To Hell and Back on SSRIs

	Book review on Dying for a cure by Rebekah Beddoe (2009) Reviewed by Beata Bishop, 2009 published in Network Review No 101
	(order this book from amazon.co.uk)

"In whose interest are these drugs prescribed?" asks the author on p.114 of her riveting book, but the question should also appear on the cover. The whole story adds up to a fully documented, searingly honest indictment of drug-based psychiatry that often causes worse problems than the ones it is supposed to cure.

The Australian Rebekah Beddoe was 28, living happily with her partner and moving up steadily in her career when she became pregnant. It was a blow, with her partner being less than pleased, but she went through with it and in 1999 gave birth to a beautiful, healthy baby girl. Unfortunately the baby cried and screamed much of the time, breastfeeding was difficult, and eventually the inexperienced new mother became exhausted enough to ask for help from her GP. He offered to refer her to the mother and baby unit of a local general hospital for respite and training in coping strategies with fractious babies, which she was happy to accept, but as she was leaving, the GP also handed her a small box of antidepressant tablets "to set you back on track." Without any formal assessment, prescription or much knowledge of the patient, he just issued a snap "diagnosis" of post-natal depression and put her on drug treatment.

That's how Rebekah Beddoe's three year long nightmare began. At the hospital she was put in the care of Max, a weird psychiatrist who broke all the rules of professional conduct: he insisted on close body contact, hugged and cuddled the patient and convinced her that she needed to exhume and confront some dreadful childhood trauma in order to get well. Meanwhile the first lot of medication had begun to work, clouding her perception so much that she became dependent on Max and accepted his instructions and prescriptions unquestioningly.

Things quickly went from bad to worse. After her first panic attack her medication was increased. This established a cast-iron pattern. Every time she showed signs of deterioration or a new symptom, more and more new drugs were added to her daily intake, until she was on eight different kinds - and on the verge of madness. Baby Jemima had to be cared for by Rebekah's mother and long-suffering partner, while she gradually sank into repeated savage self-harming, heavy drinking, chain-smoking, overdosing and violence, alternating with apathy and a sense of deadness. In and out of several hospitals, emergency wards, prison-like locked high risk sections, undergoing ECT, getting involved with a heroin addict and taking some stuff herself -hers was an increasingly fast descent into a lonely inferno, where death seemed to be the only way out.

Meanwhile she also developed diabetes mellitus and akathisia, a distressing condition of feverish restlessness, anxiety and excitement, marked by rapid walking up, down and in circles, unable to relax. Max, perhaps realising his errors in treating Rebekah, suddenly withdrew and refused to see her again. His successor, Dr Maartens was cold, austere and unresponsive, and diagnosed her suffering from bipolar mood disorder (formerly known as manic depression), a serious lifelong condition normally controlled with lithium.

At this apparently hopeless moment something unexpected intervened. One of the drugs caused the patient to put on 8 kg in two weeks; shortly afterwards she gained 20 kilos and found her obesity so disgusting that she went on a drastic diet. Weeks later, although half starved, she still hadn't lost any weight, and driven by ordinary feminine vanity - can it be the last quality we women lose when all else is gone? - she checked the side effects of her drugs and found that all eight of them were likely to cause weight gain. So she decided to cut out two without letting on, and not only lost 5 kilos in a week, but her blood sugar levels became normal, too. As she went on reducing her intake in secret, against doctor's orders, her agitation and anxiety subsided, she could once again sleep, sit still and read a book, and experience the return of her normal abilities. Withdrawal symptoms varied. Some drugs caused hardly any, others left her distressed, but eventually she became almost drug-free - and after reading "Toxic Psychiatry", a whistle-blowing work by psychiatrist Dr Peter Breggin, she realised that her psychiatrists, especially the current one, had actually caused all her life-threatening problems, first by misdiagnosing her condition and then by treating her with a cocktail of powerful, addictive and totally unnecessary SSRI drugs.

It was a shocking, barely credible discovery, but it spurred her on to research the damning evidence of the harm done by psychiatric drugs. She amassed a huge amount of material - the references alone fill 23 pages. Her findings are interwoven with the main narrative; so are her mother's diary entries, recording the suffering and incomprehensible personality changes of her daughter. The effect is distressing yet almost hypnotic; this book should be required reading for medical students and - some hope - practising psychiatrists.

Rebekah's story has a happy ending. Now in her thirties and fully restored to health, she lives in Melbourne with her husband and two children. But she is one of the few lucky ones. If she hadn't dared to take responsibility for her own life and go against her dictatorial psychiatrist's orders, she could still be one of the hapless thousands struggling with the side effects of psychotropic drugs. (In Britain some two million people are taking them at present; according to official estimates, 2 per cent, namely 40,000 patients have a "severe negative reaction" to them.)

This is powerful stuff, likely to evoke searching questions. How, when, and on whose authority have normal human emotions been turned into chemical imbalances in the brain, needing drug treatment? Sadness, depression, anxiety, worry can hit anyone, and with good reason. As a psychotherapist I know that in most cases all that is needed to relieve such justified painful emotions is total attentive listening, patience, time, empathy, common sense and good boundaries. But counselling is hard to obtain on the NHS on the grounds of cost (as if antidepressants were for free), at present a patient has to wait for eighteen months to see a therapist, and even then may be limited to a few sessions of CBT (Cognitive behavioural therapy), not always the right modality.

In his foreword Professor David Healy, director of North Wales Department of Psychological Medicine, states flatly that "drugs like antidepressants ...(cause) the greatest amount of damage to the greatest number of people; these are the real abuses, the real dramas." Which leads on to the true villain of the piece, the pharmaceutical industry with its relentless, merciless expansion into more and more areas of medicine, medical training and research, supported by an army of lobbyists and by well paid unethical doctors and scientists who lend their names to articles and studies that the drug companies themselves have produced. New products are described as safe and beneficial, the negative results of clinical trials are not mentioned. "This practice is well-known, scandalous and outrageous. It is a perfect illustration of deceptive authorship practices for commercial reasons", wrote M.Larkin in The Lancet (July 1999).

Doctors are also to blame for the severe overuse of SSRIs, a practice strongly encouraged by Big Pharma, but they have neither the training nor the time to deal with depressed patients in any other way. Also, as some GPs freely admit, receiving a prescription reassures most patients and makes them compliant - or, with a bit of bad luck, suicidal.

The only hope against a worsening culture of over-medication for depression and other emotional problems is the emergence of the so-called expert patients, the ones who research their condition and the available options of treatment, who dare to ask questions and voice doubts in the surgery and take responsibility for their own health. Let the last word belong to Rebekah Beddoe:

"Of course, the decision to take or not take a medical treatment for your emotional issues must ultimately be yours - I would never wish a person be denied the relief a medication might bring them - but each and every one of us deserves to be able to base this decision on the facts, not just on drug company marketing dressed up as medical science."

Beata Bishop  is author of A Time to Heal.

(order this book from amazon.co.uk)