Why is a Pratfall Funny?

Pratfall:
–a fall on to one’s buttocks
–a staged tumble, often onto one’s buttocks, for comedic effect
–a stupid and humiliating action
[Etymology: A compound word, combining “prat,” slang for “buttocks,” and “fall”.]

Why do we laugh at a pratfall? Why do we laugh at someone’s misfortune? More generally, why do we laugh at all?

These may all have different reasons, they may all stem from the same general considerations, or they may have no reason at all.

Psychiatry and psychology, not to be left out of any discussion that may produce a new patient or treatment, have their own contributions. Here is one: The Pratfall Effect is a theory developed by psychologist Elliot Aronson in 1966, and according to the theory one can become more appealing or likeable by admitting or demonstrating one’s own flaws [“the attractiveness of a superior person is enhanced if he commits a clumsy blunder; the same blunder tends to decrease the attractiveness of a mediocre person.”]

To be sure, these dubious conclusions were made from observing only 48 male sophomores recruited from an introductory psychology course at the University of Minnesota.

But it does not answer the question “why is it funny?”

Psychiatry does pose this question, but gets lost in the complexities of neurobiological psychiatry. By ascribing it all to the brain and various chemical neurotransmitters, psychiatry loses its way.

Here are some good observations. The visible sign of these is often laughter.

1. Humor may arise from the sudden perception of something that defies our expectations. In other words, the rejection of something incongruous or illogical. This depends upon an individual’s ability to differentiate and to see and reject situations which do not fit. The individual is surprised into rejecting.

2. Humor may arise from the release of nervous energy or painful emotional tension. This relief is actually rejection as well, since the person has now found out the truth of some situation or consideration and is rejecting the falsity under which they were previously laboring.

3. Humor may arise from the perceived flaws or misfortunes of others. In this case, however, the laughter expresses antagonism or other lower-toned emotions such as fear, and may be disparaging of others. In other words, not really funny. A person exhibiting this kind of “humor” is unable to differentiate; they identify things as the same which are really not the same, and reject things that may be restimulative.

The tendency of psychiatry to say “it’s all in the brain” unfortunately leads to the use of harmful drugs for treating any perceived impairments in one’s sense of humor, such as when one’s emotional responses do not align with the social context. Ultimately these conclusions come from psychiatric observations of people with a physically damaged brain or nervous system. Diagnoses of autism, for example, may follow from neurological dysfunction.

Psychiatry has a tendency to needlessly complicate the simplicity of humor and laughter, with extensive characterizations of humor styles, stress hormones, brain injuries, mental disorders, the ethics of using humor in psychiatric or psychological counseling, endless speculation about how to measure humor in a clinical setting, differences in humor due to some imagined difference in social, racial, genetic, age, or other category; so they can call their treatments “evidence-based.”

Let’s just make it quite simple. Laugh until you can enjoy a laugh without any reason whatsoever.

Support CCHR STL’s mission to expose and eradicate violations of human rights by the field of psychiatry by making a tax deductible donation. CCHR STL is a non-profit 501(c)(3) organization.

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Missouri Unnecessarily Institutionalizes Adults with Mental Health Disabilities

On June 18, 2024, the U.S. Department of Justice (DOJ) Civil Rights Division sent a letter to the Missouri Attorney General’s Office regarding the completion of its investigation into whether the State of Missouri unnecessarily institutionalizes adults with mental health disabilities in nursing facilities.

The DOJ investigation concluded that the State of Missouri violates Title II of the Americans with Disabilities Act (ADA) by failing to provide services to adults with mental health disabilities in the most integrated setting appropriate to their needs.

Missouri was warned that if an appropriate resolution was not forthcoming, a lawsuit would be the result.

Copied on the letter were the Governor, the Department of Mental Health, the Department of Social Services, and the Department of Health & Senior Services.

Here are some salient quotes from the investigation:

“Almost uniformly, adults with mental health disabilities in Missouri’s nursing facilities do not want to live in these institutions.”

“We found that almost none of the adults with mental health disabilities living in nursing facilities in Missouri need to be in these institutions.”

“Involuntarily committing a person to a psychiatric hospital is a severe restriction of their liberty. … In contrast, people under guardianship can have their liberty restricted in almost the same manner—by being locked in a nursing facility and forced to take medication against their will—indefinitely.”

