Recovery Protocol- Part 2

The Problem with “Medication Resistance”  

Medically defined, “medication resistance” (medication failure) is acknowledged when, at minimum, at least two or more medications, at a prescribed dose, for a specified diagnosis and duration, have been employed multiple times but are not achieving the desired outcomes.

Medication Resistance is Psychiatry’s Silent Epidemic.

From The Journal Molecular Psychiatry, Pub. July 13th, 2021, states that in the US, for example, poor treatment response reportedly ranges widely from 20-60 percent of the population receiving psychiatric treatment with medications. Do you feel you belong to this camp?

In the article “The Challenge of Presenting Antidepressant Risks and Benefits,” from Mad in America, Science, Psychiatry and Social Justice, November 7, 2023, the following was reported: the placebo response for depression, on average, is 35-40%, while with antidepressants (chemical response), it is only 42-53%, a random chance of change by medication. Can you continue living with a 50/50 chance, a toss of the die?

From the Journal of Affective Disorders, April 2021, Evaluating Dimensional Approach to Treatment Resistance in Anxiety Disorders: A two-year follow-up study reports that 30-60% of anxiety disorder patients have inadequate treatment response. Where does this leave consumers?

I wish to note that “medication failure” for our program speaks to not only low medication effectiveness over multiple drug trials but also represents its failure due to extreme toxicity, which some people cease pill taking despite the acute symptoms still experienced. For our program’s purposes, “medication resistance” does not speak to those not taking their medication as prescribed, lessening its effectiveness and efficacy. We at Citizen Psychiatry see medications as a management tool whose aim is to dampen symptoms to a degree that ensures healthier functioning and, in turn, improves their quality of life.

Pill Taking as the Savior
While psychiatry has touted the revolutionary impact of medications, it is well known, in their back rooms, institutionally, that psycho-active drugs have marginal efficacy and are relatively no more effective, overall, since coming on the scene in the 1950s, even though there is a plethora of more innovative drugs lining the prescription shelves. As well, the medications generated today are born from a very narrow and thin theory of mental illness. According to mainstream psychiatry, the faulty functioning of neural messengers, called neurotransmitters, are the sole culprits for the emergence of major mental illnesses like depression and anxiety disorders, which has led to drugs focused on these chemical messengers as the mainstay of treatment.  This thin view, however, flies in the face of other salient psychosocial and biological variables associated with each person’s mental health illness, which keeps these conditions alive and growing even more prevalent.

Psychiatry in the 1980s formally adopted the “pill-first-policy” in treatment, which came with the birth of the neuro-transmitter model of major mental illnesses. Since then, Psychiatry has built up the myth that correcting neurotransmitter malfunctioning is all that is required to treat various major mental health conditions successfully, like Depression and Anxiety illnesses.  

The Demand
The demand for treatment has increased since the 1980s as the machinery of psychiatry touted medication’s effectiveness as the holy grail. However, the results are in, and the data is disappointing. Upon review by researchers, some decades later, the “Pill” revolution can be considered a “whimper” and not the “bang,” as promised. The question that is unanswered to date is why the promise of medications, as the first line of treatment, has not been powerful enough to stem the tide of “medication resistance?” In his book, “Magic Bullets, Psychiatric Drugs and The Astonishing Rise of Mental Illness in America,” Robert Whitaker, an investigative journalist, unearthed the facts known in the backroom halls of psychiatry. Whitaker points out that statistically, though more and more people have been getting access to psychiatric treatment in the US, for example, the number of adults on government disability due to mental health disorders has more than tripled since 1987. In essence, reliance on a drug-first strategy for long-term recovery alone is least effective when drugs are only the change agent.

Consider this clue, as well. The steep rising rates of depression over the past several decades are occurring despite the billions of millions of dollars spent on research, volumes of research published, and the plethora of smarter, cheaper anti-depressants now available. The World Health Organization has now considered depression as the single most significant contributor to ill health worldwide.

Myth Busting
The prevailing view held in psychiatric medicine that drug use alone can create a recovery has been rebuffed by recovery research since the 1980s. We find consumers are gravely disappointed with hanging on to psychiatry’s promise with “Pill” taking as the answer. By applying our recovery equation, offered in the Recovery Protocol Breakthrough program, the promise of making a recovery comes alive once more.

As with anything technologically new that captivates the imagination of the public, policymakers, government, and institutions, the call to charge ahead with a “pill-first policy” in the 1980s even in light of Nobel laureate in chemistry Linus Pauling, in 1968, announcing to the psychiatric community and world, that taking the proper nutrients contained in foods, in optimal amounts, can correct many of the major mental illnesses trajectories for the better. Today, pioneering work continues in this domain and is part of a growing field known as Functional Psychiatry or Integrative Psychiatry. Since then, Functional Medicine in psychiatry has built on Linus Pauling’s early work. They have now theorized a common major pathway associated with mental health disorders that fits with the Functional Psychiatry approach and discount the current drug approaches to address a thinly veiled neurotransmitter theory.

