How to be Ignorant and Ill-informed

The standard response to my criticisms of the mass prescription of so-called antidepressant tablets is twofold.  One group denounces me as ‘ignorant and ill-informed’. The other asserts ‘Clinical depression is a reality because I suffered from it, and antidepressants saved/cured me’ . No doubt someone will soon be along to tell me that I have no business commenting on such matters because I am not myself scientifically qualified.

There are several immediate  retorts to this. First, I make no claim to be an expert on this subject. I certainly need to learn more about it. Any honest person must always accept this. But it is no good to denounce me in general for ‘ignorance’. Everyone is ignorant of something. The point is, what is that I am ignorant of, specifically, that undermines, weakens or destroys the argument I put forward?  

If my critics would put these specific failings of mine before us, explaining their significance and telling us where we can check their references, then we would have something to debate. If they cannot, it is just abuse, isn't it?

My principal source is one I have cited before, namely two articles by Dr Marcia Angell, published recently in the New York Review of Books. These articles take the form of a lengthy and thoughtful review of three books by expert and informed people.

These are to be found here

and  here

Added to this are many private communications from people who have been prescribed antidepressants, and some direct personal knowledge of people who were prescribed antidepressants (my initial experience of what happened to two very different people,  more than a decade ago, was what first persuaded me to look into the issue. Until then I accepted the conventional wisdom that ‘clinical depression’ was a physical ailment that could be treated with chemicals).

I would invite anyone who has no doubts on this issue also to read this news story, which details the reasons for the enormous fine, part criminal, part civil, recently imposed in the USA on one of the major drug companies - largely as a result of activities connected with the marketing of antidepressant pills.

This also contains some interesting reflections on the impartiality and venality of doctors themselves, and on the authority or otherwise of articles in medical journals (no doubt ‘peer-reviewed’) which my ‘scientific’ critics tend to treat as if they were Holy Writ.

I am of course  sympathetic to anyone who has felt so low that he or she has felt willing or at least ready to take prescribed antidepressants. After all, most of us trust doctors.  I am one of those who doesn’t always do so, having been prescribed the wrong drug many years ago by a plausible-seeming and apparently mature and experienced GP,  and having some days later ended up in some pain on a hospital trolley outside an operating theatre,  facing an extremely unpleasant but needless operation, from which I was saved –literally at the last minute – by the intervention of a specialist who (unlike anyone else in the whole process) looked at my notes properly and realised that the surgery was wholly unnecessary, and my problems were the consequence of a stupid mis-prescription.  What if he hadn’t been there?  Nowadays, I’d know to question what I was told. Then, I didn’t. Knowledge, especially this kind of scepticism, is hard-bought, though it could easily have been even harder. Or never discovered at all. Imagine that.

Today’s selected critic is Mr John Gibson, who writes :’What I can't abide, furthermore, is the dismissive and ignorant nonsense that Peter Hitchens implies here, which is that depression is not a real illness, and that all sufferers need do is go for a brisk walk to shake it off. This is suggestive of an attitude that "they should snap out of it," i.e. that sufferers are just weak people who should grow a backbone before they deserve any sympathy, let alone professional care. That belongs in the C19. There is a grown up debate to be had about mental health care, and the role of pharmaceutical giants therein, but after the MMR debacle, which exposed a brutal lack of medical knowledge, and (more importantly) a lack of any intent to gain said knowledge, I have severe doubts that Peter Hitchens is the individual to lead it.’

As it happens, exercise is, as far as I know, now a recognised treatment for what is called ‘clinical depression’. I’d be interested in any information on this, but I think the medical journals have material on it. Whether ‘clinical depression’ has an objective existence, I don’t know and can think of no way in which we could possibly find out. Perhaps one will be discovered, but until then it seems to me to be open to question by thoughtful people.  A whole range of complaints have been elevated, by the development of drugs which claim to treat them, into ‘disorders’ or ‘syndromes’ with lengthy Latinate names, the length of the name usually being in inverse proportion to the objective knowledge we possess of the complaint.

I have discussed here the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association, on which so many of these so-called ‘diagnoses’ are based. I draw the attention of my more politically-correct critics to the changing status of homosexuality, according to the APA, and to the current controversy over the latest edition of the DSM, which even people other than the Hated Peter Hitchens are questioning, such as an extension of ‘mental illness’ to cover perfectly normal human reactions, for example grief after bereavement.

This sort of problem – the inability to prove the objective existence of a complaint -  is usually solved nowadays by the medical and pharmaceutical industries repeatedly asserting that it jolly well does exist, and hoping nobody will ask how they know. The main current argument (as dealt with in the Marcia Angell articles to which I provide links) is that because the drugs appear to treat the alleged illness, and because the drugs affect serotonin levels, the alleged illness must therefore be caused by variations in the serotonin levels. It is interesting, as we examine this unusual scientific logic, if such backward reasoning is indeed scientific, to note that most ‘antidepressant’ medications were in fact developed with other ends in mind. The disease, in short, has been invented to be cured by the drug, rather than the other way round.

In answer to Mr Gibson’s sneering summary of my view as that ‘ all sufferers need do is go for a brisk walk to shake it off’, it isn’t that far from the truth, and if he’s sincerely concerned for the wellbeing of his fellow-creatures he might do well to be less dismissive of this possibility.

