Medicating Normal: A Film Probes the Harm of Psychotropics
Lloyd I Sederer MD
Do physicians, and now prescribing nurses, need to sign an informed consent form before prescribing a psychoactive medication? In addition to the consent form patients sign?
Medical consent is uneven, like a tilted house, or reception on a cell phone.
At times, the doctor explains the risks and benefits of a medication, its side effects, its potential adverse (unwanted) short and long-term effects, and alternative treatments to the medication. If the well-briefed patient wants to proceed with taking the medication, they sign a standardized consent form.
Other times, a thorough explanation by the doctor of the medication is cursory, or not at all, essentially saying, “This drug is fine, take it, you need it to get better.” A blank consent form usually is part of the paperwork given to a patient. In either case, the patient dutifully signs the form, and off they go to the pharmacy.
What’s missing with cursory or absent explanations of a psychiatric medication is the risk inherent in taking the drug, whether immediately or over time. Medicating Normal, a documentary by Lynn Cunningham and Wendy Radcliff, presents a collection of people whose lives were profoundly disrupted by the unwanted effects of classes of medications, like the benzodiazepines (for example, Xanax, Ativan, Klonopin), antipsychotics (for example, Risperidone, Haldol), and various sleeping pills. In all their cases, the person was emotionally suffering but that is not the same thing as having a psychiatric illness, which might improve from taking a psychoactive medication.
One in five Americans today is prescribed a psychoactive drug.
A “go to” marine sergeant is discharged from the military as disabled, as she is, but after taking a smorgasbord of psychiatric medications. She appears unrecognizable in the film from the woman in fatigues proudly standing on the roof of a military jeep.
She was symptomatic after the trauma of having one of her squad killed in battle, termed post-traumatic stress disorder, PTSD. She was suffering. But that evoked her being prescribed, in a knee-jerk manner, a psychiatric medication. Which began her journey into mental hell and disability, a deep hole she managed to climb out of to regain her life and become a social worker.
A rising naval officer, a graduate of the Naval Academy, with two graduate degrees from MIT, suffers from anxiety doing his job as a warship officer. We see him in full-dress whites, standing tall and clear-eyed.
Then we see him, disabled, no longer lean and determined, looking blankly as his mind churns—after taking too many drugs to mention. His beautiful wife separates from him after his verbal abuse. We follow his still incomplete recovery after he withdraws from drugs, a tiny glimmer in his eyes as he and his wife reunite and work to rebuild their marriage.
A smart, effective Black woman has become unemployed and desolate. She believes she has been battered from taking a host of psychiatric medications, which she is withdrawing from. She wears a hidden camera and mike as she confronts her psychiatrist, who dismisses her complaints and aggrandizes himself.
We meet the parents of a teenage girl who suffered anxiety and an eating disorder. We learn the story of a daughter’s psychotic deterioration after being prescribed higher doses of psychiatric medication, or changing from one drug to another, known as trial and effort, or adding one upon the other(s), a practice known as polypharmacy, which has become ubiquitous.
Her nightmare ends after discontinuing the drugs. She becomes her anxious self again and is attending college.
Other than doctors, nurses, and litigators, few know the word iatrogenic. It is an illness that is a consequence of medical examination or treatment.
Medicating Normal does not allege that all psychiatric medications can be iatrogenic, though some are. Especially those that are not needed, that are dispensed as the result of decades of promoting pills for anything and everything that ails us. Most doctors are well-intended, want to reduce a patient’s pain, and have little time and training to do so. They reach for the prescription pad.
“Mother’s little helper” no longer is just for mom, with her endless, mindless laundry and cooking chores, but for all of us in a world full of stress, a world in which living has become an emotional chore. A world where billions are to be made by pharma companies straining to produce ever more demand for psychoactive drugs, opioids being a tragic headline example.
This film suggests that state-legislated consent would help. As an example, it portrays a legislative session in Massachusetts on benzodiazepines. Patients and families are owed a clear risk and benefit discussion to be better at making their own decisions, rather than “the doctor knows best.”
Fine idea, but would it spare as many as needed from iatrogenic psychiatric disorders? Might doctors themselves be held to standards of clearly and consistently providing the information needed for a patient to judge the risks and benefits of taking any psychiatric medication?
There seems no simple path out of the predicaments that derive from our culture of taking a pill to remedy stress, and blunt emotional pain. In the meantime, we would be well advised to follow an admonition from the world of business: Caveat Emptor, let the buyer beware.