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Does Psychiatry Need Therapy?

    Tom Cruise gets weirdly angry with Matt Lauer, ripping Brooke Shields and the profession of psychiatry, and then we read on the front page of The Post a powerful story about psychiatry's overly biological and Eurocentric approach to mental illness. That's two bullet items about psychiatry under fire: If some enterprising journalist out there can find a third bullet item, that'd be enough for a major trend story. You always need three items. Four is unnecessary, two isn't enough.

    [Scanning over this mid-afternoon, I should probably note that The Post story in no way, shape or form supports the Cruise viewpoint on psychiatry, which is to say, the Scientiology view. Indeed, the experts quoted in The Post story are professional psychiatrists.--JA.]

  The Post story shows there's virtually a whites-only sign at the door of your average psychiatric research trial. "The [drug] companies are thinking about the average Caucasian, male patient," a psychiatrist told The Post's Shankar Vedantam.

     The bulk of the piece is a debate about whether the profession should pay more attention to non-scientific, traditional approaches to mental health. "This thing called psychiatry -- it is a European-American invention, and it largely has no respect for nonwhite philosophies of mental health and how people function," a psychiatrist tells Vedantam.

   A Puerto Rican doctor recounts a dilemma in trying to treat a patient who kept hearing voices: "For months, as top psychiatrists ordered him to keep increasing the potency of her drugs, he had told himself that hearing voices, seeing shadows and sensing presences is considered normal in some Latino communities. But he dared not challenge the wisdom of the medical model."

    Well, gosh, I want to see some footnotes that support the assertion that "hearing voices, seeing shadows and sensing presences" is normal in the Latino community. I'm not saying the doctor is wrong: Just that one of the great virtues of the scientific method is that it puts our presumptions and beliefs and articles of faith to a test. The argument from authority isn't enough. Folklore doesn't cut it. You have to do more than just say it's so. There's plenty of arm-waving in science too, and errors, and presumptions, and orthodoxies that aren't well founded -- but science tends to be self-corrective over time in a way that makes it an extremely valuable tool for any civilization.

     The mental realm, for some reason, has had a troubled relationship with science. For most of the past century the field of psychiatry was dominated by a pseudo-science. People are at their most vulnerable when seeking psychiatric help. What psychiatry needs is more science, not less science.

  The Post story ends with a powerful quote: "When science becomes a religion, it becomes scientism," he said. "There are fundamentalists among the scientists."

    Seems to me that science can't become a religion, because a religion deals with absolutes and science is always hedging its bets and changing its mind and trying to come up with a better explanation.

    As I read it, The Post story shows that an intelligent approach to mental illness ought to incorporate both the medical and cultural models. For years I've ranted (mostly to friends, but once in print for some glossy mag) that we often try to medicate "cultural afflictions." A lot of people (the rant goes) suffer not from a mental problem but from a cultural problem -- too much work, not enough fun, bad diet, not enough good clean living. There's nothing wrong with their brain, they're just not coping with the demands of work, school, family, church, the hood, etc., and they're not getting outside and breathing clean air and so on. Which is sort of what Tom Cruise was saying. More vitamins, more exercise, was his prescription.

    But Cruise was scary. The guy can be so charming (check out his online back-and-forth with Spielberg), but throw a switch and Dark Tom takes over. One of our film critics said Cruise is always best in a movie that lets him show that dark side, something like "Magnolia." Cruise told Lauer that there's no such thing as a "chemical imbalance" in the brain. Maybe Lauer should have responded, "So what's your excuse?"

By Joel Achenbach  |  June 27, 2005; 7:03 AM ET
 
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Comments

You know what Tom, I've read the studies too. And they all say that you're a whack job.

Free Katie Now!

Posted by: Joel | June 27, 2005 11:43 AM | Report abuse

thank you.
the field of neuroscience kinda supports psychiatry ... the biological part anyways.
bias in psychology might be more open for criticism in the same way the idea of evolution is criticized. by the uneducated anyways.
oh yeah ... where did tom cruise get his ejumakation? oh yeah, the scientology institute.
u huh.

Posted by: jj | June 27, 2005 11:48 AM | Report abuse

I was treated with drugs for depression (physical and emotional abuse in childhood; parent committed suicide) from age 20-40; I also received 30 electroshock treatments)nothing helped. In fact, I got worse. UNTIL, I met a psychiatrist who took me off all drugs and started me on a regime of physical exercise, green vegetables and vitamin C. Instead of harping on my past, he encouraged me to focus on the present and make plans for the future. It absolutely worked! I've been happy and healthy and drug free for the past 23 years. (However, I do feel stigmatized re mental illness, which is why I'm sending this post anonmously.

Posted by: Anonymous | June 27, 2005 11:56 AM | Report abuse

You know what- my anti-depressant makes me able to get out of bed and live a full, normal, functional life. Without it, I'm a mess, so I'm not going to ask questions. When Tom has three months of days so bad he can't leave the house, he can take his vitamins and hope he's cured. But hand me my drugs, please!

Posted by: KR | June 27, 2005 11:56 AM | Report abuse

Just because Tom is right about the vitamins and exercise, that doesn't mean he isn't nuts.

I agree with your cultural premise that what's sick is often not the individual, but the situation he lives in.

I also agree with Tom that our society uses pharmaceuticals to mask problems and we would be much better off with solutions that address the real causes of illness, in many cases.

My friend has high cholesterol. Her doctor explained that she could change her diet and exercise more, or she could take medication. She said she tried the diet for a few days, but it was too much trouble so she decided to take the pills. I usually blame doctors for the overmedication of America, but it's not all their fault.

Posted by: kbertocci | June 27, 2005 11:56 AM | Report abuse

I was treated with drugs for depression (physical and emotional abuse in childhood; parent committed suicide) from age 20-40; I also received 30 electroshock treatments)nothing helped. In fact, I got worse. UNTIL, I met a psychiatrist who took me off all drugs and started me on a regime of physical exercise, green vegetables and vitamin C. Instead of harping on my past, he encouraged me to focus on the present and make plans for the future. It absolutely worked! I've been happy and healthy and drug free for the past 23 years. (However, I do feel stigmatized re mental illness, which is why I'm sending this post anonmously.

Posted by: Anonymous | June 27, 2005 11:57 AM | Report abuse

"Maybe Lauer should have responded, "So what's your excuse?"

Ha ha ha...that cracked me up. Now I'm waiting for someone to actually say that to him in an interview...

Posted by: Steven | June 27, 2005 11:57 AM | Report abuse

"A lot of problems -- not all of them, but an awful lot of problems -- that get labeled as psychological problems really amount to people making rotten choices -- and they ought to be instructed to make better ones."

-- Jeffrey Satinover, M.D.(Psychiatry), M.S., in the film "What the Bleep Do We Know!?"

Posted by: Anonymous | June 27, 2005 12:02 PM | Report abuse

I have taken antidepressants in the past and probably qualify for them now, but I'm much more interested in looking at the patterns in my life and trying to figure out how to live differently to make myself happier. I am only responsible for my own choices, no one else's, and what anyone else decides to do is their business. Tom, it is none of your business what Brooke decides to do unless she ASKS you, 'What should I do, Tom?' Let's just all try to spend more energy on our own lives and not taking apart everyone else's.

Posted by: hoosierwriter | June 27, 2005 12:08 PM | Report abuse

As science comes to understand the fundamental processes of our brain and nervous system, we will begin to understand why some things are better treated with vitamins and some with medications.
Right now science treats vitamins and medication as 2 seperate things, but I kind of think the heart of the matter is that our body sees them as the same thing, as a chemical mixture.

Posted by: dr | June 27, 2005 12:08 PM | Report abuse

"Seems to me that science can't become a religion, because a religion deals with absolutes and science is always hedging its bets and changing its mind and trying to come up with a better explanation."
Don't make me say this again- ONLY A SITH SPEAKS IN ABSOLUTES!

Posted by: Obi Wan Kenobi | June 27, 2005 12:14 PM | Report abuse

"Four is unnecessary, two isn't enough."

Five is RIGHT OUT!

Posted by: corndog | June 27, 2005 12:20 PM | Report abuse

obi wan:
science has stochastic sides as well: quantum physics, chaos theory, statistics and so on..

Posted by: anonymous | June 27, 2005 12:32 PM | Report abuse

Re:psychiatry and culture.

I have a book called Ethnicity and Family Therapy, which is basically a bunch of articles on how ehtnicity affects a patient. It's really facinating, especially when you read about you own ethnic group and realize, "Yeah, my family does that." One of my favorites is Irish Catholics, and how when they complain about something, like a physical ailment no matter how minor, you have to treat it as deathly serious. Because Catholics like to suffer, and if they're actually complaining, they're probably about to die.

Posted by: jw | June 27, 2005 12:35 PM | Report abuse

No-one suggests that science is or can be a religion- the irrational faith that only science can determine truth in all areas of concern is scientism -which can easily become a religion. Any worldview that holds its view of reality to be certain is both religious and absolutist(btw-not all religions claim absolute truth).