Most people in this country have far too little physical exercise, thanks mainly to the car and the near-abolition of manual work, and it seems to me to be more or less axiomatic that if they have more exercise they will feel better. Rudyard Kipling’s poem about the Horrible Hump, the Hump that is Black and Blue,  which readers will remember affects ‘Kiddies and grown-ups too’ plus the normal treatment for ‘Cabin Fever’ and the experience of every observant schoolteacher and parent for centuries, are evidence that human beings have long been aware that a lack of exercise doesn’t improve the human mood.

This sort of medical knowledge is easily cast aside by the conventionally wise because – alas or perhaps not alas - it  comes entirely free of charge, unadorned with peer-reviewed articles, GP prescriptions (rewarded by trips to five-star hotels). If there were big money involved in going for a brisk walk, the conventionally wise would probably take it more seriously. Charge a man for something, and he’ll think he’s getting something in return. Charge him a lot, and he’ll think he’s getting even more.

Also nobody has ever been harmed by a brisk walk, even if it didn’t do him any good either (though I’m sure it did). So ‘going for a brisk walk’ doesn’t need to be guarded by phalanxes of PR men and lawyers, the one lot to make us approve of it, the others to scare away criticism.

If there’s an epidemic of people feeling low and sad in advanced economies (and I rather think that Clinical Depression is a First World affliction) then mightn’t it be reasonable to search for a possible cause among things that characterise First World life (and First World life alone) , such as the almost total lack of exercise in daily life? Even if the serotonin theory is correct, why would so many millions of people suddenly be suffering from the same problem?  Wouldn’t any serious doctor , and every epidemiologist, be looking for reasons why there should be so many people needing this sort of intervention?

Once again, even if you accept the logic of my opponents and critics, they don’t seem to be thinking very hard about their own case.

I also think that the warnings of ‘suicidality’ now attached to some ‘antidepressants’ by the health authorities of several major countries are extraordinarily important. The retort that depressed people 'were, like *depressed* and thus more like to commit suicide, duh!' Was never very persuasive.  Think about it. If an antibiotic given to people to treat, say, TB, was associated with a high level of death from TB, it wouldn’t be much of an answer for the makers to say that ‘They, were, like tubercular, and so they were more likely to die of TB, duh!' Would it? The pills are supposed to *cure* the problem.

When Health Canada (for instance) actually says that some of these pills can engender suicidal thoughts – itself an astonishing thing to happen – then we have to wonder how on earth these things are operating on the brain. But in fact we know very little about it, as proper hard neurology (as opposed to the immodest psychobabble pseudoscience of  ‘neuroscience’ ) is in its infancy.

Mr Gibson continues : ’This is suggestive of an attitude that "they should snap out of it," i.e. that sufferers are just weak people who should grow a backbone before they deserve any sympathy, let alone professional care.

I shall in future treasure the formulation ‘this is suggestive of’. Under Mr Gibson’s hand, it appears to mean ‘Peter Hitchens doesn’t actually say this, and I have no reason to believe that he thinks it -but I am going to suggest that he has, so as to belittle and mock him and his argument, without actually engaging with it.

I have never doubted that people can feel low without any apparent reason (though I know of cases – one of a terrible bereavement and the other of a person stalked by a violent ex-boyfriend and failed by the police, who were prescribed ‘antidepressants’ for perfectly explicable feelings of misery and fear caused by objective circumstances).

Why should I be unsympathetic in the way he suggests? What connection has this with the point I am making?  My interest is in discovering the real reasons. If it can be shown by objective experimentation that all that all they need, and precisely what they need, is an SSRI pill, then I shall retreat with apologies. But can it be so shown? Rather the contrary. Research noted in the Angell articles shows that in the drug companies’ own experiments, not publicly released, placebo sugar pills were often comparable in effect to the ‘antidepressant’.

Again, as most wise doctors know, their main job is reassurance. The simple act of being told you have something wrong with you that is understood by science, and that this prescription will put it right, starts the process of healing, even of objective, physical diseases. If you visit a good doctor, you will begin to get well again before you have even reached the chemist with your prescription.

There is a lot wrong with our society – people with no work, people with no families, people with no friends, people failed by the education system, people living amid neglect, decay and disorder. I suspect that it is among these that the prescription of antidepressants is most common. Maybe the pills numb the pain, but I doubt very much if they take it away. And once again we are on the road to Huxley’s ‘Brave New World ‘ nightmare, in which the taking of Soma aids us in the smiley acceptance of a wretched slavery.

Finally, Mr Gibson says ‘There is a grown up debate to be had about mental health care, and the role of pharmaceutical giants therein, but after the MMR debacle, which exposed a brutal lack of medical knowledge, and (more importantly) a lack of any intent to gain said knowledge, I have severe doubts that Peter Hitchens is the individual to lead it.’

Well, I have no desire to ‘lead’ anything. I just want there to be a debate and a proper inquiry, an aim no honest person can oppose.  Who can be against the truth emerging? Perhaps he could cite specific examples of the ‘brutal lack of medical knowledge’ which I allegedly exposed during the MMR debate. Also the ‘lack of any intent to gain said knowledge’.  These are strong charges, made in a  self-righteous and confident tone.

I would remind him (in case he has forgotten, or has mixed me up with someone else) that I never at any stage made any determination upon the safety or otherwise of the MMR.  I never advised anyone not to allow their children to be given it.  I concentrated entirely on the high-handed treatment of those parents who quite reasonably wished to give their children separate injections, on the existence of legitimate doubts about it, and on the crude and dishonest propaganda used against them by the authorities, and indeed the lying intimidation personally against me by persons unknown.