Dr. Stanley Goldstein - Author and Psychologist

"'Girls, Take Your Crazy Pills!' Antidepressants Recast as a Hot Lifestyle Accessory' - Today's welcome article in The Wall Street Journal details the significant financial efforts by drug companies to market their psychotropic drugs, magnify their potential benefit, and conceal their devastating side-effects. But we shouldn't blame drug companies alone since understanding of such normal human experiences as anxiety and depression and grief are sorely lacking, as is accurate knowledge of child psychological development by doctors and the general public.

All medications have side effects. A good rule is that if the potential side-effects greatly exceed the potential benefits you don't want to take it. If the potential side-effects are equal to the potential benefits you want to think twice, and if the potential benefits greatly exceed the potential side-effects, and in a true emergency situation, you want to take it.

 

Two stories: long ago a psychiatrist co-worker at an adolescent in-patient setting which rarely used medication told me a story. As an experiment, during his psychiatry training, he took a small dosage of a psychotropic drug. The effect was so profound that he was exceedingly cautious about prescribing them thereafter. At that same setting the physician father of a patient refused to have a psychotropic be prescribed his teenager saying adamantly, "They're chemical lobotomies." Which is what they are.

 

An article in The Wall Street Journal ("We Are Turning Too Many People Into Medical Patients. The swift rise in in diagnoses for everything from autism to ADHD may be doing more harm than good./March 17, 2025) aroused these thoughts.
Long ignored ignorance about child psychological development and developmental psychopathology (a term coined long ago by my doctoral advisor) enables much faulty medical diagnosis, as is decried in the Wall Street Journal article. Several factors have contributed to this.
1. Anxiety can mimic just about every physical symptom: feelings of warmth or cold; feeling faint; headache; stomach pain, elevated blood pressure and check pain; even visual symptoms in an optic migraine. Distinguishing the true medical concern from symptoms of heightened anxiety requires training which the typical physician lacks.
2. Autism is vastly misdiagnosed with some children's autistic features vanishing after brief play psychotherapy.
3. ADHD, Attention-Deficit Hyperactivity Disorder, though enabling a lucrative treatment industry, is perhaps the most unsophisticated notion in medical history. First diagnosed by a seventeenth-century English physician as "mental restlessness," it took root in early nineteen-hundreds America as Minimal Brain Dysfunction, of which a Harvard psychiatrist remarked that any doctor affixing this diagnosis must have a minimal brain dysfunction. Its symptoms are identical with anxiety and depression, which are present in nearly all medical and psychological difficulties and school difficulties too..
4. Another diagnostic error is affixing the diagnosis of Bi-Polar Disorder to children. It is difficult to speak calmly of the degree of this error since the Bi-Polar Disorder diagnosis requires a fixed, adult personality which youth lack by definition.
5. The treatment for these misdiagnoses is usually one or more of the psychotropic medications, long articles of their misuse having been recently published both in The Wall Street Journal and The New York Times. A rarely acknowledged reason for this is that today's psychiatry residents receive only ten-percent of the training in psychotherapy they received seventy-years ago, fostering the belief that the treatment of choice for any of life's ille is a drug.
Truly, ignorance abounds. Nuff said.

A moving article in The Wall Street Journal ("Generation Xanax: The Dark Side of America's Wonder Drug"/March 13, 2025) aroused these thoughts. Myths such as such the unsophisticated etiologies of "chemical imbalance" and Attention Deficit Hyperactivity Disorder (ADHD) have long troubled the mental health field. The latter has diagnostic symptoms which are identical to the anxiety and depression associated with nearly all medical and behavioral disorders. While a hospital administrator, when I spoke to the Director of Psychiatry about the side-effects of psychotropic medications he angrily stormed, "There are no side-effects!" And he was not a stupid man, one of his degrees being from Cambridge University. Myths that reduce income tend to have long lives.

 

That psychotropic medications can have crippling physical and mental side-effects tends to be ignored and the Wall Street Journal asrticle does a worthy service, describing the disabling psychological and neurological symptoms and even suicide of users. What's eqally troubling was another article describing the current push of several drug companies to create and market drugs which allegedly "cure" schizophrenia and Bi-Polar Disorder though their psychological etiology has been understood for decades except, of course, by those who don't want to know. Abetted in these quests are many present-day psychiatrists, which is understandable since today's psychiatry residents receive only 10% of the training in psychotherapy that residents gained sixty-years ago.

 

A large study fifty-years ago found that, of previously severely disturbed hospitalized psychiatric patients, the most favorable outcome post-discharge was those who received no medication with the highest rate of recidivism being with patients who were prescribed medication while hospitalized and after discharge, with former patients who were prescribed medication while hospitalized but not after discharge having an in-between recidivism rate.

To paraphrase the sixteenth-century proverb of the English writer, John Heywood, there are none so blind as those who refuse to see.

Depression is the "depressing" of feelings and reflects: (1) conflict about an issue, the person being torn between choices; or (2)having been unable to reach their parents emotionally when young and later tending to give up on important goals, believing they will fail again; or (3) the sense of having deep problems; or (4) a combination of  Read More