Keeping an open mind is the essence of science-and the materialist position you come close to endorsing can(and often has) degrade into dogma when applied too easily to ranges of the mind beyond the brain's neural structure.

Posted by: Kirk Hughey | June 27, 2005 12:37 PM | Report abuse

The difference here is that the Washington Post is a respectable newspaper, and Tom Cruise is a whacked-out cultist. Regardless of how you feel about psychiatry, everyone should be able to agree that L Ron Hubbard was a terrible sci-fi writer, and his brainwashing victims show it. How else could people belive that *all* of their personal problems are the fault of aliens that died in a volcano millions of years ago?

Posted by: cranky | June 27, 2005 12:38 PM | Report abuse

Although Tom is, indeed, wacked, this is the kind of discussion that needs to be present in order for advancement to be made. Who knows what we'll know in the future? A hundred years ago, folks studied the bumps on your head to tell you about your personality (read, personality 'flaws'); it certainly seemed like science to the folks that used it. (I once had my 'bumps' read by a gentleman that had studied antique texts. He certainly seemed to know a lot about me - he even correctly stated that i drive too fast!)

Posted by: LP | June 27, 2005 12:38 PM | Report abuse

There was a lot of truth to what Tom says - but why are you debating the discussions of a talk show host and an actor over the soundness of science, medication, and alternative therapies??

He is an actor for God's sake, talk to him about movies. Otherwise, I can get the same conversation and responses at the dinner table of a family reunion.

Tom maybe a little off, but it was Laurer who went "off the reservation" with that interview.

Posted by: rmfiora | June 27, 2005 12:40 PM | Report abuse

Actors should stick with acting and leave the practice of medicine to the medical experts.

Until Tom Cruise experiences what Brooke Shields experienced after giving birth, he is in no position to criticize how she dealt with postpartum depression.

Katie Holmes should run as fast and far as she can to get away from this WHACK JOB!

Posted by: Mary Gonda | June 27, 2005 12:42 PM | Report abuse

Tom Cruise WAS way off... of course medication can mask symptoms... and possibly allow the individual to function and find a way to live a more satisfying and successful life. And search for a long-term approach in the meantime.

Turn the cameras off of this clown. "I'm not a doctor... I distort medicine on tv."

Posted by: D | June 27, 2005 12:44 PM | Report abuse

jw -

That really struck me funny about Catholics. I was raised Catholic and that is kind of true now that I think about it.

Posted by: jlessl | June 27, 2005 12:46 PM | Report abuse

I think there are situations that call for medication, such as post-partum depression because after carrying a baby I refuse to believe that your brain and body aren't a little mixed up. So I think Tom needs to lay off Brooke. Besides, he's been acting a little manic lately with all the public couch jumping, so he has no room to talk. But I also think that a lot of other situations (not all, but a lot) just call for a better situation. I find if I exercise and eat well and drink lots of water then I don't feel down very often. If I stop being healthy, I tend to get a little on the depressed side until I start it up again.

Posted by: Sara | June 27, 2005 12:46 PM | Report abuse

Hi Joel, I wouldn't say hearing voices or seeing shadows is considered "normal" in the latino community but keep in mind these perceptions are based on traditions and folklore where religion is sometimes mixed with pagan elements, elements dating back 50, 80 or even more years.

Certainly I don't expect americans to fully understand my assertions since we are talking about different cultures but that's how thing are south of the border, also is worth noting the extended network of relatives and friends one has, it certainly helps to cope with any bumps on the road, the extreme individualism in this country takes a tool in its inhabitants in terms of being mindful one to another, just an example, you cannot call anybody (let alone your own relatives for God's sake!)or drop by out of the blue unless you have something important to say or it has been arranged well in advance, you risk a very cold response or even worse..

Most of us don't have that problem (cross fingers here), we know we can have a close friend or relative who can lend a sympathetic ear whenever we have a problem, time permitting, of course, grudge, issue we just to want to take off our chests. That's cheaper than a session with a shrink and far healthier than pills, our culture promotes closeness, family ties.

Still, some round of beers between you and your office buddies any given Friday evening also falls in that therapautic category, we have a say in spanish that roughly translated quotes: "a pain shared between two is less hurting", you get the idea, don't you?

Posted by: limeño | June 27, 2005 12:49 PM | Report abuse

I wouldn't make a good Irish Catholic. One, I'm hardly Irish. Two, I tend to tell people to suck it up unless they're obviously injured or ill.

Posted by: Sara | June 27, 2005 12:52 PM | Report abuse

I've always wondered whether this "chemical imbalance" is a cause, or a symptom. And I've noticed that a lot of people who take antidepressants are still pretty depressed. I'm not a psychiatrist, and I've never taken a psychiatric drug (just call me "Tom"), but it seems to me that treating the chemical imbalance is a Band-aid approach, kind of like treating obesity with a Weight Watchers program instead of addressing compulsive overeating or food addiction. (Of course, Band-aids have their place, especially for those who are unusually prone to cuts and scrapes and who are still trying to learn how to avoid them.)
But yeah -- Cruise was scary.

Posted by: Achenfan | June 27, 2005 12:55 PM | Report abuse

Most amusing line of the Cruise WP story:
"While Cruise Chernobyled on "Today," ..."

Simply marvelous. On the psychiatry issue...some people have issues that are helped with medicine; others don't need it and think they do because of their psychiatrist. Still others, as mentioned before, use the medicinal excuse to mask what real problems might exist.

The fact of the matter is, even in our 'advanced' society, we really don't know much about the human brain; though there is a lot of interesting research being done now.

And finally, on the Rove thing...I don't post much, but read everything. I was absent over the weekend and after reading the green plant discussion I was interested in seeing the Rove posts for myself...then I saw that it was up to almost 800 posts and can't bring myself to open it...what happened in there??

Posted by: J | June 27, 2005 1:03 PM | Report abuse

Tom is right. I'm going with my gut which is just as good or better than crappy, undefined science. It seems to me that before the big boom in the economy, you heard a lot of "mommy/daddy made me do it" issues, then we hit the boom and you kept hearing about bigger suvs and houses. Now that the economy has been shaken down, we're back to suicidals and unhappy blamers. It's not because your chemicals are imbalanced it's because you don't take responsibility for yourself and when you have a bad day that you just can't blame on someone else, you blame your God-given brain. Of course if I paid constant attention to all my failures and heartaches I will be less content. But some people - I believe - just become addicted to self-pity.

Posted by: Post Reader | June 27, 2005 1:03 PM | Report abuse

Religion and science are one in the same. Flexibility is the mark of the science of religion. On its base, though, science is dependent on numbers and other symbols that are creations of the human mind to help us communicate. There is no total varification and at some level we must put faith that 1=1, or doesn't. In the meta sence, however, it is replacing the supernatural with the numerical. Both religion and science attempt to solve the same large issues, but are compartmentalized today into aspects that seem more apt to their particular field (science helps you build planes, religion helps you cope with death). Anyway, thats all I got.

Posted by: Andrew D | June 27, 2005 1:08 PM | Report abuse

The problem with Tom's comments about psychiatry is that they further stigmatize mental illness. Saying that "chemical imbalances are not real" and that "vitamins and exercise" can cure you are just flat out false. Because of the stigmas related to mental illness, many people who suffer from something treatable neglect to seek help. An amazing statistic to remember is that there are over twice as many suicides in the US as there are homicides.

None of this means that psychiatry in its current state is the be all, end all. Remember that modern "Freudian" psychiatry is no more than just over 100 years old. We are still learning about neuroscience as well. Just like any science, the theories of today will probably be obsolete after a century or more. Remember that science once considered the world to be flat and that the Earth was the center of the universe (these were scientific facts, not religious beliefs).

Check out www.nami.org or www.nmha.org and see what the current research is.

As far as psychiatry being Euro-centric. Well medications are developed by Pfizer, Merck, and the like. We all know they can come up with Viagra but not a cure for cancer. They are led by a bottomline, and white males are good for the bottomline.

Professionals out there in the field are realizing that psychiatry has to conform to culutural perspectives, and they are learning. But like I said before, we are still in the early stages of learning.

Tom Cruise needs to keep all of this in mind before he spouts off with what he's been told by the leader of his church. Which for the record was founded by a science fiction writer!

Posted by: Tiffany | June 27, 2005 1:14 PM | Report abuse

Re: Tom Cruse and anti-depressants
In one of my books on how to write science fiction (by L. Sprague DeCamp, I believe) from when I was a kid, Ted Sturgeon who served with Hubbard during WWII reports him as saying, "Some day I will pull something that will make P.T. Barnum look like a piker."

And he did. He really did. Moreover, Tom Cruse has fallen for it hook, line and sinker.