“Missouri fails to connect adults cycling in and out of psychiatric hospitals with community-based mental health services, including services proven to work for individuals skeptical of or resistant to care.”

“Because of deficiencies in its community-based service array and the manner in which the State administers its adult mental health system, the State relies on segregated settings to serve adults with mental health disabilities who could be served in their homes and communities.”

Coercive Psychiatric Mental Health Care

This investigation points up the coercive nature of psychiatric mental health care, particularly in Missouri. There is an urgent need worldwide for a shift away from coercive psychiatric treatments.

Overmedication and coercive psychiatric practices—such as forced drugging, institutionalization without consent, and diagnostic overreach—are gaining increasing public attention. Especially concerning is how these practices affect marginalized groups and how they are justified in the name of “mental health care.”

Even more disturbing is how this coercion becomes routine. People are prescribed harmful and often addictive psychiatric drugs not because it’s proven to help them recover, but because it makes them easier to manage.

Governments like the state of Missouri enable and legitimize these actions, often without any real oversight or accountability, in this case leaving the U.S. Department of Justice to enforce corrective measures.

Guidance issued jointly in 2023 by the World Health Organization (WHO) and the United Nations Office of the High Commissioner for Human Rights (OHCHR) lays out steps towards ending coercive practices and “establishing mental health services that are respectful of human dignity and comply with international human rights norms and standards.”

Let’s stop pretending that coercion is care. Let’s start listening.

Have you or someone you love been impacted by overmedication or coercive psychiatric practices? Report your experience here.

Your mental health, and the mental health of your family, friends and associates, can be questioned by just about anyone. If this makes you uncomfortable, execute a Living Will (Letter of Protection from Psychiatric Incarceration and/or Treatment).

Contact your State or other Government Representatives and let them know what you think. In Missouri go here, and email a copy to the U.S. Department of Justice.

Help us investigate and expose psychiatric violations of human rights. Make a tax deductible donation to CCHR St. Louis.

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St. Louis Area Psychiatrists Sentenced for Health Crimes

In 2005 an investigation of the Malik family of psychiatrists in the Greater St. Louis Metropolitan area revealed that they were the top fraud violators of the psychiatric profession in the St. Louis area.

Dr. Mohd Azfar Malik, 71, pleaded guilty in April 2025 to making false statements related to health care matters.

Dr. Asim Muhammad Ali, 54, an internal medical specialist working for Malik, also pleaded guilty to illegally distributing controlled substances (ketamine) and several other crimes.

They have now both been sentenced for their crimes.

Malik was sentenced in August 2025 to five years of probation, fined $20,000, and ordered to pay $19,442 in restitution.

Ali was sentenced in September 2025 to 70 months in prison and ordered to pay $1,846,818.

If you know someone who has been abused by psychiatry, encourage them to file a complaint here.

Help us investigate and expose psychiatric violations of human rights. Make a tax deductible donation to CCHR St. Louis.

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CCHR International Executives Address United Nations in Geneva— Calling for Global Ban on Coercive Psychiatry

Dear Supporters,

I wanted to share an important step forward in our fight to end coercive psychiatric practices worldwide. I recently returned from a landmark visit to the United Nations in Geneva — the UN’s main center for human rights — where I had the honor of testifying before the Committee for the Convention on the Rights of Persons with Disabilities (CRPD). This UN committee makes sure governments are in compliance with the Convention, which is a global agreement that protects the rights of people with disabilities, including those impacted by mental health practices. 

The Convention guarantees basic rights such as personal autonomy, informed consent, and freedom from forced institutionalization and treatment. If governments fully honored these protections, there would be no legal or ethical justification for coercive psychiatric treatment or detention. 

Together with our Executive Director, Fran Andrews, we presented evidence against harmful practices such as forced institutionalization, electroshock, and psychiatric drugging, including their use on children.

This testimony both affirmed our decades of work exposing psychiatric abuse and also how we achieved reforms worldwide—including securing bans on electroshock and psychosurgery for minors.

It was evident from our presentation that there is an urgent need for a global shift away from coercive psychiatric treatments. The CRPD Committee has long been committed to ending such practices, and their response to our evidence was encouraging.  

This visit marked the beginning of a larger, coordinated international campaign led by CCHR International. We are now preparing for further actions at the UN. 

