nothing more than agents, pimps for the pharmaceutical industry. Examples of these front groups can be seen in the the four articles I highlighted back in 2007 entitled, 'GlaxoSmithKline, Money Trail Down Under'. [5], [6], [7], [8]

Psychiatrists that are well respected among their peers are also targeted by the pharmaceutical industry, often paid huge sums of money to promote the use of antidepressants in children and adolescents.

A and B list celebrities must also carry the shoulder of blame. Quite often they are used as advocates for antidepressant type medications, be they famous sports personalities, Hollywood film stars or TV and radio talk show hosts. These people have huge fan bases, many of their fans hang on to every word they say. In many instances they promote psychiatric medication with financial support from the pharmaceutical industry.

Play therapists are individual practitioners. Neither they, nor their professional associations have multi-million dollar marketing arms which are able to buy doctors, celebrities or journalists to promote their product. Nor are they able to create or take-over patient advocacy groups with the sole purpose of promoting their work and building revenues.

The God factor also comes into play. If you, as a parent, do your own research on the drug your child has been prescribed and you bring your concerns to the prescribing doctor's table you will, more often than not, be dismissed as either not knowing what you are talking about or be accused of reading too many internet conspiracies.

The Play Therapists I have encountered are convinced of the benefits and importance of the work they do but not of their own omnipotence as so many psychiatrists are and are unlikely to promote themselves in quite the way psychiatrists such as Dr Beiderman do in the following famous testimony on his qualifications in a case against pharmaceutical company  Johnson & Johnson.

In a deposition between Dr. Biederman and lawyers for the states, he was asked what rank he held at Harvard. “Full professor,” he answered.

“What’s after that?” asked a lawyer, Fletch Trammell.

“God,” Dr. Biederman responded.

“Did you say God?” Mr. Trammell asked.

“Yeah,” Dr. Biederman said.

Hard to believe huh? With the modern wonders of the internet we can see Biederman in action here.

PRESS PLAY

When the competition has that much clout it's hardly surprising that play therapy, despite its proven efficacy, is rarely used by healthcare professionals.

Then there is cost and convenience. It's so much cheaper and easier for a parent to choose psychiatric medication for their child than it is to enroll them in play therapy sessions. Global governments subsidize prescription medication, this makes taking drugs even cheaper. They do not subsidise Play Therapy which makes it both relatively expensive and unavailable.

If your child is distressed, disruptive, anti-social and unhappy, as a parent you need a short term solution but also to weigh the long term risks and benefits of the available interventions.

The following chart shows the relative risk of stimulant medication such as ritalin and play therapy on longer term outcomes for kids.

Chart references at foot of post

Every day parents are taking that risk when they dispense their prescription at the pharmacy on behalf of their children.

If a kid is being a kid then let them continue to be a kid. Psychiatric medication as first-line treatment is absurd when the option of play therapy exists.

If further evidence were needed regarding the importance of play then The Importance of Play in Promoting Healthy Child Development and Maintaining Strong Parent-Child Bonds [10] published in the Official Journal of Pediatrics, clearly sends out a stark message, a message that is somewhat contradicted.

"Play is a cherished part of childhood that offers children important developmental benefits and parents the opportunity to fully engage with their children. However, multiple forces are interacting to effectively reduce many children’s ability to reap the benefits of play. As we strive to create the optimal developmental milieu for children, it remains imperative that play be included along with academic and social-enrichment opportunities and that safe environments be made available to all children. Additional research is needed to explore the appropriate balance of play, academic enrichment, and organized activities for children with different temperaments and social, emotional, intellectual, and environmental needs."

All seems good until you delve deeper into the published article...

"Pediatricians should refer to appropriate mental health professionals when children or their parents show signs of excessive stress, anxiety, or depression."

It's almost like an add-on, a disclaimer - such is the stranglehold psychiatry has on the modern day. Unless we recognise that Play Therapists are mental health professionals and their therapy addresses stress, anxiety and depression by nurturing rather than damaging children's growing brains.

When weighing up the benefits of psychiatric medication against the risks, one should always remember that there are many adverse reactions reported, some so severe that children have died because the prescribed medication induced their suicide...you cannot get a more adverse reaction than death.

Brain damage has also been linked to children taking these powerful drugs. In 2009, 'Differential regulation of psychostimulant-induced gene expression of brain derived neurotrophic factor and the immediate-early gene Arc in the juvenile and adult brain' was published in European Journal Of Neuroscience. [11] The authors concluded:

"The psycho-stimulant drugs Methylphenidate (Ritalin) and Amphetamine are widely used in children for the treatment of ADHD, but recent data suggest that exposure to these agents in early life could be detrimental to brain development."

Ritalin is widely used in children with behavioural problems.

In another study, Stimulant Induced Psychosis, published in the Child and Adolescent Mental Health Journal in 2009 [12] the authors concluded that:

"Our findings highlight potential issues in the care of children treated with stimulant medication. Throughout the United Kingdom practices differ; many localities have specialist ADHD clinics, which include Paediatric services or Child and Adolescent Mental Health Services. The practice of shared care with the General Practitioner is amongst NICE recommendations. We feel it is important for all professionals involved in the use of stimulant medication to have mental health training, particularly in the careful screening and identification of psychotic symptoms which could easily be mistaken as a deterioration in the symptoms of ADHD and result in an increase in the dose of stimulant prescribed, potentially having serious implications."