To understand how believing in Dianetics can really screw-up your neural semantic reactions to statements (such as the argument which Cruse and the TV person had) read the article on Dianetics in "Etc." the Journal of General Semantics (vol. VIII, No. 4 SUMMER 1951 BOOK REVIEWS) in which S.I. Hayakawa takes apart Dianetics piece by piece. It is a brilliant piece of writing.

http://www.lisamcpherson.org/hayakawa.htm

Then start learning General Semantics, a field founded by Alfred Korzybski, based on his book "Science and Sanity" which suggests that most people still live and think in an Aristotelian sense (ergo a logical structure fit for the Greeks in about 500 AD) and he teaches people how to think in a Null A sense. (Non-Aristotelian logic and Non-Newtonian physics). S.I. Hayakawa references this book several times in his article.

Dianetics has obviously programmed Cruse to think he has all the answers, because he is "cleared" and has paid a lot of money to go to the "higher realms" of the cult of Scientology and is trying to exploit himself for scientology's gain. He is also woefully uninformed about modern neurological medicine and the workings of the mind - due to Scientology. Anti-depressants, and Ritalin is not an anti-depressant, it is a stimulant which helps people concentrate, have helped millions of people endure their lives because of they temporarily fix a chemical imbalance in the brain. Where their world was black and while: for some, now:

The world is a carousel of color,
Wonderful, wonderful color.
The world is a carousel of color,
History, comedy, fantasy,
There's drama and mirth,
There's old mother earth
With all of her secrets to see.

The world is a treasure-trove of faces,
Fabulous, faraway places.
The hopes and the fears,
The joys and the tears
Of people like you and like me.

The kingdoms of magic science,
The glorious story of art,
The world of romance,
Of music and dance,
This world where we each play a part.

The miracle of imagination,
The marvels of earth, sea and sky,
These wonders untold
Are ours to behold
In the funny world,
The sunny world,
The wonderful world of color.

Because of anti-depressants taken by people every day. They make life bearable for millions of people who could not endure their existence if the remained depressed. It enables creative people to build masterpieces at 10 at night that they could not do if they were still depressed. It is not their fault or because of a lack of will that they are this way and if they can change their outlook, and be happier why not?

Otherwise, there would be more suicides, and their lives would be unbearable. Will power and Dianetics, Tom, seems to think, can conquer anything. To me, it seems like its driving him on a power trip he cannot stop.

So, remember the words of the band "Living Color" and their song "Cult of Personality" it applies perfectly in this case. Bother with Cruse, Scienology and Bush

Look into my eyes, what do you see?
Cult of Personality
I know your anger, I know your dreams
I've been everything you want to be
I'm the Cult of Personality
Like Mussolini and Kennedy
I'm the Cult of Personality
Cult of Personality
Cult of Personality
Neon lights, A Nobel Price
The mirror speaks, the reflection lies
You don't have to follow me
Only you can set me free
I sell the things you need to be
I'm the smiling face on your T.V.
I'm the Cult of Personality
I exploit you still you love me
I tell you one and one makes three
I'm the Cult of Personality
Like Joseph Stalin and Gandi
I'm the Cult of Personality
Cult of Personality
Cult of Personality
Neon lights a Nobel Prize
A leader speaks, that leader dies
You don't have to follow me
Only you can set you free
You gave me fortune
You gave me fame
You me power in your God's name
I'm every person you need to be
I'm the Cult of Personality

Posted by: Kxrcooper | June 27, 2005 1:18 PM | Report abuse

"No passion is stronger in the breast of man than the desire to make others believe as he believes."

Virginia Woolf, "Orlando"

Posted by: Anonymous | June 27, 2005 1:20 PM | Report abuse

"it seems to me that treating the chemical imbalance is a Band-aid approach, kind of like treating obesity with a Weight Watchers program instead of addressing compulsive overeating or food addiction"

Or you could say that it's kind of like treating diabetes with insulin AND diet and exercise. There's a place for all of it. The chemical imbalance theory currently has the strongest evidence behind it. Meds aren't a magic cure that makes it okay to not deal with one's problems--for those who have depression, bipolar disorder, and anxiety disorders, they make it possible to find a stable place where one can deal with one's problem

Talk to someone who has suffered from serious bipolar disorder, for example, about how the meds make it possible for the brain to think straight most of the time, which gives them the breathing space to do the exercise, vitamin, cognitive-behavioral therapy stuff instead of having racing thought, inability to sleep, suicidal ideation, or howling depression that makes just getting out of bed a major ordeal.

People who have not dealt with these things seem to think that these disorders are just like the bad moods or sadness the rest of us deal with sometimes. There is so much more to them, as anyone who has actually had to manage these illnesses, and their family and friends, can tell you.

Posted by: Loved one has bipolar disorder | June 27, 2005 1:25 PM | Report abuse

I really liked Cranky's take on Hubbard. I tried reading one of his books once and threw it out after about three sentences. comic books were better written. Did anyone ever find out if he was really kidnapped by his own demented followers when they hijacked his cult and went public?

Posted by: Eggroll | June 27, 2005 1:32 PM | Report abuse

You're right. As I said, "Band-aids have their place." Sorry about your loved one.

Posted by: Achenfan | June 27, 2005 1:33 PM | Report abuse

Way to go Tom,

We all know that Hollywood and many big city citizens use psychiatric help as a crutch for their lack of intimacy and bonding with their so called friends.

Posted by: Farid | June 27, 2005 1:35 PM | Report abuse

"In general, the field of psychiatry strips people of the need to feel responsible. And, often enough, so does religion. But if you take quantum mechanics seriously enough, it puts the responsibility squarely back in your lap. And it doesn't give answers that are clearcut, or comforting. It says, 'Yes, the world is a very mysterious place. Mechanism is not the answer, but I'm not going to tell you what the answer is. Because you're old enough to decide for yourself.'"
--Jeffrey Satinover, M.D., M.S.

"I think a lot of the problems that we're seeing with the children today are a sign that the culture is in the wrong paradigm and not appreciating the power of thought."
--Candace Pert, Ph.D.

From "What the Bleep Do We Know?!"

Posted by: Bleep Nut | June 27, 2005 1:50 PM | Report abuse

Wow! Did I miss Tom Cruise becoming a creditable resource in mental illness? If I ever start quoting him or using his insight as a way to direct my thinking, I hope there is a real mental health resource available for me.

Posted by: TurboAlto | June 27, 2005 1:51 PM | Report abuse

As someone who has benefitted from anti-depressant/anti-anxiety medication, I can tell you that for some people it is imperative. Achenfan is right that it somewhat like a band-aid, however I think that for those who have never experienced it firsthand, it is hard to understand what such a chemical imbalance can do to your thought processes.

Depression can make entirely irrational things, seem perfectly normal and acceptable. I remember wishing that I would have a car accident, just so I could be unconcsious in the hospital for a while and have everyone leave me alone! I knew intellectually that that wish, and suicidal thoughts weren't "normal" but something in my brain made it seem acceptable--and really my life wasn't THAT bad!

With the help of the drugs I was able to keep functioning daily, go to therapy and pull myself out of that place. With a couple of years of that, I was able to go off the drugs and go back to living a happy healthy life. Without them, I don't know if my daughter would still have a mom right now.

Somtimes it takes a tourniquet to stop the bleeding till you can get help for the larger problem.

I used to like Tom Cruise, now I think he's not just a flake, but a dangerous, ignorant one to boot.

Posted by: formally imbalanced | June 27, 2005 1:52 PM | Report abuse

My personal Scientology experience:
Ok, so my brother and I were walking through the mall one year before Christmas, and there's this guy selling Dianetics from one of those kiosks. I walk up to the stand, pick up one of the books, and say to my brother, "Hey, Dianetics. This is that crazy Scientology stuff."

The guy selling the books gets out of his chair, walks towards me, and says, "You have no idea what you're talking about. Dianetics has NOTHING to do with Scientology."

I say, "It's written by L. Ron Hubbard" I'm thinking that's really all I need to win the argument.

"So what?" the Scientologist guy shoots back.

"Um. Didn't he start Scientology?"

The guy steps even closer, and I'm kind of holding up the copy of Dianetics like some sort of magic shield against crazies. "L. Ron Hubbard founded over 800 organizations, and Scientology is only one of them. Have you even read Dianetics? Do you even know what it's about? You should be more careful and not walk around talking about things that you know NOTHING about!"

"I always thought Scientology was more of a cult than an organization." At this point my brother is slowly backing away from both of us. I think he was a little afraid that Tom Cruise and a bunch of Scientologist-ninjas were going to rappel down from the ceiling. I decided that now would be a good time to return the book to the stand and walk away. Ironic that the guy got whipped into a fury trying to tell me how "mainstream" Dianetics is. I loooove Scientologists. That guy was obviously not vibrating at a very high level of realization. Or whatever. Crazies.

Posted by: jw | June 27, 2005 1:58 PM | Report abuse

i agree that we tend to over medicate ourselves sometimes (especially children) but i don't get cruise's rant against therapy. those poor decisions people make and just personal traits/thoughts/beliefs that keep them from enjoying their lives are exactly what people should have help to change. you don't necessarily need to be medicated for it but you also don't need to pay $100K to the l. ron hubbard memorial fund.

