Primum non Nocere: A Psychiatrist’s Review of “Medicating Normal”

This blog post come from psychiatrist Dr. Awais Aftab. It begins:

“I was lucky to see a screening copy of the documentary Medicating Normal (2020, directors: Lynn Cunningham & Wendy Ractliffe) earlier this weekend, and this post is intended partly as a review and partly as a way of organizing my preliminary thoughts and reactions to it.

As described by the filmmakers: “Medicating Normal is the untold story of what can happen when profit-driven medicine intersects with human beings in distress.” The film is well-made and remarkable. It is engaging and rewards emotional investment.

The focus of the documentary is on the harms of psychiatric medications, the harms these medications can do while one is taking them, and the harms these medications can do when one tries to stop taking them or has stopped taking them. The documentary primarily focuses on the stories and experiences of five individuals who took psychiatric medications and experienced derailment of their lives. There are also interviews with various authors/commentators/experts (which include Allen Francis, David Cohen, Anna Lembke, Robert Whitaker, Peter Gøtzsche, among others). In terms of medications, the focus is mostly on benzodiazepines and stimulants, to a lesser extent on antidepressants, and very little on antipsychotics and other psychotropics. The documentary doesn’t make much of a differentiation between these different medication groups in terms of their harms and risk of dependence and withdrawal, and generally paints them with the same brush.

The personal narratives of the ex-patients/survivors are certainly the most powerful component of the film. They are also the most persuasive: the tremendous suffering of these individuals is indisputable and heart-wrenching. Common threads among these various stories are: high “premorbid” psychosocial and occupational functioning; experiences of anxiety/trauma/grief/stress/insomnia which were diagnosed by various clinicians as specific mental disorders (PTSD/GAD/MDD, etc.) with little to no exploration of the psychosocial context; these diagnoses were offered with a generally implicit disease-based understanding; psychotropic medications were prescribed, with little to no informed consent, and the potential harms of these medications were either not discussed or discussed in a manner that severely minimized them; there was typically quick short-term relief, followed by onset of side-effects and problematic experiences (emotional blunting, cognitive impairment, suicidality, psychosis, worsening anxiety, etc.); these new experiences were attributed to the progression of their disease with little to no consideration that these might be due to the medications; this led to a cascade of multiple additional diagnoses (ADHD, MDD, psychotic illness) with compounding polypharmacy such that many of these individuals were on psychotropic cocktails which included benzodiazepines, stimulants, antidepressants, and antipsychotics; this was followed by a rapid decline in psychosocial and occupational functioning leading to a disabled status; years of misery and disability in which their disability continued to be attributed to their illness and not to their medications; slow loss of trust in the system; decision to go off medications; experiences of withdrawal; finally coming off medications and slow restoration of psychosocial and occupational functioning …”

You can read more from here.

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