The fight is far from over, and our success depends upon continued advocacy and support from individuals like you. Together, we can help shine a light on the abuses occurring in mental health institutions around the world and work towards real change. 

To make this vision a reality, we count on your continued support. The actions we are undertaking require significant resources to maintain momentum and expand our global outreach. Please consider donating today, so that we can press forward with the next steps of our campaign to eradicate psychiatric coercion and abuse.

With your partnership, we can achieve a future where all individuals have the right to live free from psychiatric abuse and forced treatment. 

Thank you for your unwavering commitment to human rights and the protection of vulnerable individuals everywhere.

Sincerely,

Jan Eastgate, President CCHR International

Make a donation to CCHR International.

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Psychiatric Corruption of Our Judicial System

“The introduction of psychiatric considerations into the administration of the criminal law – for example, the insanity plea and verdict, diagnoses of mental incompetence to stand trial, and so forth – corrupt the law and victimize the subject on whose behalf they are ostensibly employed.” [Thomas Szasz, late Professor of Psychiatry Emeritus, in his book The Myth of Mental Illness]

Have you ever thought that a particular court case was frivolous and should just be thrown out of court without any further consideration? I have; and it got me thinking about what exactly is the purpose of the Judicial system.

Constitutionally, the Judicial system is laid out in the very short six paragraphs of Article III of the U.S. Constitution. It is rather specific about what cases shall be referred to a court; I suggest you read it to find out exactly what a court should be able to adjudicate.

Practically, the Judicial system acts as a check and balance against the other two branches of the government, the Legislative and Executive branches.

A check or balance against what? Basically, against controversies or crimes.

I can think of these two main purposes for a court case. 

One purpose is to settle disputes arising from ambiguities in the Constitution, or in the actions and decisions of the Executive, Legislative or Judicial branches of the government, or between individuals or other legal entities.

One purpose is to provide Justice for perceived wrongdoing, serving as a means of establishing guilt or innocence and awarding damages to an injured party.

Generally, the popular view of a court case is to enforce civil or criminal laws.

When used for revenge or for securing advantages, Justice is misused.

[Etymology of “Justice”: Middle English, from Anglo-French justise, from Latin justitia, from justus, “just, upright, righteous, honorable”.]

The Psychiatric Influence

When psychiatry entered the justice and penal systems, it did so under the subterfuge that it understood Man, that it knew not only what made Man act as he did, but that it knew how to improve his lot. This was a lie. Psychiatry has had opportunity to prove itself. The experiment has been a miserable failure.

There is a hidden influence in our courts, one which, while loudly asserting its expertise and desire to help, has instead betrayed our most deeply held values and brought us a burgeoning prison population at soaring public costs. That influence is psychiatry and psychology.

In 1946, Canadian Psychiatrist G. Brock Chisholm [a co-founder of the World Federation for Mental Health and the first Secretary General of the United Nations’ World Health Organization] proclaimed the psychiatric intention to infiltrate the field of the law and bring about the “re–interpretation and eventually eradication of the concept of right and wrong.”

And they did, with the consequence that today, because of their influence, the system is failing. Now it is up to the many conscientious, hardworking and increasingly disheartened people within the system to realize this and rid it of these destructive intruders.

The psychiatric “insanity defense” and its derivatives have done the most damage. The psychiatric industry jumping on the “not guilty by reason of insanity” (NGRI) bandwagon has lead to a massive erosion of public confidence in the justice system’s ability to mete out swift and equitable justice.

“Not Guilty by Reason of Insanity” is defined in the Missouri Revised Statutes Chapter 552 Section 30 as “A person is not responsible for criminal conduct if, at the time of such conduct, as a result of mental disease or defect such person was incapable of knowing and appreciating the nature, quality, or wrongfulness of such person’s conduct.”

Although the insanity defense is introduced in less than 2% of all criminal trials, it is one of the most controversial and hotly debated issues in American and British criminal law.

It all started in 1812, when psychiatrist Benjamin Rush claimed that crime was a mental disease, curable by psychiatry.

Once there was the idea that a person is responsible for his own actions. How is it that we face the absurd situation of psychiatrists testifying to excuse the wrongdoers’ actions? Especially in view of the fact they have proven beyond doubt their inability to agree with each other, let alone cure anyone.