For the eminent psychiatrist Christoper M. Palmer MD, in his book Energy Brain, 2022, A Revolutionary Breakthrough in Understanding Mental Health-and Improving Treatment for Anxiety, Depression, OCD, PTSD, and More, this pathway is metabolic in nature. He has theorized that major mental health disorders, from his analysis, are highly correlated with metabolic disturbances in our body and brain. He ties metabolic issues with the body’s energy making cells inability to produce balanced energy output to ensure a humming metabolism within the body properly.  From his work, integrative or functional psychiatry is most concerned with the major metabolic factors that can significantly disturb healthy metabolism over time, which are connected to the quality of foods, nutrients, movement, and sleep, among others engaged. These are the same factors that keep our metabolism humming. When these metabolic-mediated factors are in play, the hardware of the Soul can not only hold the stress and weight of the mental health conditions as perceived but also reduce the symptoms significantly without the great toxicity effects. As such, when poor quality consumption of nutrients, lack of movement, and sleep disruptions occur with Anxiety and Depression Conditions, the worse these disorders are.

For example, take the intake of added sugar that is consumed in overabundance today. Metabolically, this nutrient in excessive amounts can induce insulin resistance, leading to excessive weight gain in the body and, on the other end, influence the promotion of inflammation in the brain that has been highly correlated with depression, for example. Research has shown that those who are obese have a high risk of depression, and those who are depressed have a high risk of being excessively overweight. In essence, the brain affects the body via the metabolic conduit, and the body impacts the brain through this conduit, hence the term “bi-directional,” as indicated in Dr. Palmer’s readings. The Recovery Protocol Breakthrough capitalizes on this foundation to make recovery possible and enhance a person’s recovery psychology.

However, for allopathic psychiatry (drug-focused) with their alignment with drug manufacturers, there is no proprietary and profit-making patentable value in nutrients, movement, and sleep, nor is this discovery considered a technological marvel. Mainstream psychiatry actively disavows to the public and psychiatric intern training that there is a connection between mental illness and diets consumed. However, this program considers nutrients in diets, supplements, movement, and sleep as metabolic enhancements and essential recovery care factors that make recovery possible. Attending to this domain collectively in this way targets the hardware of Soul, while the recovery software is attended to through capacity building targeting a person’s strengths, a twin approach. The synergistic impact of these two significant avenues with this protocol breakthrough is a powerful combination to migrate a person from a weakened recovery state due to medication non-responsiveness to a position of strength, living a person-oriented life.

Consumer Impact on Recovery
What has transpired due to the “Pill” culture dominating the clinical room with a psychiatric provider relates to how the oxygen expended with the patient is almost entirely taken up by the focus on symptoms, the diagnosis, symptom management, and drug response. Here, the “person” as an agent of change possesses little to no value or airtime as the magic of medications is deemed all one needs. The “Pill” itself cannot support a personal recovery unless the person becomes an active agent of change. This is at the heart of The Recovery Protocol Breakthrough. Nor does pill taking have the capacity to support the weight and stress of a person’s life, as the public seems to believe. Without the individual being utilized as an agent of change, like medications are, a vacuum is created and sustained in the psychiatric provider’s meeting room that inadvertently stifles the person’s agency and empowerment. Here, we find the patient becomes a passive recipient of care with nothing to contribute other than being a good “Pill” swallower. For physician providers, introducing Functional Medicine as an adjunctive or mainstay treatment involves the consumer as a participant in their change, a key recovery principle. For clinical and non-clinical providers in mental health, ensuring the client is an active agent of change is enhanced when the person’s strengths and capacities are upheld and supported as laid out in the Recovery Protocol Breakthrough.

-Recovery does not occur in a vacuum. It requires something with meaning and purpose (Deegan, Patricia Ph.D., 2009 lecture)-

The Formulary
Over the decades, with medications taking center stage, the relational posture and culture of the Treatment Room have developed as a Formulary (see link below) that sets out the conditions for shaping the climate for helping interventions, whether with a physician, clinical, or non-clinical providers. While the Formulary is suitable for posing the client as a passive recipient of care that is amenable to traditional mental health care, it does not position the person as an agent of change as this program does. The tenets in the Formulary have been adopted by many helping disciplines like those in psychotherapy and psychiatric providers, for example.

Traditional Formulary of Care Guidelines

To counter the formulary, research on recovery orientation developed a The Framework of Recovery Orientation which outlines the tenants to culture a climate within a meeting room setting that invites the person to be a change agent. Within such a climate, applying this protocol breakthrough can directly leverage a person’s capacity and strengths, putting the person first as an equal partner in the helping equation. This is not an either-or proposition. However, with a recovery-first policy navigating between both approaches, the Formulary and the tenants of recovery orientation inherently complement and support each other, providing greater influence than on their own. In recovery, when a “recovery person first” position is given life in The Meeting Room, people can bring to the surface what is working right for them along with their personal resources such as abilities, purposes, skills, values, strengths, connections, community, family, interests, and passions. Recovery research to date has shown that this impact paves the way to greater empowerment, agency, and hopefulness tied to making a “personal recovery” a reality. In this reality, the weight and stress of the mental health conditions are held in a position of strength, thus freeing the person to live a more person-centered life versus the illness-led life presently experienced. This regenerative work cannot take flight within the existing formulary framework. In essence, The Framework for Recovery Orientation provides an antidote to those one-sided formulary standards, thereby removing the “agency” vacuum. In recovery, when a “recovery person first” position is given life in The Meeting Room, people bear witness to what they do that makes their life meaningful and purposeful, a strength position. This regenerative work is less likely to take flight within the existing formulary framework with mainstream service providers allowing illness-led living to continue.

Continue to The Recovery Protocol Part 3 – Click Here