Daniel Neal
@DanielNeal2
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I play violin and write code but I mainly post here because I had neuroleptic induced akathisia and I think we must find non violent interventions in psychosis.
London, England
Joined July 2011
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Pinned Tweet
@JosephHarvey01
Following your example of sharing your journey - here is the proposal I sent to my mental health team as part of the negotiation to allow me to do a hyperbolic taper.
I'm down to 90mg of quetiapine from 150mg so far.
To get from 100mg to 90mg I used the crushing and liquid
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I think contemporary psychiatry is little more than stories, like
- Lithium is old, but effective at reducing suicide
- Antidepressants work by increasing serotonin levels in the brain.
- Antipsychotics work by reducing dopamine levels, reducing the "salience" of events
-
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The heartbreaking thing about the psychiatry / anti-psychiatry debate is that I thought medicine at its heart was a doctor and patient working together to diagnose and treat an illness, backed by science and evidence.
Now it looks like patients who have been harmed by
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Here's my hypothesis on the cause for psychosis:
1. Lack of proper REM sleep means the body is unable to process events in the usual way through dreams and nightmares.
2. This means that the dream / nightmare world leaches into the awake experience.
3, The actions, fears and
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Something I've noticed about psychiatrists is a propensity to use words like "mild" and "well-tolerated" before dispensing a chemical with the power to fuck you up in ways beyond mortal comprehension.
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It's commonly known that drinking alcohol can reduce social anxiety, but no-one claims it achieves this by correcting a deficiency of alcohol in the brain.
-- metaphor from "The bitterest pills", by Dr. Moncrieff
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The most beneficial intervention when I had my first episode of psychosis was not the "medication", which even though I tolerated was unpleasant and unhelpful.
It was the graphic novel I was given after I was discharged about what psychosis was, written from the point of view
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In 2021, my friend brought a guitar to a psych ward, and, before my phone was confiscated, I recorded this Beyoncé cover secretly in the toilet.
I actually had not too bad a time, that admission. Before the guitar arrived, I entertained myself by cleaning / unblocking the
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@drjanaway
I disagree. The anger at psychiatry is based upon the widespread administration of drugs with severe and dangerous risk profiles, without gaining meaningful consent, or a balanced consideration of the consequences.
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@Lubchansky
Big 6!?!? But which planets do they omit? You might as well go all in and learn all the 7 classic planets and the rising sign it's only two more!
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@AlecStapp
It's all fun and games until they meet up with your health insurance provider in a dark alley somewhere and hand over data your Big Mac data in an unmarked envelope...
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@NotAnyUse
Something I've found in my life is that "no good deed goes unpunished" is frustratingly true.
To counteract this, I've taken to paying myself in little treats (or big ones) if I ever do something difficult or onerous for someone else that they may not notice or appreciate (or
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A great explanation of selection bias.
Why do some psychiatrists claim withdrawal issues and severe side effects are rare, when patients claim they are common?
The patients with those symptoms are not coming to you, because you don't acknowledge these conditions exist, or
And, many patients just stop going to their psychiatrists when they don’t get the help they need (and often find this help in patient communities), or they just stop going because they’re miserable without clear knowledge of why, so there is a selection bias: the patients that
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@drjanaway
Every time I see someone voicing criticism about psychiatric practices (which hardly have the most ethically sound history including forced lobotomy, insulin coma treatment and chemically and electrically induced seizures), I see doctors issuing the challenge "come and take over
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Neuroleptics supposedly act by binding to the dopamine receptors, disrupting the normal functioning of these circuits.
To compare mild akathisia / restlessness to severe akathisia is like comparing a blocked nose (uncomfortable but still possible to breathe as you have access
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@drjanaway
Apologies for the bluntness, but I think patients would be served better if you spent less time attacking Joanna and more time paying attention what she is saying.
I don't think it's a contentious point to argue that there are conflicts of interest that stem from the interaction
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This song was written for my friends and family who were there for me during a hard time.
I had being sectioned following a breakdown where I had jumped off a railway bridge, fracturing my spine.
In hospital I was then treated with a drug causing an extreme toxic reaction
This week's song of the week is a beautiful original by MIA Reader Daniel Neal.
#madluv
#madmusic
#musicheals
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Thank you so much
@markhoro
for doing this work.