The late Dr. Thomas Szasz said, “Crimes are acts we commit. Diseases are biological processes that happen to our bodies. Mixing these two concepts by defining behaviors we disapprove of as diseases is a bottomless source of confusion and corruption.” 

If a dangerous offense is committed by a person, then the fact remains criminal statutes exist to address this. As Szasz also said, “All criminal behavior should be controlled by means of the criminal law, from the administration of which psychiatrists ought to be excluded.”

Psychiatry’s attempt to eradicate the concept of right and wrong and thereby destroy personal responsibility by inventing excuses for the most flagrant misconduct, undermines the justice system.

Recommendations

1. First and foremost it should be recognized that every person is responsible for his or her own actions and must be held accountable for their actions.

2. State and federal legislators should repeal any laws permitting the insanity defense and diminished capacity pleas.

3. Judges, attorneys and law enforcement officers need to ensure that psychiatric evidence is removed from the courts and that psychiatrists and psychologists are no longer afforded “expert” status.

4. Remove psychiatrists and psychologists as advisors or as counselors from police forces, prisons and criminal rehabilitation and parole services. Because psychiatrists have no scientific foundation for their claims, do not permit them to render opinions about or to treat drug addiction, criminal behavior and delinquency, or to probe for alleged dangerous behavior.

Support CCHR STL’s mission to expose and eradicate violations of human rights by the field of psychiatry by making a tax deductible donation. CCHR STL is a non-profit 501(c)(3) organization.

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CCHR Traveling Exhibit in Kansas City

CCHR Traveling Exhibit in Kansas City 9/5/2025-9/8/2025
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Some Involuntary Commitments Lead to Twice the Risk of Death or Charge of Violent Crime After Discharge, New Research Finds

New study finds that psychiatric hospitalization for some people doubles the risk of suicide, overdose death, and violence, adding to the medical literature indicating forced psychiatric treatment can do more harm than good.

by  CCHR National Affairs Office 

New research finds that for some people involuntarily committed to psychiatric facilities, there is an increased likelihood of death or being charged with a violent crime within a short time after release. This outcome is contrary to the justification used for forced psychiatric detention, which is to reduce the likelihood of danger to self or others.

Using physician and administrative data from Allegheny County, Pennsylvania, investigators from the Federal Reserve Bank of New York focused on the roughly 40% of adult, first-time involuntary hospitalizations that were judgment calls – where some physicians would involuntarily commit but others would not. For these hospitalized individuals, the researchers estimated the causal effects of involuntary hospitalization on harm to self, as measured by subsequent suicides or overdose deaths, and on harm to others, as measured by subsequent charges of violent crime.

The  results  indicated that involuntary commitment “nearly doubles the probability of dying by suicide or overdose and also nearly doubles the probability of being charged with a violent crime in the three months after evaluation,” according to the study report, referring to the initial mental health evaluation.  Moreover, the greater likelihood of being charged with a violent crime – harm to others – continues for six months.

“Our results suggest that, on the margin, the system we study is not achieving the intended effects,” the investigators wrote.

They further provide evidence that disruptions to income, employment, and housing from psychiatric detention provide some explanation for an increased risk of harm to self and others post-discharge. “Such employment and earnings disruptions have implications for mortality and crime,” the report says.

Though the researchers noted the results should not be generalized to all people involuntarily committed to psychiatric facilities, their findings are consistent with other recent research on harm resulting from psychiatric hospitalization.  Studies have found that patients hospitalized for depression have an extremely  high risk  of suicide following discharge – a risk one study found was  44 times greater  compared with those who were not hospitalized – and a risk even greater for those who were involuntarily committed.

Evidence shows that involuntary commitment has become far more prevalent in recent years.  In 22 states with available civil commitment data for the five-year period ending in 2016, the states’ average yearly involuntary detention rate increased at three times the rate  of their average population growth.  It has been estimated that four of every ten admissions to psychiatric facilities are involuntary, a figure that reportedly rose by 27% over the last decade.

The World Health Organization (WHO) has called on nations worldwide to end nonconsensual mental health practices.  “People subjected to coercive practices report feelings of dehumanization, disempowerment and being disrespected.  Many experience it as a form of trauma or re-traumatization leading to a worsening of their condition and increased experiences of distress,” WHO advised.