Posted by: Lisa | June 27, 2005 2:00 PM | Report abuse

I think that Tom was extremely rude to Matt. It's one thing to have a different point of view it's another to shut down people when they are trying to have a conversation. I know that alot of women swoon over TOM CRUISE but I am not one of them. I am 37, married, a mother of 3 boys, smart and cute. I am a former middle school teacher, now a stay at home mom. I don't think that ritalin is necessary for a vast majority of children. However,the changes that are necessary from parents to naturally change the child's behavior require a huge commitment that I don't think alot of parents are willing to make. Some parents can't even manage to remember to give their child their medicine before they leave the house and encounter a day of school fraught with craziness instigated by their inappropriate behavior! Some parents are more concerned about their own lives and their own needs, mid-life crisis, whatever, to focus soley on their kids needs.I think Tom is a hard-headed, egotistical, male who only functions in his happy go lucky manner when things go his way. When Katie enters her 30's and grows a backbone we'll see if Tom really thinks she's awesome! Heaven forbid if they have a child that needs any medical help. Kate will have no say in the treatment of her child unless she agrees with Tom's assessment. If she has a different point of view or questions his opinion he will probably shut her down with the same hatefulness that he used in the Laurer interview. I am so thankful that Nicole is her children's lives so that they will have someone who can relate to them in a compassionate and empathetic manner and not in a dismissive, oh your stupid to let this affect you, kind of way.
Tom only wants to hear the good news...
Well theres lots of sadness in the world Tom. Why don't you get off your high horse and get your hands dirty by listening to peoples problems and trying to make the world a better place instead of preaching to the world how stupid they are because they don't agree with you?
I think Tom is in the perfect profession because at least for 2 hours on the big screen he can pretend to be a feeling, compassionate human being and we might believe him, until we see him again in his next interview.

Posted by: christine | June 27, 2005 2:01 PM | Report abuse

Actually, SSRIs and other psychoactive drugs are THOUGHT to work on neurotransmitters like serotonin and so on, but the only way to know that for sure is to take a sample from someone's brain and observe--so Cruise knew what he was asking and how to be a good Devil's advocate. However, it's accepted that the drugs do indeed work, to an extent. Personally, I think he should have just kept his mouth shut about Brooke Shields, as her treatment is between her and her doctors. But I do think he has a point about things like Ritalin and about the overuse of psychoactive drugs. WAY too many people run to their regular internists with their hands out for Prozac and so on, and don't get the appropriate psychiatric counseling. Well, guess what? Stop the drug, your depression will come back becaus you haven't worked out whatever issues you have that triggers the depression. Depression is a mind AND body thing. As for Ritalin, well, maybe there are SOME kids who have problems with concentration, but I do think it's overused and that a lot of the behavioral problems in kids these days are a product of poor nutrition, crummy parenting, and a stressful environment with no structure. Ninety percent of them have nothing wrong with them that a nun with eyes in the back of her head couldn't cure.

Posted by: Terri | June 27, 2005 2:20 PM | Report abuse

"People who have not dealt with these things seem to think that these disorders are just like the bad moods or sadness the rest of us deal with sometimes. There is so much more to them, as anyone who has actually had to manage these illnesses, and their family and friends, can tell you."

This is so well put, thank you. So many people are lumping people who are kinda blue with people with severe depression. And post-partum? Telling a new mom who is dealing with severe post-partum to suck it up, quit whining, take some vitamins and get some exercise will just further the problem that has been present for so many years...moms who are afraid to come forward and admit they need help when battling these post partum demons. This has nothing to do with lack of sleep and and everything to do with something happening in the body/brain after childbirth. I'm no doctor, but Cruise is going to cause many new moms to suffer in silence out of fear that they'll be ridiculed. Until Cruise gets post-partum depression, he can keep his "researched" comments to himself.

Posted by: Jennifer | June 27, 2005 2:30 PM | Report abuse

She should have said "that's just too stupid to live" and thrown him off of the show right then.
That WAS too stupid to live!
That is quite like a "creationist" and I have that same zero tolerance for intolerant people. (yeah, there's some irony there)

Cruise told Lauer that there's no such thing as a "chemical imbalance" in the brain. Maybe Lauer should have responded, "So what's your excuse?"

Posted by: gberke | June 27, 2005 2:32 PM | Report abuse

She should have said "that's just too stupid to live" and thrown him off of the show right then.
That WAS too stupid to live!
That is quite like a "creationist" and I have that same zero tolerance for intolerant people. (yeah, there's some irony there)

Cruise told Lauer that there's no such thing as a "chemical imbalance" in the brain. Maybe Lauer should have responded, "So what's your excuse?"

Posted by: Anonymous | June 27, 2005 2:32 PM | Report abuse

Ah, "a nun with eyes in the back of her head." That really brings back memories . . .

Posted by: Achenfan | June 27, 2005 2:35 PM | Report abuse

I want to endorse the comments made by "Loved one has bipolar disorder."

Without meds, it is very difficult for a severely depressed person to find the strength and energy to do other things that might help relieve the current depression and reduce the likelihood of recurrence, i.e., sort out maladaptive thinking patterns, do the work (shopping, cooking) required to maintain a healthy diet, create a supportive social network, and exercise.

People with less severe depressive disorders (generally called dysthymia) can often get past their problems by taking certain actions on their own and, sometimes, working w/ a therapist. A good book on this topic is "Beating the Blues: New Approaches to Overcoming Dysthymia and Chronic Mild Depression" by Thase and Lang. (Thase is an internationally renowned psychopharmacologist, as well as a highly skilled cognitive-behavioral therapist. Lang is a science writer.)

I think it's important to understand that, at some level, everything is about neurochemistry. Exercise makes you feel better because of its neurochemical effects. Every thought, every feeling is based in the operation of the brain. The more we understand about the brain, how neurochemistry affects behavior and vice versa.

In the meantime, though, it's clear that mental disorders (especially severe disorders such as bipolar illness and schizophrenia) have their basis in neurochemistry that must be modified by medication for the individual to exert even a modicum of control over his or her behavior. No serious scientist would dispute this.

As to the role of culture in defining mental illness (or protecting against it), it's likely important, but these effects, too, are best understood through science, i.e., behavioral/sociological research that examines the relationship between cultural beliefs and practices and mental illness. Some such beliefs and practices are likely to be more adaptive than others, but it makes no sense to simply assert that that is true without verifiable evidence supporting the validity of the relationship between certain cultural variables and psychological well-being--or the lack of it.

Posted by: Anonymous | June 27, 2005 2:45 PM | Report abuse

Someone who has not lived through depression -- mild, bipolar, postpartum -- has no right to tell someone else to just get over it. In a lot of cases, it's genetic. Quite a few members of the younger generation in our family is on antidepressants just to get through the day. The older generation didn't have such luxuries. I thank Wyeth Labs every night for the meds I take for depression.

BTW -- aren't vitamins a form of chemical? If he's badmouthing the use of a chemical for depression, why is he pushing vitamins for a better life?

Speaking of cultural illnesses -- iron overload, or hemochromatosis, is the most prevalent genetic disease in the world and the majority of people have never heard of it. Too much iron is as dangerous as anemia. It can cause early heart attacks, cancer, liver disease, diabetes, arthritis, impotence, infertility. You are born with it. It's not a result of bad habits, poor nutrition, unsafe sex, or environment.

Posted by: WASP | June 27, 2005 2:48 PM | Report abuse

I heard the debate between Matt and Tom........I just laughed and said, "Tom is truly having a mid-life crisis." It was obvious even before he expressed his so called intelligence".....and his comments about Brook Shield made me sick enough for medication.

Posted by: Mary Ann | June 27, 2005 2:48 PM | Report abuse

Ignoring entirely the contents of the article, as Mr. Cruise has surely had his day in the sun, it would be nice if the writer and/or his editor has noticed his grammatical errors: "four is unnecessary. two isn't enough"? Yegods. As I understand verb tense, if you have more than one item for a subject, the verb becomes plural. Thus, the sentences should read: Four are unnecessary. Two aren't enough.
Is it too much to expect that a paid writer for a nationally renowned newpaper should know this? Very disappointing.

Posted by: frieda | June 27, 2005 2:49 PM | Report abuse

Ignoring entirely the contents of the article, as Mr. Cruise has surely had his day in the sun, it would be nice if the writer and/or his editor has noticed his grammatical errors: "four is unnecessary. two isn't enough"? Yegods. As I understand verb tense, if you have more than one item for a subject, the verb becomes plural. Thus, the sentences should read: Four are unnecessary. Two aren't enough.
Is it too much to expect that a reasonably well paid writer for a nationally renowned newpaper should know this? Very disappointing.

Posted by: frieda | June 27, 2005 2:50 PM | Report abuse

Hey Joel, can I handle this one? This. Is. A. Weblog. Joel writes it on the fly, and he's usually drunk on his back porch, trying to type with one hand while holding a stogy in the other. If the quality of the writing rises above a certain level then the paper won't let it just be a weblog any more and we won't have anything to do at work.

Posted by: jw | June 27, 2005 2:58 PM | Report abuse

"Religion and science are one in the same."

