Probably the most disturbing and worrying difference between medicine and psychiatry is that in medicine, if all the tests are normal, say for the heart, the conclusion is, ‘There is nothing wrong with your heart’.
Alarmingly, in psychiatry, when all the tests are normal, the conclusion is: ‘You have a psychiatric disease – a mental illness’ – even when you don’t.
Then you’re told, ‘Something is seriously wrong with your brain. You have a chemical imbalance.
But don’t worry,’ you’re told reassuringly, ‘it’s not your fault; it’s a disease like cancer, arthritis or diabetes and you can take our drugs for it. You’ll need to take them for a long time, possibly for the rest of your life.’
‘But, doctor, this is terrible news. Is it really true? Is it really meant to make me feel better or more confident by telling me that I have a disease like cancer or diabetes?’
If you ask, ‘How bad is it, doctor? What level are the chemicals in my brain?’
You’re told ‘Well, there are no tests for it, so we can’t measure it.’ ‘Then how can you tell there’s a chemical imbalance in my brain?’
The honest answer would be, ‘We don’t know. No one has ever measured the chemicals in anyone’s brain. It’s just a theory, popularised by advertisements made up by advertising agents and drug companies and, because it’s very convenient for us, we’ve all accepted it as true, although no one can show that it is true.’
If, as doctors, we were honest with our patients, we would say: ‘To tell you the truth, contrary to what we tell the media, psychiatry is not evidence-based and it’s not scientific.’
But no one dares say this, either because their jobs, and so their income, might be at stake or because they still believe the theories are true.
Even NICE (the National Institute for Care and Excellence), the official body that decides on treatments in the UK National Health Service (NHS), still goes along with the myth that depression is due to a chemical imbalance and should be treated with antidepressant drugs, despite the lack of evidence for the cause and knowing that the drugs cause long-term serious side effects, addiction and suicide.
‘Surely this can’t be true. We trust doctors to know (almost) everything. They must know what the evidence is for the cause of depression and anxiety. They must know whether antidepressants and tranquillisers are harmful – don’t they?’
It is a sorry state we are in because most doctors do not know. Their actions are protected by the Law because they are expected to follow the guidelines given by NICE. It’s not clear why NICE continue to give these guidelines for depression.