It can't have been easy sticking your head above the parapet to produce these guidelines, but it adds a level of credibility and support to patients that need it where only ad-hoc and peer guidelines existed before.
Big love.
The Maudsley Deprescribing Guidelines is available in the UK , US , Australia Canada elsewhere around the world (also at other booksellers).
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To the biological psychiatrists:
Sometimes, a sincere apology can go a long way.
None of the psychiatrists responsible have apologized for almost killing me with neuroleptic drugs. I would probably not be here harping on about my experience if they had.
I'm a software
@drjanaway
@atomicaceso
The attitude you should have, if you are in the system, is (to your peers): “We need to do this. We have caused this problem. We have severely hurt these people. This is a tragedy & it’s our fault & our responsibility to stop causing more harm & to help those harmed already.”
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It's not about anti or pro psychiatry.
When any new understanding or invention appears there is an adoption curve, whether that's the internet, flat whites or the fact that lobotomy is a sadistic and useless invention.
For example with the discovery that psychiatric drugs have
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Remember the pain box from Dune?
#akathisia
is that but for your entire body
Pharmaceutical companies and some psychiatrists gloss over it it as an unfortunate side effect.
No - a side effect is something like nausea, sexual dysfunction, weight gain or temporary blindness.
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To say there is something wrong with the "dopamine system" in psychosis and treat it with neuroleptics is like saying when your computer crashes there is something wrong with the "electricity system" and treat it by de-rating the voltage or changing the mains supply frequency.
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As someone who has suffered many months severe akathisia it is incredibly disheartening to see articles like this being published.
I think the absolute first line, the default option the moment akathisia occurs has to be:
Halt the drug that is causing it.
Is it a good idea
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I asked my psychiatrist and CMHT practitioner about tapering strips today. They hadn't heard of them, but my practitioner immediately had in mind another patient who might benefit. They are going to speak with their pharmacist and get back to me.
I've tried cutting pills in the
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@HoratioClare
I had neuroleptic induced akathisia, from forced drugging by "antipsychotics" which was horrifying.
Some suggestions:
1. A diagnosis-free, drug-free pathway for those that choose it.
2. End coercive and forced treatment.
3. Tapering strips to be made widely available for
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The plural of anecdote is data.
The singular of burying data is lying.
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@RandomSprint
2 equations, 3 unknowns...
Nah.
Oh wait I misread, you only need their sum...
ahahaha I got it ;)
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People who say psychiatric drugs are beneficial like to say their use is supported by the "evidence" and "the science"
Is it a good idea to trust the "evidence" when it is prepared by organisations who pioneered a devastating new breed of pharmaceutical marketing, and convinced
This stunningly grim report.
@purduepharma
($9B), Johnson & Johnson ($8.4B),
@kline_glaxo
($7.9B) &
@pfizer
($7.8B) accounted
for nearly half of all fines. None came close to the profits reaped by these winners.
#PharmaCrime
continues to pay.
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It's sobering to read about this study about antidepressants that was buried, but it reflects my experience on antipsychotics - "benefits" that appear by selectively publishing the positive effects of random chance, and harms that are tragically real.
"Neither paroxetine nor
Study 329, Paxil and scientific fraud
Study 329 was a clinical trial conducted by GSK in the 1990s to study the efficacy of the antidepressant Paxil (paroxetine) for adolescents with major depressive disorder.
Unfortunately for GSK the results failed to show efficacy for the
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@upzone_CA
@Lufthee
I don't know about you, but I like to see more than 5 menu options at the same time, preferably on a large piece of paper that I can point at and say "this one please"
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@drjanaway
"Psychiatric inpatient units tend to be depressing, dysfunctional, chaotic, unsafe places using coercion, high dose polypharmacy and ECT. And telling people they have irreversible illnesses/chemical imbalances/inferior genes."
What part of this is nonsense?
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Even if you think those who suggest hyperbolic tapering have made errors in their science, at least they are trying their best to support patients who wish to discontinue their "medication", which is more than you can say for the rest of the field.
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@drjanaway
My experience on a PICU matches
@ReadReadj
's description.
Depressing:
- I was locked in the ward and was forbidden any access to the internal garden to get fresh air. My phone - my only means of contacting friends and family was - taken from me.