The organization’s call for an end to involuntary mental health treatment extends to those experiencing acute mental distress. WHO notes that individuals in mental health crisis “are at a heightened risk of their human rights being violated, including through forced admissions and treatment…. These practices have been shown to be harmful to people’s mental, emotional and physical health, sometimes leading to death.”

CCHR has been a global leader in the fight against the use of involuntary commitments, seclusion and restraints, forced psychiatric drugging, and electroshock. The  Mental Health Declaration of Human Rights  lays out the fundamental human rights in the field of mental health that CCHR advocates, including the right to one’s own mind and the right to be free from forced mental health treatment.

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The Hidden Crisis in Psychiatry: How Overmedication and Coercion Are Failing Mental Health

Overmedication and coercive psychiatric practices—such as forced drugging, institutionalization without consent, and diagnostic overreach—are gaining increasing public attention. Especially concerning is how these practices affect marginalized groups and how they are justified in the name of “mental health care.”

Mental health awareness has exploded in recent years, and with it, a push for more effective care. But beneath the surface of these well-intentioned campaigns lies a darker, more urgent reality: the widespread use of coercion and overmedication in psychiatry.

A groundbreaking doctoral dissertation by Spanish researcher Henning Garcia Torrents reveals that what many assume to be “mental health care” often amounts to systemic abuse—and it’s all too common. The thesis, based on years of fieldwork, surveys, and lived experience, exposes a mental health system that regularly violates the rights of the very people it claims to help.

At the heart of the issue is pharmacocentrism—a near-obsessive reliance on psychiatric drugs to manage mental distress. These drugs are frequently prescribed without informed consent, and often at dosages or combinations that cause serious harm. The result? A silent epidemic of iatrogenic illness (that is, harm caused by medical treatment itself), including metabolic disorders, cognitive decline, emotional blunting, and in some cases, irreversible damage.

Torrents’ work documents a psychiatric culture that equates dissent with disease. Expressing one’s pain, resistance to treatment, or even questioning a diagnosis can be enough to trigger forced hospitalization or treatment. Instead of being asked what happened to them, patients are too often labeled as “non-compliant” or “delusional”—stripped of personal agency, dignity, and credibility.

Even more disturbing is how this coercion becomes routine. People are prescribed harmful and often addictive psychiatric drugs not because it’s proven to help them recover, but because it makes them easier to manage. Families, overwhelmed and unsupported, sometimes turn to psychiatry not for healing, but for containment, epitomized by the involuntary commitment of inconvenient family members (or as it is euphemistically called, “civil commitment”). Governments enable and legitimize these choices, often without any real oversight or accountability.

For example, the Missouri Revised Statutes (RSMo) Chapter 632 Section 300, Chapter 660 Section 290, Chapter 632 Section 305 and Chapter 552 Section 20 specify the conditions under which, and by whom, someone can be forcibly incarcerated in a mental health facility. Involuntary commitment laws hike federal, state, county, city and private health care costs under the strange circumstance of a patient–recipient who cannot say no.

There is another way.

Guidance issued jointly in 2023 by the World Health Organization (WHO) and the United Nations Office of the High Commissioner for Human Rights (OHCHR) lays out steps towards ending coercive practices and “establishing mental health services that are respectful of human dignity and comply with international human rights norms and standards.”

Those standards call for “free and informed consent as the basis of all mental health-related intervention,” as well as patients’ “effective and meaningful participation” in mental health treatment.

This referenced dissertation doesn’t just critique; it offers a roadmap for reform. Through what it calls “shared decision-making” and “dialogical practice,” Torrents advocates for a mental health system that sees patients not as problems to be fixed, but as people to be heard. This means involving them directly in treatment choices, prioritizing recovery over sedation, and addressing the structural causes of suffering such as poverty, trauma, and exclusion—instead of pathologizing them.

Imagine a system where doctors work with, not on, their patients. Where communities provide real support, and mental health isn’t outsourced to a pill bottle or an enforced institutionalization.

This vision is not Utopian—it’s already being piloted in small pockets around the world, from Open Dialogue in Finland to trauma-informed care models in the U.S. What Torrents’ thesis makes clear is that we have the choice, the science, the ethics, and the stories to guide us. What we need now is the courage to act. Contact your local, state and federal officials and representatives and let them know what you think about psychiatric fraud and abuse.