That's just not true. As Joel pointed out in his post, science is subject to self-correction. As others have said, our current knowledge of the brain will seem primitive in 20, or 50, or 100 years, but that change will be a result of scientists identifying the limits of what is currently known, as well as the errors in our current understanding, and, over time, working to refine our knowledge. There is no such self-correcting mechanism in religion.

Religion involves acceptance of mystery based on faith; science involves generating questions that help us identify what is unknown and using systematic methods to generate knowledge.

Boy, I could go on about this topic all day--both about psychiatry and the role of particular treatments for mental illness, the importance of science, and importance of understanding how science works---as a self-correcting social enterprise that, over time, brings us closer to solving important human problems.

Unfortunately, the research firm where I work wants me to do my piece to help generate useful solutions to human problems.

Posted by: Anonymous | June 27, 2005 2:59 PM | Report abuse

For frieda:
I think "four is" and "two isn't" are correct, since the verbs are referring to the numbers "four" and "two," which are singular, not to "items," which -- you're right -- is plural.
(Joel, do you see that? "The writer"!)

Posted by: Tom [not Cruise] fan | June 27, 2005 3:02 PM | Report abuse

This is an over-medicated society filled with cry babies whose answers are pills and therapy - grow up folks!
And after that stop feeding your kids ritalin.
Think about it, how healthy can it be to give a child these powerful "medicines" - has everyone lost common sense in the last 10 years - or just watching too many talking experts who are trying to make drug companies and themselves rich.
I am no fan of scientology either - just common sense.

Posted by: Frank | June 27, 2005 3:03 PM | Report abuse

"Seems to me that science can't become a religion, because a religion deals with absolutes and science is always hedging its bets and changing its mind and trying to come up with a better explanation."

Loyal science supporter though I may be, one who finds no conflict at all with his religious sensibilities, and much as I do appreciate your commentary, that has to be, at best, one of the more naive statements I've read today. Religion has plenty of people who maintain an open mind and look for "better explanations" than those they were taught in the past. And science, hard though you may find it to believe, has very solid representation among the narrow-minded, the dogmatic, and the hypocritical. The first step in dealing with a controversy between practitioners of different belief systems is to accept that they are all equally human to begin with, thus individuals among their membership will exhibit all varieties of standard human behavior...good, bad, and indifferent.

Religions point to their lofty ideals while critics point to the failure of many of their practitioners to practice what they preach. Look at matters a bit more objectively and you may find that, more often than you and I might like, the same can be said of the sciences.

Posted by: Bob | June 27, 2005 3:09 PM | Report abuse

To Post Reader:
While some people may be, as you put it, just addicted to self pity, the entire point of listing various types of depression as legitimate medical disorders was to get away from the stigma of laziness and a lack of will that people with severe depression had to deal with. Also, if blaming your brain for your problems isn't legitimate, I don't know what is...it's the same as the vitamins/meds argument-- dr pointed out that your body sees both as what they are, chemicals. Your brain tells you how you feel with CHEMICALS, regardless of whether you "should" be depressed or not.

On another note, I took a personality test from some scientologists one time (they were handing out flyers on the street and I had a couple of hours to kill, so...). The test was pretty straight forward multiple choice, asking me about my usual responses to various situations. Very basic stuff. About twenty different books (all by Hubbard) were stacked up around me while I sat there scribbling infinite x's. Afterwards, the guy basically told me what my problem is (he gave me a graph that showed me what parts of my life were making me miserable (work, for instance...Shocking...)) and basically said he knew a book that had a solution. I was like, "ooh, ooh, let me guess who wrote it!" Anyway, I ended up being gently escorted out.

Posted by: n | June 27, 2005 3:10 PM | Report abuse

"This is an over-medicated society filled with cry babies whose answers are pills and therapy . . . has everyone lost common sense in the last 10 years?"

No, in the past 20-30 years, scientists have helped to produce meds to deal w/ problems that were formerly believed to be the result of demons, lack of self-discipline, and bad parenting.

Just watched "The Aviator" this past weekend. Today, Howard Hughes would be given Prozac (or another drug) for his obsessive-compulsive disorder, which would have enabled him to continue to have a productive career rather than dying an isolated old man who saved his urine in bottles, wouldn't allow anyone to trim his nails or his hair, and, generally, lost his ability to work or interact w/ the world because his brain wasn't working the right way.

Common sense wouldn't have helped him, and there are many other situations in which people with good common sense use it to get the help they need for themselves and their loved ones.

Posted by: Anonymous | June 27, 2005 3:16 PM | Report abuse

To Bob:

Amen! and the secular scientific equivalent, too.

Posted by: n | June 27, 2005 3:22 PM | Report abuse

Cry babies - where have all the real men gone.
Dont put yoru faith in prozac - son.

Try God.

Posted by: Frank | June 27, 2005 3:27 PM | Report abuse

Tom has a point, but not a scientific one - it's hardly controversial that many mental "ailments" are not purely mental, and that a variety of treatments and combinations therof, from exercise, nutrition, and medication would be useful in overcoming them - with success defined on a case by case basis.

In the Post Vedantam piece, a research psychiatrist is quoted saying that cultural approach advocates have little to offer because they do not conduct controlled case studies - they mostly just complain about the status quo, which is fine because it presents alternative, though untested hypothetical treatments.

"Do not block the way of inquiry" is a two way street. But If a proposition is un-falsifiable either because it goes untested or because it rests on authority, then it is not scientific, and any inference drawn in reference to it is a bad inference: see Scientology and other religious credos that fix belief through authority rather than rational inquiry.

In the absence of further evidence, it is a matter of taste to believe that a cultural approach is more useful than traditional psychiatry.

On a lighter note, Tom Cruise is related to a crop of web-toed sprint swimmers in Kentucky.

Posted by: peter | June 27, 2005 3:31 PM | Report abuse


I'm actually rather astonished that the _Post_ was willing to take on the "official State Religion of Psychiatry".

Secondly, there was today's article on the apparent higher success of non-western "cultural based" approaches to treatment of people with mental disorders.

But first, there was Sunday's article "Patients' Diversity Is Often Discounted" by Shankar Vedantam (unday, June 26, 2005; Page A01) which has the rather damning admission by "...Columbia University psychiatrist Robert Spitzer, who played a key role in popularizing the medical model of psychiatry...":

[Quote]
In response, Columbia's Robert Spitzer led efforts to update American psychiatry's manual of mental disorders in 1980 and again in 1987. Experts drew up lists of specific symptoms associated with particular mental disorders -- and gave the field a common lexicon. The "Diagnostic and Statistical Manual of Mental Disorders," commonly known as DSM, became the bible of the medical model of psychiatry.

Yet, as Spitzer readily acknowledged in a recent interview, the DSM classifications did not rest on new scientific data.

"The DSM is not a scientific document," Spitzer said. "It is a bunch of smart people who studied the literature and then came up with the best way to define diseases -- very few of the categories have an empirical base." As doctors wrestled with overlapping symptoms, he said, subsequent editions greatly expanded the number of disorders: "It is not a scientific document, but it facilitates science."

Spitzer said he had never oversold the scientific credentials of the manual. But powerful factors heightened its prominence.
[/Quote]

The DSM is effectively the "holy bible" of the pseudoscience known as "Western Psychiatry". Despite the fact that even the primary compiler states "[t]he DSM is not a scientific document", social workers, State officials, researchers, and people who set official State and Federal policies rely on it with the absolute assurance of chemists consulting the Merck Manual or the Periodic Table of the Elements, documents which _are_ unquestionably scientific documents.

Is it any wonder that huge numbers of Americans experience significant mental illness each year, or intermittently throughout their life, or on a chronic basis? Our treatment policies seem to be based on non-science. If we're going to maintain separation of religion and government, we should no more let Scientism influence policy than we'd let Scientology or Christianity or Islam influence policy.

DSM and all deriviative works are, essentially, a codex of beliefs; they are documents of Faith no less than Scripture or the Koran. How many more mentally ill people will find themselves metaphorically burnt as witches for doubting the official State Religion based in the DSM? How long will the State mistake Beliefs for Science, effectively (metaphorically) aiding and abetting the Inquisitors of the State Religion?

Admittedly, you are no more likely to produce widespread sanity if you base policy on Dianetics or any of the Scientologist's faith-based practices.

Clearly, either the mainstream of American life has become too stressful and perhaps too philosophically irreconcilable for all of us to handle without conflicts sufficient to put us close to, or beyond, the edge of madness. Else, our approaches to treatment are based on flawed concepts and clearly those concepts must be re-examined.

Certainly it's time to re-examine our culture's policy of "out of sight out of mind and dope 'em while you're at it" as regards the mentally ill. Driving out the mad only fills the streets with the homeless. A truly compassionate society applies only the necessary restraint and embraces the injured and assists them to heal as a part of society.

Thanks very much to the _Post_ for daring to point out that foreign witch-doctors have a higher success rate than our own highly-credentialed witch-doctors.