Dysfunctional:
- Despite
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I thought this was interesting.
In aggregate, about half of results of SSRI random trials were never published.
Which half do we think gets published?
And if half the trials are unpublished in the first instance, how confident are we in the veracity of the unpublished
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"All drugs have side-effects".
Yeah, so do all punches in the face.
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If the only evidence you're capable of making sense of is a pharma-funded RCT, you're not really capable of making sense of evidence.
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@drjanaway
@anonymeempathin
@GeorgeKirov1
@ReadReadj
It sounds like you think administering neuroleptics removes persecutory delusions and command hallucinations.
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Don't even get me started on ECT, where the only evidence that inducing seizures with electricity doesn't cause brain damage comes from papers published in the Journal of ECT, written by the makers of ECT machines.
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@justin_garson
Yes, when we shift our language away from verbs to one based on labels, we remove our agency and our understanding of cause and effect. It can lead to hopelessness "I am schizophrenic" vs "A stressful event led to me not sleeping for a week and I entered a waking nightmare"
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Saw this thread by a new outpatient psych, it's kind of encouraging.
We need more psychiatrists who are willing to do nothing, and (although not mentioned in this thread) responsibly deprescribe.
It's not your ability to prescribe risky drugs that is
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@DrPlantel
If when doctors hold other doctors accountable they risk being referred to regulators as an intimidation tactics, what makes you think patients have a chance of holding those who treated them negligently to account?
When doctors deny or don't recognize the dangerous side effects
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@Psychistential
Based on all the data? Or just the published data?
What happens If you take into account the fact only about 50% of the data is published, and that the remaining unpublished data is entirely negative?
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@jessitron
@heathercmiller
@zeeshanlakhani
Reminds me of some of your advice I really liked - rewrite your team’s code to help *your* mental model - then throw the rewrite away - to safeguard *theirs*
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In the end, the battle between legacy psychiatry and critical psychiatry will be won by whoever has the best merch.
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Is the campaign to reduce stigma around mental health anything more than a marketing funnel?
The so called mental health advocates want to identify people who need help. But after they are harmed, they couldn’t care less about them. They want to reduce the stigma, but they leave people on their own because of the stigma attached to being harmed by sacred antidepressants.
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In any situation, the person who is most comfortable is usually the person with the most information.
In the case of psychosis, this is typically not the patient, it's the psychiatrist, and the various staff.
In all my admissions, I've been interrogated, shuttled from
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@awaisaftab
We do not believe these ideas harder, out of spite.
We believe them because they are true. We have felt the effects of these compounds, and the horrors they can inflict with our own bodies.
Have you?
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For a little example on how these stories perpetuate, consider this article.
Headline: "Mirtazipine may be the best option for antipsychotic induced akathisia"
If you read into the article, you'll see the original quote is “I favor reducing
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@jill_d35
Indeed, it's time to stop calling critical, harmed patients "anti-psychiatry" and start calling psychiatrists who don't listen, wilfullly ignore the burial and misrepresentation of RCT data and push dangeours substances on people against their will "anti-patient".
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@OliNejad
How many hours a day do you have to spend pacing, screaming, or electrocuting yourself to handle the symptoms?
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@drjanaway
@DrDJWilde
@eliotmuir
@benzosarebad
@AndreaB63735256
@Fiddaman
@sash_andy
@eekymom
@jill_d35
@Pharmageddon24
@AntipsychiatryU
@_PSSD
@goslee_aaron
@BlackshepSusan
@Onbodyandsoul
@louieNebula
@_roseyesha
@CuntedCorpse
@DrBruceScott
@DrMcFillin
"I'm sorry you feel that way".
The classic non-apology.
It's a shame, I thought Ben was one of the good ones.
But it seems like when it comes down to it he's just another apologist for psychiatric violence.
Do we really need more of that?
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@Rebecca99LT
The anger is directed at the perpetrators of psychiatric violence who use the "just following the science" defense to avoid listening to their patients.
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@rcpsych
Are you going to continue to be silent on the extent and severity of iatrogenic harm from psychiatric drugs?
Are you going to continue to do nothing about the cyber bullying and hatred directed at harmed patients by your members?
Do you think it's appropriate to be celebrating
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How I think pro-pharmaceutical psychiatrists think about subjectivity
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@albertbrookdonj
Indeed. It's just a hypothesis about one single causal factor.