If you’ve ever felt uneasy about the quickness with which psychiatry reaches for the prescription pad, you’re not alone. And you’re not wrong. It’s time we ask harder questions: Who benefits from this model of care? Who gets silenced? And most importantly—what kind of mental health system do we want to build?

Let’s stop pretending that coercion is care. Let’s start listening.

Have you or someone you love been impacted by overmedication or coercive psychiatric practices? Report your experience here.

Your mental health, and the mental health of your family, friends and associates, can be questioned by just about anyone. If this makes you uncomfortable, execute a Living Will (Letter of Protection from Psychiatric Incarceration and/or Treatment).

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Sometimes I Just Feel Like A Fake

Imposter Syndrome, first described by two psychologists in 1978, is getting a lot of attention in social media, often by coaches, psychologists or psychiatrists advertising their expertise in helping a person get over it.

Imposter Syndrome (aka imposter phenomenon): Suffering from feelings of intellectual and/or professional fraudulence; the generally false perception of self-doubt in one’s abilities and accomplishments, particularly by otherwise high-functioning persons.

[imposter: assumption of a false identity; pretending to be someone else; ultimately from Latin imponere, to put in or upon, impose, deceive.]

Connections with Psychiatry

Comorbidity: The simultaneous presence of two or more conditions in a patient.

Discussions of imposter syndrome often involve the observation that it co-occurs (has comorbidity) with so-called psychiatric disorders such as anxiety, depression, or other mood or personality disorders named in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the fraudulent psychiatric billing bible used for insurance reimbursement. Poor or low self-esteem is a popular one, expressed in the DSM as “Developmental coordination disorder”.

It should be no surprise that imposter syndrome is being researched in various ethnic minority groups, which we know are already being targeted by psychiatry for harmful mental health services. African Americans receiving mental health services are disproportionately assessed with disruptive, defiant and psychotic disorders, evidence of the systemic racism that psychiatric and psychological associations admit is ingrained in mental health practices.

Imposter syndrome itself is not separately diagnosed as a mental disorder, but it can be the subject of psychiatric treatment when observed as present with another psychiatric diagnosis.

As with other DSM diagnoses, there is no clinical test for it, and of course no known medical etiology; its presence remains an opinion based on observations of various criteria, although there is no generally accepted set of such criteria. There is particular psychiatric interest in this phenomenon since getting it voted into the DSM opens up a new class of potential patients and potential income from its treatment.

Recommended treatments include counseling, particularly Cognitive Behavioral Therapy (CBT); psychotherapy; and psychiatric drugs for comorbid behavioral conditions.

CBT is a form of psychotherapy that attempts to modify dysfunctional emotions, behaviors, and thoughts — by evaluating for the person, challenging the person’s behaviors, and getting the person to change those behaviors, often in combination with psychiatric drugs.

The Etiology (The Actual Causes of a Condition)

As a result of psychiatric and psychological intervention in schools, harmful behaviorist programs such as “values clarification,” “outcome based education,” “mastery learning,” “self-esteem” classes, and psychotropic (mind-altering) drugs now decimate our schools. For more than 40 years these programs have been a destructive failure, in effect escalating the very problems that psychiatrists claim they prevent or resolve. Could this be one of the precursors of the current spate of imposter syndromes?

Instead of directing children toward genuine achievement and the demonstration of competence they can be proud of, the psychiatric “self-esteem” concept is to tell the child he has accomplished something whether he has or not. Sounds like this could indeed be the etiology of imposter syndrome that psychiatry has not been able to find.

The only thing that causes self-esteem is confidence and production. Confidence is intimately related to competence; and competence is based upon observation, study and practice. Thus we have the lead-in to an actual effective treatment for imposter syndrome.

The Bottom Line

Knowing all this now, are you going with the psychiatric promotion of imposter syndrome, which will likely lead to harmful psychotropic drugs; or are you going with real competence and confidence to bolster self-esteem, which you can do yourself with observation, study and practice?

