There are many reasons as to why psychiatry may be one of medicine’s most unloved specialties. After all, in the eyes of many, psychiatry may as well be the practice of psychological “voodoo magic” meant to warp and control patients’ minds. Even the term “shrink” (slang often used to refer to a psychiatrist), is derived from the shamanistic practice of preserving and shrinking heads for indigenous ritual. Despite the medical practice’s seemingly dark history, psychiatry nonetheless remains an important bastion for the worldwide promotion of mental health today. Why is it, then, that antipsychiatry sentiments still thrive in 2019? Why did the 2020 Democratic presidential candidate Marianne Williamson criticize the use of antidepressants, and is she correct in her anti-psychiatric views? Why should anyone care at all about the public’s sentiment towards psychiatry and its bearings on the truth?
It doesn’t help that psychiatry has always had to bear the weight of its controversial past. Beginning in the 1950s, the anti-psychiatry movement passionately condemned the practice’s use of asylums and measures such as electroconvulsive therapy and lobotomies. Today, individuals like Williamson accuse the field of abusing its patients by overprescribing them drugs. In fact, through books and social media posts, Williamson has labeled psychiatry’s distinction between everyday sadness and clinically-diagnosed depression as “artificial.”
The multiplicity of allegations that have submerged the entire practice into the murky waters of stigmatization is detrimental for not only those suffering from mental illnesses, but also for aspiring psychiatrists. Because supporters of anti-psychiatry movements argue that the medical practice brings more harm than good to patients, psychiatry has, historically, accumulated a comparatively poor reputation in respect to other medical specialties. As a result, individuals who would benefit from mental help — such as many military personnel, a population at high-risk for suffering psychological trauma — maintain a distrust for the practice. To make matters worse, those in need of care often experience stigmatization and judgment from family, friends, and peers from other areas of their lives. Likewise, aspiring psychiatrists face a dearth of professional encouragement and are few and far between (according to the American Psychiatric Association, the percentage of seniors in medical school electing to pursue psychiatry was only 4.2 percent in 2015).
The latter issue is especially concerning when one considers the escalating nationwide shortage of psychiatrists alongside the apparent rise in depression in youth across the nation. A study conducted by Columbia University’s Mailman School of Public Health found that from 2005 to
2015, depression rates rose from 6.6 percent to 12.7 percent among Americans older than 12 years. Renee Goodwin, PhD, of Columbia University’s Department of Epidemiology, has also stated that, “depression appears to be increasing among Americans overall, and especially among youth.” Researchers have also noted that while more Americans meet criteria for a clinical diagnosis, the breadth of mental health services available to treat patients has not expanded to meet the rising demand.
Because of the massive disparity between those needing psychological treatment and practitioners who can administer help, individuals suffering from untreated clinical depression are prone to suicide more than before. Contrary to Marianne Williamson’s belief, psychiatric drugs for treating depression have not been and still are not being overprescribed — rather, they are being vastly under prescribed. And, although psychotropic drugs are no panacea, the fact of the matter is that thousands of individuals suffering from clinical depression and other conditions rely on crucial mental health services — such as psychiatry — daily. For many, psychotropic medications, combined with effective therapy, can make the difference between life or death.
From lobotomies to dingy asylums, psychiatry has admittedly had particularly somber and cruel beginnings. That said, much of the practices that were common while the field was in its infancy could be attributed to lack of knowledge about the internal workings of the brain at the time. The inner experiences of the human mind, after all, are elusive entities that are difficult to quantify and even harder to capture, and where there is vagueness, there is the all-too-tempting opportunity embedded within human nature to attempt to substitute our own explanations for unseeable phenomena instead of utilizing scientific reasoning. Nonetheless, human experiences remain universal, and what unites us all as humans is our darker spells. Indeed, the pharmaceutical industry is not always perfect in its intention, and greedy doctors are not unheard of. However, anyone can suffer from depression, and its distinction from typical, everyday sadness is used by psychiatrists as a scientific attempt to apprehend those very vagaries and disorders of the mind — not to accumulate more money. Further, treatments supported by empirical data and peer-reviewed studies, though no cure-all, stand at the forefront of mental healthcare today, and statistics surrounding the suicide and depression epidemic exist as a window to the mental health of our nation. We must listen to the numbers, and it is thus essential that we remain wary against those who may simply dismiss the usage of psychotropic drugs and psychiatry as a whole. Education about mental health and available life-saving treatments may also help in deterring against harmful sentiments that prevent those in need from seeking proper help. If we wish to save lives, we must ultimately seek to break the stigma against psychiatry and mental illness together.