I wish I could say that for the past few weeks nothing happened here on this blog because I was away on a wonderful vacation in sunny France. The truth, I’m afraid, is that I’ve been far too depressed to write a single word. Luckily, I’m recovering now.
So how to celebrate my return to the land of the living?
Well, to go a little easy on myself, here is another image from my collection of old pharmaceutical advertisements. Showing how in the good old days, pharmaceutical companies tried to convince psychiatrists of the magical qualities of their newly-invented medicines.
Often, what strikes us today in these old ads is that they demonstrated little respect for the patients for whom the medication was intended. In many cases, these ads tried to visualize mental illness in ways that we nowadays would find crude or even disturbing. For another example, see the Nembutal ad here.
Below is a circa 1960 advertisement for Thorazine (American brand name; known in Europe as Largactil). Based on chlorpromazine hydrochloride, it was introduced in the 1950s as a calming antipsychotic drug and quickly became very popular. Psychiatrists were happy to prescribe it to patients with psychotic tendencies.
I will let the ad speak for itself:
With this frightening ad, the people of “Smith Kline & French Laboratories, leaders in psychopharmaceutical research”, wanted to show what they thought psychosis did look like.
Shall we try to find a musical equivalent? How would it sound?
Maybe the Finnish rock band Poets of the Fall has something that comes close to an answer. If you want to know more about them and hear more of their fascinating music, please go to their official Poets of the Fall website.
This is just their song Psychosis from their 2008 album Revolution Roulette – and if you feel inclined to complain that it doesn’t sound soft and sweet, the answer is of course that this really shouldn’t sound soft and sweet:
(click the “Play” button – if it does not work, install Flash)
Please don’t worry. This is not going to be some kind of dumb rant against pills or the pharmaceutical industry. I just want to show you how what was considered normal in psychiatric health care 50 years ago, is seen a very different light by us today.
And by implication, how what we now think is normal, may be considered weird 50 years from now.
Frankly – Frankensteinly – I think those people in the future will find this way of treating children just as unbelievable and weird, as we find this old Nembutal advertisement.
This portrait here is not Emily Autumn, who is filling the rest of this post.
Last week there’s been a lot of hubbub about the background and contents of the upcoming DSM-V, the successor to the 
The new DSM is being prepared by several topical 
Some examples: for the Psychotic Disorders Work Group this is 80% (8 out of 10); for the Mood Disorders Work Group and the Anxiety Disorders Work Group this is 56% (for both, 5 out of 9). All major pharmaceutical companies, such as Abbot Laboratories, Astra-Zeneca, Avera, Bristol-Myers Squibb, Forest, GlaxoSmithKline, GSK, Janssen-Cilag, JDS Pharmaceuticals, Johnson & Johnson, Lilly, Novartis, Pfizer, Wyeth, are paying several of these people.
Suppose your city has installed an Urban Transportation Work Group of experts tasked with writing new guidelines and directives for the city’s traffic and transportation policy for the next ten years. Now suppose that most members of this Urban Transportation Work Group have direct financial ties with Ford, GM, Chrysler, BMW, Mercedes, Audi, VW, Toyota, Nissan, Honda and also with major road building companies. Would you be surprised if your city will adopt a policy of planning just more new highways and parking lots, instead of giving public transport alternatives a fair consideration too?
My view is that governments and universities themselves should enforce a much more strict legal line here. Either you work as researcher for a company (nothing wrong with that, in itself) or you work as an independent academic researcher for a university. In the latter case, you simply should not be allowed to accept direct commercial grants. The two positions ought to be kept strictly separated. Not combined and mixed up in the shady, non-transparent way that is contaminating much of today’s psychiatric research.
Of course depression has always interested doctors – in fact, since the earliest times. In the 1st century AD, the prominent Greek physician 
But I digress. The real process of “illnifying” depression began much later, in the second half of the 19th century. It has accelerated significantly since about 1900. Gradually, pharmacists, psychiatrists and hospitals discovered that there was big business in treating common mental health problems – including depression.
The question that arises here is, haven’t we pushed the borders far enough by now? Aren’t we beginning to overdo it?
Maybe that’s where we should draw the border line between illness and non-illness again. And, resisting commercial impulses, stop further illnification.
They also remind me of the old philosophers who, in the tradition of 17th century philosopher René Descartes (above), tried to understand and analyze and chart the human body and brain as some kind of complicated machine, with virtual cogs and wheels. Most philosophers have since long abandoned such a limited view, but some psychiatrists still seem to adhere to it.
The most extreme example of Steampunk Psychiatry is of course ECT (electroshock therapy). What this amounts to, it is like taking your grandfather’s broken old pocket watch, and shaking it violently in the hope it will start running again. Actually this can work in a few cases. When I got ECT myself several years ago, perhaps it did help me a little. But it may cause only more damage just as well. (Let me prevent misunderstandings: this image here does not show ECT. It’s more Steampunk…)
This tDCS can be considered a milder, more modern form of ECT. Unlike ECT, it is not based on the effect of electricity-induced convulsions: rather, it uses the effects of electricity itself. It involves stimulating specific parts of the brain with currents that are weak enough to make anesthesia unnecessary. As you can see here, tDCS equipment almost looks like iPod earplugs put in the wrong places. This is Steampunk Psychiatry taken to a new level of hi-tech.
To mention a few. My present network of friends may be too small for my emotional needs. I also face unexpected financial problems (an old mortgage loan I’m saddled with, has suddenly changed into a burden). For practical reasons, I’m also not happy with the place where I live today. And exactly because I had been getting better last year, I’ve now begun to miss the rewarding challenges of the university job I had to give up because of my depressions eight years ago. Also, I’ve still not been able to cut short my smoking habit, even though I know very well (cough, cough) that I really ought to quit smoking. Need I go on?
Other psychiatrists, all those who have locked up themselves in different theoretical cages, often from their own perspectives make the same kind of mistake. The mistake of limitedness. The mistake of not looking beyond their own walls-of-theory, the cells that happen to confine them. This makes them too partial, too one-sided. Seeking the definitive solution in changing external circumstances. Or in adjusting the patient’s habits. In reprogramming emotional reactions. In furthering self-insight. You name it.
What I would like, is for psychiatrists to come out of their limited theoretical cells and for once take a look at the rest of the world. I would like them to stop viewing their otherwise oriented colleagues as marginal idiots, and to finally begin to work all together – systematically – to create a more integrated perspective on fighting depression. To recognize that each one of them, from the Steampunk tinkerer to the Freudian listener to the Socio-counselor to the Mindful type, may be a little bit right. And, sometimes, a little bit wrong.
May 25, 1965 –