I was surprised to learn when talking to my mental health team that 70-80% of the cases they see are drug induced.
Obviously that's its own thing.
Just because the presenting symptoms of a situation may be the same
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Here's the thing about "anecdotal" evidence.
Imagine you have 3 urns.
- Urn A has 1 red ball, 99 white balls
- Urn B has 50 red balls, and 50 white balls
- Urn C has 99 red balls, and 1 white ball.
You draw a ball. It is red.
Which urn did it come from?
The "you're
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It shouldn't surprise you that interrupting neurotransmitter circuitry (often acetylcholine, but also dopamine is used as an effective poison)
e.g. see this on the use of dopamine antagonists as insecticides.
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@DrCarolJasper
Ah it's interesting that it comes across that we think that way, like we secretly believe there's a government plot haha. Or some high orchestration to deliberately harm patients.
I guess we can seem lunatics when we get agitated about being hurt and it's very easy to conceive
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@OliNejad
@ReadReadj
@drjanaway
Does having a different experience to you make it nonsense, in your opinion?
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Now for something a little different to my usual whingeing about the violent nature of psychiatric interventions!
Here's an exerpt from the soundcheck for a recent deep rest event we held at .
The aim of this section was to surround people with a
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I'm going to be honest,
@DailyMailUK
, surprised me with this one!
@HoratioClare
has, imho, knocked it out the park, and written a piece light years ahead of what other newspapers are willing to publish. They seem to be stuck in an timeloop regurgitating the pharmaceutical
I once thought I was working for aliens and engaged to Kylie. Now, I’ve learned the hard way that medication doesn’t cure mental illness — but one treatment really DOES work
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@LufcAndCrypto
@benzosarebad
@atomicaceso
@BadMedicalTakes
What makes a survey of patient experience less reliable than a pharma funded RCT?
Do you you automatically assign more credibility to the opinion of companies who stand to net billions from being creative with their statistics, than to the directly reported experience of people
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At
#euroclojure
today (thanks
@SocialSuperStr
). Loved this presentation about making notoriously hard bayesian analysis fast using the gpu
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The fact that the human body and mind can sometimes still function, orient itself and find meaning despite the presence of enormous disruption (like neurotransmitter disrupting neuroleptics) says little about whether these compounds are beneficial, and is instead a testament to
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@drjanaway
Do you enjoy insulting harmed patients for doing the legwork and reading necessary to understand the aetiology behind their condition when their psychiatrists have failed them?
Do you also enjoy insulting the work of your peers when they call out the flaws of what still passes
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@atomicaceso
@eliotmuir
Yeah, it seems like some folk think that questioning current psychiatric practice is an over-the-top reaction to nearly dying as a consequence of it.
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@awaisaftab
It seems like you believe that benefits of psychiatric drugs outweigh their harms.
To take an example I am painfully familiar with.
What incidence of akathisia do you base your beliefs on?
How severe a harm do you consider it?
And how many people would you willingly
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If you told me that the "antipsychotic" drugs were actually never intended for use, but were toxic byproducts from the synthesis of other, useful compounds (like dyes) I would say "don't be stupid".
If you told me that "antipsychotic drugs" had no useful mechanism of action and
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@Adeleart3
This is so true. I don't know about you, but I've learned that hiding symptoms is the only way out of some very dangerous spaces.
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@eliotmuir
@BipolarBattle
As someone under the banner of antipsych, whether I like it or not, it is mainly the force, the lack of consent, and the systematic overstating of benefits and denial of risks that I wish would change most.
If you come to an informed decision to use drugs to help manage your
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@sanilrege
I'm sorry Sanil, it looks like you're attacking fellow psychistrists who are doing important work in reducing patient harm.
Is that helpful?
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@eliotmuir
This may be a suitable image for the nature of intervention antipsychiatry stands against.
We should also aspire to get the Nobel Prize(!) for inventing the lobotomy retroactively removed from its inventor Antonio Moniz.
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@mattmight
Your story and journey is such an inspiration. I've been an admirer of your work since I saw the "War on Error" talk. Your essay about grief inspired me to write this song, dedicated to you and your family
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@DrCarolJasper
It sounds like you want to reduce patient harm and stigma caused by groupthink.