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When Stopping Antidepressants, Withdrawal Symptoms May Be Severe and Persistent, New Research Finds

Research in recent years indicates that withdrawal symptoms from antidepressants are common and are more severe and long-lasting for some, with long-term users especially at risk of the symptoms.

by  CCHR National Affairs Office

Withdrawal symptoms are common for patients trying to quit their antidepressants, and for a substantial proportion of these users, the withdrawal effects are severe and long-lasting, a new study indicates.

While there is disagreement in research findings over the years about the incidence, severity and duration of withdrawal symptoms from stopping antidepressants, research in recent years has indicated that the symptoms are more prevalent and may be worse and linger longer than previously thought, especially for long-time users. 

To collect and further assess data on withdrawal symptoms, British researchers surveyed adult patients, recruited from primary care settings, who had ever tried to stop antidepressants.  The 310 respondents to the survey met the minimum number the researchers deemed necessary to determine the incidence of withdrawal symptoms.

The  results  of their survey showed that 79% of antidepressant users experienced some degree of withdrawal symptoms, with nearly half of them (45%) reporting that the symptoms were severe or moderately severe.  More than one in three (38%) were not able to stop antidepressants after one or more attempts. 

When stopping their antidepressants, more than half of survey respondents reported experiencing some degree of increased anxiety, worsened mood, agitation, tearfulness, fatigue, insomnia, mood swings, irritability, confusion or trouble concentrating, angry outbursts, headache, forgetfulness, dizziness/lightheadedness, and/or derealization/depersonalization.

As for how long the withdrawal symptoms persisted, 59% reported their symptoms lasted less than 4 weeks, while one in five (20%) reported a duration of more than 3 months and one in ten (10%) experienced symptoms for more than a year. 

Those who used antidepressants for more than 24 months before trying to stop were five times more likely to experience severe withdrawal symptoms and to be unable to stop than users who took the drugs for less than 6 months. 

“Antidepressant withdrawal symptoms were common, and severe and prolonged for a substantial proportion of users,” wrote the study’s lead author, Mark A. Horowitz, MBBS, Ph.D., researcher and founder of the Psychiatric Drug Deprescribing Clinic at North East London NHS Foundation Trust. 

The researchers in the study recommended that antidepressant “guidelines should be updated accordingly and patients informed of these risks” when deciding whether to start or stop taking the drugs.  They also advised that “the increasing withdrawal risks with longer use provides one rationale to minimise long-term antidepressant prescribing.”  The study was published in  Psychiatry Research. 

An urgency to know more about antidepressant withdrawal symptoms and how to treat patients experiencing them comes from the fact that some 45 million Americans are currently taking antidepressants.  Among them is a growing number who have reportedly used the drugs for years.  As recent research is indicating, an untold number of them may no longer be depressed, but instead be unable to come off their antidepressants because of the debilitating withdrawal symptoms they experience.  

“Some 15.5 million Americans have taken antidepressants for at least five years,” according to science reporter Benedict Carey,  writing  in the  New York Times  in 2018.  “The rate has almost doubled since 2010, and more than tripled since 2000,” he added.

“What you see is the number of long-term users just piling up year after year,” said Dr. Mark Olfson, a professor of psychiatry at Columbia University, quoted in Carey’s article.

Other recent research has also  indicated  that the longer antidepressants were used, the greater the risk of experiencing withdrawal symptoms when stopping.

Even more fundamentally, recent research findings have raised the question of prescribing antidepressants in the first place.  Because a common rationale for prescribing SSRI (selective serotonin reuptake inhibitor) antidepressants, the most commonly prescribed type of antidepressant, is to correct a chemical imbalance in the brain, researchers recently conducted a comprehensive  review  of all relevant research and found that the theory of a low level of the brain chemical serotonin causing depression is not supported by scientific evidence.  The researchers conducting the study wrote that the finding “calls into question the basis for the use of antidepressants.”

“The FDA must take immediate action due to the growing body of research indicating that withdrawal symptoms when attempting to stop using antidepressants are more widely experienced and potentially more severe and persistent than current prescribing information and medication guides indicate,” said Anne Goedeke, president of the CCHR National Affairs Office.  “With tens of millions of Americans taking antidepressants, many of them for years, FDA action is long overdue on this urgent public health issue.”

The content on this site is for informational purposes only and is not intended to substitute for personal medical advice given by a physician or other prescriber. 

Anyone wishing to discontinue or change the dose of an antidepressant or other psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms or other complications.

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