Self-help guru and democratic presidential candidate Marianne Williamson had a break-out moment at the recent CNN Democratic debate when she cut through the mind-numbing discussion about Medicare for All. In her moment she reminded us that the 2020 presidential election is something completely different than the usual choice between policies and political personalities; instead, it is a battle for the American soul, as consequential perhaps as the 1860 pre-Civil War election of Abraham Lincoln. What has been lost or at least drowned out in the Democratic presidential debates to date is that the target should not be on the Obama Administration’s policies — which on its worst day was far better than the Trump Administration’s best day — but on the current White House incumbent. According to Williamson, Trump poses an existential threat not only to our democratic values, but also America’s moral infrastructure and collective psychic well-being. As Williamson put it at the CNN debate:
If you think any of this wonkiness is going to deal with this dark psychic force of the collectivized hatred that this president is bringing up in this country, then I’m afraid that the Democrats are going to see some very dark days.
The audience responded with thunderous applause to Williamson, who also reminded us that “when we’re talking about health care … we need to realize we have a sickness care, rather than a health care system. We need to be the party talking about why so many of our chemical policies and our food policies and our agricultural policies and our environmental policies and even our economic policies are leading to people getting sick, to begin with.”
Following the debate, the internet practically exploded with viewer interest in Williamson and her views. Google trends showed that she appeared in the most searches after the debate in 49 of the 50 states. This increased interest immediately led to a mad scramble by mainstream journalists and opinion writers to try to drive a stake through the heart of Williamson’s quixotic campaign before it gained any more traction. Articles such as that by Brian Boyle of the LA Times predicting that “we’re all probably doomed” if Williamson were to succeed in her quest to drive Trump’s “dark psychic forces” from the White House.
On Thursday night, August 1st, CNN’s Anderson Cooper had Williamson on his show in what could have been a very informative discussion on the massive over-prescription of antidepressants in the United States, possibly the most severe drug crisis facing the country today – with the possible exception of the opioid crisis. Instead, Cooper seemed intent on totally trashing Williamson’s legitimate message regarding the dangers of overuse of antidepressant and psychotropic prescription medications by focusing on one or two ill-advised statements that Williamson had regretted making in the past, including a reference to clinical depression as a “scam” and a statement referring to antidepressants as merely “numbing our pain.” Cooper also dredged up her promotion of an article on the death of Robin Williams that had been written by an arm of the Church of Scientology, which, strongly opposed psychiatry in general and almost all medications in particular. However, what Williamson was agreeing with in the article was the relatively non-controversial position that antidepressants are “helpful for some, but harmful for others.”
To be sure, Cooper started the segment by noting that Williamson has been outspoken regarding the “legitimate” issues of over-prescription of antidepressants, the aggressive marketing by pharmaceutical companies, and their potential harmful side effects. However, he then spent the balance of the segment, taking Williamson to task for arguably suggesting that antidepressants may cause harm by “numbing” or “masking” emotions. Williamson denied promoting that message, but did articulate her core message that too many doctors are treating the “normal spectrum of human despair” with antidepressants, adding that, in her view, “We have lost our sense that there are times when sadness is part of life.”
Instead of blindly attacking and dismissing Williamson’s views as “kooky” or so outside the mainstream that they should not be taken seriously, it should be noted that there is growing recognition in the psychology and psychiatric fields that psychotherapists and other mental health professionals have been far too quick to view patients from a purely psychopharmacological perspective. Powerful antidepressants and psychotropic medications are often prescribed far too quickly, without a proper diagnosis and without taking into full consideration the potential dangerous negative side effects and addictive qualities of such medicines.
In 2002, researchers at the Rand Corp. surveyed close to 700 adults who were taking antidepressants, but fewer than 20% had tested positive when screened for clinical depression, and fewer than 30% of those receiving medication had any symptoms of depression at all. Put another way, more than 70% of patients in the survey presented no medical need for antidepressant treatment, and an additional 10% had insufficient symptoms to warrant the American Psychiatric Association’s official DSM diagnosis of depression.
In June 2012, an article in the American Psychological Association noted that a study by the Center for Disease Control and Prevention (CDC) found that “patients often receive psychotropic medications without being evaluated by mental health professionals,” and that that many Americans are being prescribed powerful antidepressants and other medications without a proper diagnosis. Often these patients are unaware of other non-drug treatments, such as cognitive behavioral therapy, that might work better for them without the risk of dangerous side effects. In 2016, the prestigious Journal of the American Medical Association (JAMA) published a study based on a review of 100,000 prescriptions for antidepressants written by about 160 doctors for 20,000 people.
A growing number of therapists who are either not licensed to prescribe medications or choose not to prescribe medications for many of their patients believe that non-drug related therapy (Dialectical Behavior Therapy (DBT) or “talk therapy” as it is often referred to) is the most effective and least dangerous tool to provide treatment to their patients. There are also many members of the clergy or spiritual healers, such as Williamson, who offer counseling and therapeutic services to individuals who are not taking antidepressants or psychotropic medications. However, these “non-drug” therapists are the exception, rather than the rule, and, as Williamson stated in the CNN interview, “We’re living in a society now where somebody is going through just a normal breakup, and somebody says, ‘You should be on something.’”
As Anderson Cooper repeatedly pointed out, a patient who has been appropriately diagnosed with clinical depression may well benefit from a proper prescription of antidepressant medication as long as he or she is closely monitored by a qualified physician or other mental health professional. However, as multiple studies have shown, antidepressants and psychotropic medications are being over-prescribed for thousands – if not tens of thousands – of patients who have not been properly tested and diagnosed with depression, often with disastrous results.
In one medical malpractice case that I handled for the family of their deceased son, the young man of college age was prescribed nearly two dozen antidepressant and psychotropic medications, even though the medical providers who were prescribing these medications to him never conducted any psychological testing to determine whether, in fact, he was clinically depressed. It was later discovered through a comprehensive battery of psychological testing; he did not have any mental problems but, rather, may have had some organic and neurocognitive problem related to a bout with Lyme’s Disease that he suffered from as a young child. In other words, the massive doses and chemical cocktails that he was forced to take during several hospitalizations were wholly inappropriate and unnecessary, and caused classic side-effects, such as extreme agitation and severe akathisia (literally, inability to sit), extreme mental anguish, self-violence, suicidal ideations and, eventually, attempted suicide.
Two of the drugs the patient was required to take – Celexa and Zoloft – carried “black box warning” on its label as required by the FDA. This warning cautioned that, based upon various studies, the drugs may increase suicidal thoughts and behaviors in children and adolescents (under 25). Nevertheless, the medical providers insisted that the young man continue to take these and other prescription medications with dangerous side effects. When the patient began making progress with a therapist who specialized in DBT “talk” therapy that did not rely upon any prescription medications, the other doctors who were prescribing the antidepressants for him ordered that such drug-free therapy cease since it was supposedly interfering with his pharmacologically-based treatment.
Eventually, the young man’s downward spiral resulted in him dousing himself with gasoline and lighting himself on fire, resulting in severe burns over 90% of his body. He lingered near death for six months in a hospital ward before he eventually died.
Tragically, this case that I worked on is not an isolated incident, and although some of Marianne Williamson’s rhetoric on the subject of the overuse of prescription medications is undoubtedly “over the top,” the topic deserves much more public attention and debate, since it is a crisis throughout our country as real as the opioid epidemic.
Kenneth F. McCallion is a former federal prosecutor and principal attorney with McCallion & Associates LLP, a law firm specializing in human rights and medical malpractice cases involving the inappropriate and overuse of antidepressant and psychotropic prescription medications.