Regards,

Posted by: klaatu | June 27, 2005 3:33 PM | Report abuse

Joel said: Seems to me that science can't become a religion, because a religion deals with absolutes and science is always hedging its bets and changing its mind and trying to come up with a better explanation.

Bob said: Religion has plenty of people who maintain an open mind and look for "better explanations" than those they were taught in the past. . . Religions point to their lofty ideals while critics point to the failure of many of their practitioners to practice what they preach. Look at matters a bit more objectively and you may find that, more often than you and I might like, the same can be said of the sciences.

I say: Better explanations of what? The Virgin Birth? Moses parting the Red Sea? The idea that there is an omniscient, omnipresent God? How can such ideas be tested? What would be a better answer than "faith in things unseen" for any of these phenomena? If one stops believing these ideas, one is left without a religious leg to stand on. Seems to me to be hard to get around the idea that religious faith is, ultimately, an untestable hypothesis, as whatever happens can always be explained as something that is the will of God, which surpasseth human understanding.

On the other hand, scientifically derived knowledge can be found wanting w/o rejecting its source--the process of doing research. Indeed, it is science that gives rise to both revelations about the limitations of scientific findings and to better answers.

W/ regard to the distinction between ideals and practice, though, I agree w/ you. There are gaps between lofty ideas and the human limitations of practitioners in both domains. But, again, in science there are systems for judging the actions of practitioners--not only human social systems such as peer review but requirements such as replicability, which demand that results must be independent of the observer. In religion, there is no such system for judging the actions of practitioners. Thus, to take an incendiary issues, one can be both opposed to and in favor of legalized abortion, and there is no system for determining which of these positions is more consistent w/ "the will of God."

Posted by: Anonymous | June 27, 2005 3:37 PM | Report abuse

Tom, is that you?

Loved you in Legend.

Posted by: jw | June 27, 2005 3:39 PM | Report abuse

Not only did Reverend Mother Clothilde have eyes in the back of her head, she wore a silver thimble on her "bird" finger to thunk us on our little heads when we transgressed. Good old Reverend Mother Clothilde.

Posted by: Good Catholic Girl | June 27, 2005 3:40 PM | Report abuse

jw funny. hehe.

Posted by: n | June 27, 2005 3:49 PM | Report abuse

Hey! Didn't this blog entry have a different title earlier today? Something like "Was Tom Cruise Right"? Or did I just imagine that? Is Joel trying to mess with our minds here? How long will it be before I start hearing voices, seeing shadows, and sensing presences? (I guess some would say that would serve me right.)

Posted by: Achenfan | June 27, 2005 3:52 PM | Report abuse

Her "bird" finger! That is so great. Truth really is stranger than fiction.

Posted by: Achenfan | June 27, 2005 3:55 PM | Report abuse

Maybe Joel wasn't licensed to use Tom Cruise(tm) in the headline.

Posted by: jw | June 27, 2005 3:55 PM | Report abuse

My post was #69.

Posted by: jw | June 27, 2005 4:08 PM | Report abuse

n -

I agree we all have serotonin levels and endorphins, etc, which can be manipulated by drugs. But instead of taking responsibility for why people act and feel depressed, they take this mumbo-jumbo psychiatric bs ("chemical imbalance") and use it to qualify their sour moods. What they should be doing is getting to the root of why they are depressed (bad childhood, ptsd, etc) and moving foward. When people start saying "I've got a chemical imbalance" they are stopping the search for their sour moods and just going with this as the fall for all their problems. They will never get better, just addicated to drugs. If people would take a few moments, days, weeks, whatever to figure out why they are upset, they might just want to make changes in their lives which will make them less depressed (less "chemcially imbalanced").

Posted by: Post Reader | June 27, 2005 4:08 PM | Report abuse

It did have a different name. I came back this afternoon and get momentarily excited because I thought there was another blog for today. And then I realized there wasn't. And I sighed and caught up on the comments. It seems like some of the googlers have hung on.

Posted by: Sara | June 27, 2005 4:09 PM | Report abuse

It's apparent here that for some people, explaining the difference between chemical depression and a bad mood is like trying to explain the color orange to a blind man.

Posted by: jw | June 27, 2005 4:12 PM | Report abuse

jw-

If there is such a thing as "chemical depression" does that mean there's also such a thing as "chemical optimism"?

Posted by: Post Reader | June 27, 2005 4:40 PM | Report abuse

I have to disagree with the idea that science can't become a religion because it constantly changes it's position. That phrase even seems a bit dogmatic.

History is chock full of exampes where new ideas in science are not allowed to disrupt the satus quo, and faulty ideas linger long past their expiration dates. Theories are often stated as fact and given little room for evaluation in some scientific and academic circles. Not to mention many believe in the work of science with out questioning or evaluating the sources.

Which is not to discount science, but to say that there seems to be the potential for science to become like a religion.

Posted by: g1 | June 27, 2005 4:47 PM | Report abuse

Case 1 - At sixteen, I self-diagnose myself as depressed after a horrible academic semester and wonder if I should be on medication. Instead, my father helps me get involved in a community theater/support group and other activities. By senior year, I'm mostly fine and preparing to leave home to go to college.

Case 2 - My father, a minister, has been battling depression for decades. He had to go to a clinic at one point, it was so bad. He's better now, because he's on the right medication and has been through extensive therapy. It has nothing to do with his faith in God, but with chemical issues he has had for a long time.

Did I need medication to help myself? No, I was your typically angsty teenager and I worked through it by growing up and talking with people. Did my father need psychiatric help? Yes, and I'm glad he was able to get it. I'm frustrated by people who would prescribe the same solutions for both of us. Sometimes, people need more than a change of attitude or environment and in those cases, they don't need someone lecturing them on the fact that all they need is sunlight/the Bible/'proactivity' to feel better.

Posted by: jb | June 27, 2005 4:49 PM | Report abuse

"If there is such a thing as "chemical depression" does that mean there's also such a thing as 'chemical optimism'?"

Actually, yes. The extent to which individuals are--more or less consistently--optimistic vs. pessimistic has been well-documented (look for articles by Michael Scheier and colleagues) and is related to many important outcomes, such as the rate at which one recovers from surgery.

Posted by: Anonymous | June 27, 2005 4:51 PM | Report abuse

In my mid forties I lost my management job of eight years when the manufacturing company merged and downsized and I became expendable. After several months of unsuccessful job seeking, I became depressed and sought professional help. I took Zoloft and other drugs and had professional therapy. Did it help? Not dramatically, but some. Mostly it gave me a sense of regaining control of my life and that others were aware of the problems and were able to help. For those of you who scoff and cry "Suck it up!", I would suggest a steady six months diet of rejection for jobs you're overqualified for and pitying looks from former colleagues. Oh, and throw in a few tough to answer questions from your children about why they can't have and do the things they used to. Sometimes people do have very real problems.

Posted by: Anonymous | June 27, 2005 4:51 PM | Report abuse

Post Reader, your question is really a statement about language, not a baiting question about brain chemistry, as you probably intended.

OTOH, a "physical depression" is what we hope to observe when the NASA Deep Impact Craft rockets towards the comet Tempel I on July 4. Images of Captain "Jet Propulsion Lab" Ahab abound.

Posted by: peter | June 27, 2005 4:53 PM | Report abuse

Post Reader -- "chemical optimism" I believe would be another name for "elation", also known as the flip side of depression for someone who is bi-polar.

Posted by: Tiffany | June 27, 2005 4:55 PM | Report abuse

Someone above mentioned that TC's couch jumping seems manic - I am glad I am not the only person who noticed that. Perhaps he should decrease the dosage of vitamins he's taking.

I have an in-law and a cousin who have suffered from schizophenia and schizo-affective disorder, and medication was the only thing that pulled them back from homelessness. And my in-law was taking huge amounts of vitamins and lifting weights 3 hours a day. Medication got him to focus on how to make it through the day and survive. Yes, he does have to make an effort to be happy, he knows it's hard work, but he doesn't want to be hospitalized again.

Today's article in Mind and Culture series struck a chord with me - because as the in-law was getting sicker, more of the family abondonned him or let him withdraw, until he was divorced and alone, living on a beach in his van. I wonder if an approach like those described in India would have made his last 15 years easier.

Posted by: TP | June 27, 2005 4:56 PM | Report abuse

The doctrine of fallibility is necessary for science.

The doctrine of infallibility is necessary for religion.

The two CAN co-exist in individual habits of thought, but they cannot co-exist in a field of inquiry whose purpose is to eradicate doubt and settle on belief.

Therefore, science is not religion and should not strive to be religion.

Posted by: peter | June 27, 2005 5:02 PM | Report abuse

Eh, I think I meant 'clinical' depression. Whatever. In any case it's obvious that a lot of people have the attitude that, "I was in a real bad place once, and I was able to turn my life around without drugs, so everyone on antidepressants is a big baby." Although I'm certainly not an expert, I don't think it's that simple. The brain is very complex--even the idea that what amounts to a series of chemical reactions and electrical impulses serves as the foundation of human consciousness is staggering. It seems to me that in such a complex system, it would be easy for some of those impulses to jump the track, and creating a feedback loop amounting to a litteral downward spiral. When my alarm goes off on a Monday, I hate life. But for some people, that feeling is magnified and exagerated to the point where they can't function in society. Behavioral changes can help, but sometimes you need some heavy machinery to get the train back on the track.