Play therapy, however, report no adverse reactions.

Still not convinced yet?

Perhaps the following article will sway your opinion. It was published in the Ethical Human Psychology and Psychiatry journal last year. 'The Risks Associated With Stimulant Medication Use in Child and Adolescent Populations Diagnosed With Attention- Deficit/Hyperactivity Disorder' [13] was written by Jeanne M. Stolzer, PhD of the University of Nebraska-Kearney.

In her summation Stolzer writes:


"ADHD-type behaviors are nothing new. They have been documented across cultures, across time, and across mammalian species (Stolzer, 2005). The fact of the matter is that children have always been fidgety, highly active, inattentive, spontaneous, and prone to engage in behaviors that exacerbate adults. What has been compendiously altered is our collective perception of what constitutes normal-range child behaviors. The simple and reductionistic medical model refuses to acknowledge bioevolutionary based traits, financial incentives to label children with ADHD, inappropriate educational systems, the influence of the pharmaceutical industry, nature deprivation, and alterations in cultural perceptions of childhood. The medical model remains adamant that ADHD behaviors are pathological and can be attributed to a chemical imbalance within the child’s brain in spite of the fact that no empirical evidence exists to substantiate this hypothesis. We have two choices. We can cling to a hypothesis which has no scientific credence, and continue to prescribe dangerous and addictive stimulant medication to millions of children who have been diagnosed with a mythical disease—or we can demand an end to this lunacy."


If, after reading all of the above evidence, you still think medicating children and adolescents is safe and effective then you'll just add to my despair - I can deal with that via some adult play... normally my guitar.

As I said in the beginning of this post, "For me it's a no-brainer."


There are no seven wonders of the world in the eyes of a child. There are seven million.
~ Walt Streightiff

Bob Fiddaman


[1] Babies Given Antidepressants In New Zealand [Link]
[2] NZ urged to shift stress on drugs as first option [Link]
[3] To Give Or Not To Give Antidepressants To Young People [Link]
[4] The Efficacy of Play Therapy With Children: A Meta-Analytic Review of Treatment Outcomes - Sue C. Bratton, Dee Ray, Tammy Rhine, Leslie Jones - Professional Psychology: Research and Practice - 2005, Vol. 36, No. 4, 376–390
[5] GlaxoSmithKline Money Trail Down Under Part 1 [Link]
[6] GlaxoSmithKline Money Trail Down Under Part 2 [Link] 
[7] GlaxoSmithKline Money Trail Down Under Part 3 [Link]
[8] GlaxoSmithKline Money Trail Down Under Part 4 - Enter Dr Martin Keller [Link]
[9] Knowles v. Minister for Defence [2002] IEHC 39 (22 February 2002)
[10] PEDIATRICS Vol. 119 No. 1 January 1, 2007 pp. 182 -191 (doi: 10.1542/peds.2006-2697)
[11] Differential regulation of psychostimulant-induced gene expression of brain derived neurotrophic factor and the immediate-early gene Arc in the juvenile and adult brain - European Journal Of Neuroscience [serial online]. February 2009;29(3):465-476.
[12] Stimulant Induced Psychosis - Child and Adolescent Mental Health Volume 14, No. 1, 2009, pp. 20–23
[13] The Risks Associated With Stimulant Medication Use in Child and Adolescent Populations Diagnosed With Attention- Deficit/Hyperactivity Disorder - Ethical Human Psychology and Psychiatry, Volume 14, Number 1, 2012

CHART REFERENCES


[1] Shatha Shibib & Nevyne Chalhoub Stimulant Induced Psychosis Child and Adolescent Mental Health Volume 14, No. 1, 2009, pp. 20–23
[2] Banerjee P. Differential regulation of psychostimulant-induced gene expression of brain derived neurotrophic factor and the immediate-early gene Arc in the juvenile and adult brain. European Journal Of Neuroscience [serial online]. February 2009;29(3):465-476. 
[3] Lambert N. The Contribution of Childhood ADHD, Conduct Problems, and Stimulant Treatment to Adolescent and Adult Tobacco and Psychoactive Substance Abuse. Ethical Human Psychology & Psychiatry [serial online]. Winter2005 2005;7(3):197-221.
[4] Jeanne, M. S. (2012). The risks associated with stimulant medication use in child and adolescent populations diagnosed with attention- Deficit/Hyperactivity disorder. Ethical Human Psychology and Psychiatry, 14(1), 5-14. 
[5] Samuels, Franco, Wan, & Sorof, 2006
[6] Gould, M., Walsh, B., Munfakh, J., Kleinman, M., Duan, N., Olfson, M., et al. (2009). Sudden death and the use of stimulant medications in youth. American Journal of Psychiatry, 166(9), 992-1001
[7] Stein, M. (2009). Psychiatric reactions to ADHD medications. Pediatric and Adolescent Medicine, 123, 111–120.

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