I appreciate that, and share this desire.
Thank you for your kindness and consideration of patients wellbeing :)
If you don't mind - I'll sum up what I understand to be your point of view.
I
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@atomicaceso
@RealDoctorMike
@jonathanstea
Worse - posychiatry does it under the guise of "we're doing this to you for your own good"
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Boosting this thread for visibility.
My experience with neuroleptics was awful as a white man - I can't imagine how much more severe it could feel if you are being treated without consent and racism, misogyny and class hatred (or all three) are also present.
So for those who say don't bring race into this, it isn't about race, you couldn't be more wrong. At its roots biomedical psychiatry is all about racism, misogyny and class hate. It's about social control. So having Black voices lead its dismantling makes complete sense.
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As someone who is critical of psychiatry, you might think of me as anti-science.
The reverse is true!
Here are 5 scientists (+ 1 bonus!) that that fill me with hope
1. Matt Might
@mattmight
Transitioned from Computer Science (where he was already a pioneer in proving the
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@Deedoherty2
When I had akathisia and an extreme pain with no known name (an unlisted side effect of olanzapine), I was asking my doctor if there was a way I could get euthanasia. I couldn't imagine tolerating that situation for a lifetime. Luckily after 9 months, they stopped the 'treatment'
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@DrCarolJasper
Do you think patients are actively conspiring, or that conspirational thinking is an unconscious phenomenon based on a shared group identity?
Is it true that only harmed patients think incorrectly?
Is the psychiatric discipline is free of such cognitive biases?
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How do you debate in good faith when they start by calling you a conspiracy theorist, then a sealion (a kind of troll), then call your attempts at understanding and summarising "misrepresentation", then demand evidence, then, when evidence is provided, challenge you on whether
@DanielNeal2
@ali1569939
@atomicaceso
Thus demonstrating you are not prepared to debate in good faith.
Have a nice day Daniel. I hope you find all you seek elsewhere.
Muted.
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@ChrisSheltonMsc
@_eleven13_
@cchruk
It sounds like you think that passing sufficient current through people's brains to artificially induce a seizure is good science.
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@psychharm
Yes it's incomprehensible to people who have not experienced it the kind of toxic load that these neurotransmitter disruptors can put on our bodies. This meme comes to mind.
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@PloederlM
Yeah, it's a grim metaphor, right?
Let's immerse rats in beakers of water from where escape is not possible, and then try and find a drug that makes them keep swimming anyway.
Say they find a compound that does - is that a good thing?
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@KimberlyKonzal
Indeed. And then the "treatment" which does interfere with neuotransmitters does cause mass physiological dysfunction (akathisia).
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@KingFranklinIV
Jesus! 3 antipsychotics and 2 antidepressants. How does it get to trust point? What are you supposed to do in that situation?
Sounds like going to work on someone's electrics and seeing someone has replaced the fuse box with a cabinet full of snakes.
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@DrCarolJasper
Did I get everything else in my summary of your viewpoint right, and it's only my incorrect use of the term "groupthink" that you object to?
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@DrPinyaPlomer
@BlackshepSusan
@DrDJWilde
@benzosarebad
@AndreaB63735256
@sash_andy
@Pharmageddon24
@atomicaceso
@jill_d35
@eliotmuir
I'm sorry Jaume, it sounds like you are trying to use diagnosis as a weapon.
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@saffronkulfi1
@iam_emilyanne
Any time when patients are most vulnerable, and need the most support, but the chemicals are responsible, there is a tendency to dismiss and invalidate.
I think because it presents a disconnect between reality and the overwhelmingly positive emotional associations for
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@atomicaceso
@eliotmuir
Indeed - it's easy for those of us who have nearly been killed or suffered greatly at its hands to see psychiatry as nothing but the enemy, and want nothing to do with it.
On top of the physical harm we have suffered, it seems we also have to be ignored, discredited and
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@markhoro
The best choice regarding psychiatric drugs is not to start, but the second best choice is a hyperbolic taper.
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@eliotmuir
@atomicaceso
I like the idea of leaving psychiatry in its current manifestation behind, but I doubt it will catch on.
What are all the psychiatrists and psychiatric wards supposed to do if only neurology and psychology remain?
What would happen to all the patients?
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