Posted by: jw | June 27, 2005 5:32 PM | Report abuse

Who knew Tom Cruise was such a nut case? A good reason why he has been so "private" all these years. Apparently his "people" must have had his tongue on a leash -- and with good reason. Not private, just wacky.
But I agree that we are an overly medicated society - take a pill, get better. And psychiatry is overused in many cases by people who choose to be depressed instead of getting on with life. Been there, done it.

Posted by: mg | June 27, 2005 5:37 PM | Report abuse

But which comes first? The chemical imbalance, or the events/feelings associated with that imbalance? Can a person be perfectly happy one day, and then wake up the next day with a chemical imbalance and feel depressed? Just like catching a cold? I sure hope not; that would be pretty scary. I like to think that it happens more gradually, and that it is possible to reverse depression by reversing our thought patterns and reinforcing more positive habits and attitudes -- "rewiring" the brain, as it were. It may be too late for some folks to do this. But in the early stages, it may be worth a try. Maybe Tom is just saying that we sell ourselves short by going the medication route before we've exhausted all other options. There is something better out there, if we but dare to reach for it. Again, people who are severely depressed will probably be in no position to use this approach. But for those who are, surely it is the more attractive option?

Posted by: Dreamer | June 27, 2005 5:49 PM | Report abuse

...speaking of drugs,I remember for whatever reason when our son, having heard the tapes at music camp, spouted from memory some Cheech and Chong routines, one featuring "Sister Mary Elephant."

On Hubbard: I seem to recall a Newsweek article a few years back which reported L.Ron, in his last days, was attended by nubile girls in harem costumes; a photo showed him being carried on a litter.

Also keep in mind that Cruise is said to be dyslexic, dropped out of high school. Most likely he is more susceptible than most to stuff he hears...but doesn't read. The Hubbard material is on tapes, I believe.

Posted by: M.A. | June 27, 2005 6:07 PM | Report abuse

Clinical depression is a myth created to explain why people need to feel sorry for themselves. Ask those people who were hit with that tsunami if they need therapy and are they going to get it and medication - the short answer - NO - they are just damn happy to be alive - they cant afford therapist, nor drugs - they dont have the luxury of thinking they need professional help. So keep fooling yourselves you cupcakes - and as the saying goes- get real - toughen up - this is called life.

Posted by: Frank - | June 27, 2005 6:24 PM | Report abuse

Maybe mental health (not cause by chemical inbalances) problems are related to outside factors that therefore creat chemical inbalances. Is like a cold, when everyone is sick, you get sick too.

Posted by: fdg31 | June 27, 2005 6:24 PM | Report abuse

"Clinical depression is a myth created to explain why people need to feel sorry for themselves. Ask those people who were hit with that tsunami if they need therapy and are they going to get it and medication - the short answer - NO - they are just damn happy to be alive - they cant afford therapist, nor drugs - they dont have the luxury of thinking they need professional help. So keep fooling yourselves you cupcakes - and as the saying goes- get real - toughen up - this is called life."

Frank: This attitude is unbelievably obtuse and outdated, both in general and w/ regard to the tsunami survivors. Have you talked to them? If not, you might consider reading parts of the blog written by Post reporter Michael Dobbs. In his interviews with survivors, he certainly found evidence of symptoms that psychiatrists would call depression and PTSD.

And consider the U.S. soldiers who are returning from Iraq. Many of them have grievous physical wounds, but there are also plenty who are coming home with psychological problems--depression and PTSD, for instance--and the VA is unprepared to deal w/ them. (See a recent article in the New England Journal of Medicine.)

Posted by: Anonymous | June 27, 2005 6:44 PM | Report abuse

"Clinical depression is a myth created to explain why people need to feel sorry for themselves. Ask those people who were hit with that tsunami if they need therapy and are they going to get it and medication - the short answer - NO - they are just damn happy to be alive - they cant afford therapist, nor drugs - they dont have the luxury of thinking they need professional help. So keep fooling yourselves you cupcakes - and as the saying goes- get real - toughen up - this is called life."

Frank: This attitude is unbelievably obtuse and outdated, both in general and w/ regard to the tsunami survivors. Have you talked to them? If not, you might consider reading parts of the blog written by Post reporter Michael Dobbs. In his interviews with survivors, he certainly found evidence of symptoms that psychiatrists would call depression and PTSD.

And consider the U.S. soldiers who are returning from Iraq. Many of them have grievous physical wounds, but there are also plenty who are coming home with psychological problems--depression and PTSD, for instance--and the VA is unprepared to deal w/ them. (See a recent article in the New England Journal of Medicine.)

Posted by: Anonymous | June 27, 2005 6:45 PM | Report abuse

Maybe someday folks will get to the real issues -
1-Why are gov't bean counters always trying to cutting VA benefits ?
2-Why dont they raise the cap on the social security contributions ( currently after a certain high figure - you dont contribute to it - maybe that will save the system.
3- Why is it easier for news/editors/people to focus on a celebrity opinion - than on real issues like the destruction of US tax base when jobs are outsourced ?

Frankly - I dont think anyone sees what value $125 an hour shrink can provide other than a legal way of getting drugs - that in the most cases they stick taxpayers or cause my premiums to go up. Stop making the drug companies money - everything is a disease/syndrome and can be fixed by medication, refer to the DSM for proper analysis- yeah right! A real doctor goes to medical school and is called MD for a reason.

Find your strength in the Lord and a hope for a better day.
Nuff said.

Posted by: Frank | June 27, 2005 7:14 PM | Report abuse

Personally, not having to pay social security contributions at all would really cure MY depression. That extra $3K a year would be really nice to, say, save towards a down-payment on a home, or put towards school. Instead it's supporting people like Frank who sit on their butts and talk about things they know nothing about. :)

Posted by: jw | June 27, 2005 7:34 PM | Report abuse

Frank,

First, Psychiatrists are MDs. Second, the DSM is a catalogue of diagnosis, not analysis. Third, an analogy:

Americans are blessed with an abundance of resources to meet their needs and their wants. The fact that big pharmaceutical companies are peddling drugs to willing a consumer market, even if the drug treatments are unnecessary and excessive - is like big automakers peddling gas-guzzling SUVs to a willing consumer market, even if the vehicles are unnecessary and excessive.

While large SUVs simply appeal to the reptilian side of our brains, psychotropic medications behave in a much more complicated way.

I'm assuming that you are not a Christian Scientist, and if not - the principle of human medical intervention is firmly established and psychiatrists are free to do as their professional knowledge suggests, discoveries of strength or weakness before the Lord notwithstanding.

Posted by: peter | June 27, 2005 7:47 PM | Report abuse

So, why is it that kids in American are diagnosed with ADD and ADHD, when kids in Europse don;t seem to suffer the same maladies?

I think Cruise is onto something and he's being attacked because drugs are the new religion.

All doctors seem to overprescribe these days -- 15 years after being in total remission from asthma my doc is still pushing the meds -- even though a computerized readout of my lungs prove I don't need them.

Posted by: dennis b | June 27, 2005 9:12 PM | Report abuse

For the mis-informed
There are two types of physicians: M.D.--Doctor of Medicine--and D.O.--Doctor of Osteopathic Medicine. M.D.s also are known as allopathic physicians. While both M.D.s and D.O.s may use all accepted methods of treatment, including drugs and surgery, D.O.s place special emphasis on the body's musculoskeletal system, preventive medicine, and holistic patient care. D.O.s are more likely than M.D.s to be primary care specialists although they can be found in all specialties. About half of D.O.s practice general or family medicine, general internal medicine, or general pediatrics.

The difference - your psychiatrists "think" their doctors :-)

Posted by: Anonymous | June 27, 2005 9:13 PM | Report abuse

I took Prozac for obsessive-compulsive disorder and noticed a change (for the better) in a matter of weeks. I realized I should have been taking it as a kid.

I'm just waiting for all of the "Toms" of the world to become pharmacists and then they can use the 'conscience clause' to refuse to fill prescriptions for anti-depressants.

Posted by: Diane | June 27, 2005 9:57 PM | Report abuse

Apparently, Brooke Shields was suffering from such severe postpartum depression that she felt unable to care for her baby, she couldn't feel or express love for her baby, and she ultimately had fantasies about hurting her baby. In that dire situation you use whatever remedy works, and you do it as quickly as possible. Brooke Shields probably didn't have time to explore different vitamin combinations -- and frankly, she looks to be in excellent physical shape, so I doubt that lack of exercise was the problem.

Maybe some medications are overprescribed, and perhaps psychiatrists have trended away from "talk therapy" to simply managing patients meds, but nobody should presume to know the specifics of someone else's brain chemistry. Human brain functions are still something of a mystery -- Tom Cruise's most certainly included.

Posted by: Sirin | June 27, 2005 10:05 PM | Report abuse

Are psychiatrists doctors ?
Not really. They came into existence first as researchers and philosophers,
and eventually as practitioners. In a turf battle, psychiatrists pre-empted
them, and consigned them to doing testing for their own work. Psychiatrists
did a lot of worthless psychoanalysis on the mildly disturbed, and a lot of
silly treatments on the seriously mentally ill, including hot baths and
eventually prefrontal lobotomies. In time, psychiatrists moved to mostly prescribing medication.

Posted by: Josh | June 27, 2005 10:05 PM | Report abuse

Leave Mr. Cruise alone - he is entitled to his opinion - and besides real doctors look down on psychiatrists because unlike most of medicine, they "diagnose disorders" based on subjective value judgements rather than empirical evidence and objective reasoning
developed from that.

Posted by: Tim | June 27, 2005 10:07 PM | Report abuse

Katie, is that you?

Posted by: Mommy | June 27, 2005 10:33 PM | Report abuse

Re: "Are psychiatrists doctors?"

YES. Try being one without completing medical school, Board exams and a residency program in psychiatry. You can be a psychologist or counselor without being an M.D., but NOT a psychiatrist.

It is irrelevant whether they "came into existence first as researchers and philosophers..." Way back then, any guy with a knife and a shingle could perform surgery -- are you going to use that to discredit today's surgeons?

The fact that some medications may be overprescribed does not make them worthless or broadly unnecessary.

The fact that Tom Cruise has opened his big mouth one too many times DOES reveal to the world that he's ill-informed, boorish, erratic and, what the hell, a whack job.

Posted by: A | June 27, 2005 10:53 PM | Report abuse

Sounds like allthose folks mad about Tom needs some prozac.

Posted by: Jim | June 27, 2005 11:14 PM | Report abuse

www.freekatie.net

Be the first person you know with a kick-ass "FREE KATIE" t-shirt. Don't let her be Patti Hurst-inated!

Posted by: jw | June 28, 2005 8:05 AM | Report abuse

When the APA admits that ADD is not real then I think most folks will take modern psycho therapy serious - otherwise its credibility in the long term will always be open to scrutiny.

Posted by: Wild Bill | June 28, 2005 8:06 AM | Report abuse

For all those picking on ADD and stimulant meds. I was diagnosed w/ADD at a young age, and placed on ritalin. When, as a teenager, I tried to discontinue the drugs and try flying on my own (using exercise to try and channel my excess energies), I crashed to a C average- the guidance counselors thought I wouldn't be able to get into college. Since being placed back on my ADD meds, I was not only able to get into an Ivy League school, but was able to complete my dream - a degree in physics. I have plenty of brains, faith in God, and get plenty of exercise and vitamins - but those meds were neccessary to help me sit down and concentrate on my studies - without them, my brain was like a wild stallion, racing from thought to thought and impossible to slow down and put to work. My ADD meds helped me live up to my potential and become a productive member of society - and I ask anybody who condemns their use or the diagnosis of ADD in general to think of people like me, and where they'd be without the help their psychiatrists provide.

Posted by: Babette | June 28, 2005 10:09 AM | Report abuse

I think the difference between science and religion can be summarized by one word: faith. Without it, religion would not exist. There isn't (or shouldn't be) any place for faith in science. If it can't be proved or disproved by reproducible experiment, it isn't science. One reason why Carl Sagan could neither accept religion nor atheism.

Posted by: Babbler | June 28, 2005 10:55 AM | Report abuse

I think I'll pass on seeing "War of the Worlds" - it's escapist fare and would mask the problems I should be thinking about.

Posted by: pen | June 28, 2005 12:28 PM | Report abuse

You know, all blood pressure medicine does is mask symptoms. Of course these symptoms can lead to strokes and heart attacks. All glaucoma medicine does is mask symptoms, like blindness.

Posted by: Blah bah | June 28, 2005 1:10 PM | Report abuse

I'm tired of hearing the whole "pull yourself up by your bootstraps" junk. Not all situations are the same!

I can say from personal experience that post-partum depression is just as much a physical illness as a broken arm. You just can't see it, and you know that half the population thinks you're just a whiner. So you keep it to yourself that you can't feel anything or care about anything, even though you used to, and should because you have a wonderful new child.

I think Brooke Shields was a brave woman to talk about her situation, and I hope that more women will.

I think that anyone who has not experienced depression, or talked to a loved one with depression will have a hard time understanding how depression twists your thoughts so that scary irrational things can seem so normal and rational.

Untreated post-partum depression can lead to suicide, or maybe worse, post-partum psychosis. If medication can (and does) stop this, why on earth would we tell women that they shouldn't take the meds, and should just "buck up"?

Posted by: tired of the skeptics | June 28, 2005 2:01 PM | Report abuse

I can guarantee you that Frank has never had to care for someone who was psychotic.

Bipolar disorder runs in my family, I have been diagnosed as well. Studies done by E. Fuller Torrey and his colleagues illustrate that bipolar disorder and to a lesser extent schizophrenia, are inherited disorders. Work is being done to try to identify the genes responsible.

My father was enjoying both personal and professional successes when he became manic for the first time. His episode was severe - he was psychotic. He believed God had chosen him as a special messenger, that our family was the 12th family spoken of in the book of Revelations. He told us he could stay awake for 100 days without any effort. He was arrested twice - this was someone who had never been arrested before. He was violent and unpredictable. He was a danger to himself and others.

Tom Cruise has no idea what he is talking about, and neither do you Frank.

Posted by: Lisa | June 28, 2005 4:40 PM | Report abuse

"Maybe Lauer should have responded, 'So what's your excuse?'"

Lewis Black concluded his piece on last night's Daily Show with the same joke. Seems you are entitled to some royalties!

Posted by: King Pigeon | June 29, 2005 1:08 PM | Report abuse

So tell me fans of modern psych- what to you classify murderers and serial killers as ?
Poor folks who require medication due to an imbalannce so do they neeed teherapy or medication ? Give me break. Modern psych therapy is a psudeo science.

Posted by: The Question | July 1, 2005 2:08 PM | Report abuse

I think when people argue that there's "no such thing as a chemical imbalance" they are really arguing semantics. It's a specious argument. Yes, it's correct that you didn't get a lab test that measured your brain chemicals and indicated which chemical in what amounts was needed to correct it. But the "point" of that layman-friendly term is that the drugs work on what can logically referred to as "brain chemistry," and the average layperson (who does not understand you when you start talking about neurons and synapses and selective serotonin reuptake inhibitors) can understand that concept. But to say that there is "no science behind it" is ludicrous. There is such a thing as a serotonin deficiency. This has been measured, post-mortem (in suicide victims). It can be measured in living people (BEFORE they commit suicide) but only via spinal tap. I'm sure the HMOs would love to foot that bill! Eventually MRIs will be able to show people the differences in their brain vs. a normal one. Research is being done in this area and much has already been learned. Further, you don't necessarily need to have a quantifiable deficiency of something to benefit from more of it. Echinacea helps prevent me from getting a full-blown cold or flu. That doesn't mean I had an echinacea deficiency beforehand. I can go to a doctor and get a prescription for antibiotics based only on my verbal description of the symptoms of bacterial infection (as opposed to a viral one). He didn't order a lab test so he must be a quack, right? He had no PROOF that I had a bacterial infection yet he prescribed something that was very likely to help. No science to it? Hardly.
Are anti-depressants overprescribed? YES. But the vast majority of these prescriptions are written by GPs because the HMOs (who are in bed with Big Pharms) deny patients their right to proper psychiatric diagnosis and treatment. And even if they get a psych referral, it is very possible their intake and diagnostics will be done by someone who isn't even a medical doctor who passes off a chart to the MD who is allowed to look someone over for a few minutes and write a script based on the non-MD's "diagnosis". And the big business HMO is the one deciding how to treat them and with what medication. And how many visits you can get and how many minutes you get. And whether or not you're even allowed any "therapy" to go with your presription. And the Big Pharms directly market their wares aggressively to the uninformed public. Why are they allowed to do this? It's not allowed in many if not most other countries. It didn't used to be done in the US.

And if there is no science behind the concept of "brain chemistry", then how is it that these same drugs are being used quite effectively to correct compulsive and aggressive and anxious behaviors in dogs and horses and other animals? Are they just lazy drug addicted animals with no coping skills? Do the dogs need Scientology too? Are the vets just drug pushers trying to control Fido's thoughts? Think about it people!!!! Address the real problem--for profit HMOs in bed with Big Pharmaceuticals.

Posted by: LauraK | July 3, 2005 10:55 PM | Report abuse

tom cruise is losing his mind - this is the third interview he's blown a gasket in - run Katie run!!!
and for those that say "suck it up" to mental illness - you haven't lived it. I never whined about the fact that i was living a miserable excuse for a life until I was diagnosed and medicated. Now i am able to face my problems head-on. Yes, i'm still medicated but that's because i refuse to go back to living in a grey world. until you've walked in my shoes you can't judge me.

Posted by: maureen | July 5, 2005 3:59 PM | Report abuse

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