Mad in America: Rethinking Mental Health

Susan Grundy is an author who writes about the weight of emotional distress and an easier way of being. Her book, Mad Sisters, is a highly personal account of her caregiving journey for an older sister diagnosed with schizophrenia at the age of 13. When not at her writing desk, Susan can be found walking in nature towards a café. She divides her time between Montreal and London. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. https://www.madinamerica.com/donate/ To find the Mad in America podcast on your preferred podcast player, click here: https://pod.link/1212789850

Ellen Vora is a board-certified psychiatrist, acupuncturist, and yoga teacher. She's the author of The Anatomy of Anxiety and takes a functional medicine approach to mental health. She considers the whole person and addresses imbalance at the root. Dr. Vora received her BA from Yale University and her MD from Columbia University. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow by becoming a subscriber. https://www.madinamerica.com/donate/ To find the Mad in America podcast on your preferred podcast player, click here: https://pod.link/1212789850 © Mad in America 2024. Produced by James Moore https://www.jmaudio.org

Rose Cartwright is a screenwriter and the author of Pure, a hugely successful memoir which was then turned into a series for Channel Four. She is also a writer and producer on Netflix’s 3 Body Problem. Pure portrayed Rose’s autobiographical account of finding that she had OCD, a “mental illness”, and the breakthrough that this medical framework provided her. This was short-lived. In her new book The Maps We Carry, she writes about the dawning realization that the “illness” story she had believed in and publicly advocated for, was wretchedly incomplete and often dangerous. In this interview, Cartwright charts her journey of painful and lonely disillusionment with the “mental illness” framework. She talks about understanding the place of her own childhood trauma and also the limitations of simplistic trauma narratives. She speaks about the place of psychedelics and meditation in helping her uncover her disconnection, eventually to realize the importance of trusting relationships and communities. In this brutally honest book and interview, Cartwright reflects on the importance of holding all our understandings around mental health and suffering, lightly. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. https://www.madinamerica.com/donate/ To find the Mad in America podcast on your preferred podcast player, click here: https://pod.link/1212789850 © Mad in America 2024. Produced by James Moore https://www.jmaudio.org

Dr. Paul Andrews is an Associate Professor of Evolutionary Psychology in the Department of Psychology, Neuroscience and Behaviour at McMaster University. His research focuses on understanding the evolution of depression, which he argues may be an evolved emotional response for understanding and solving complex problems. Dr. Andrews is also concerned with the evolution of the serotonin system and the effects of antidepressants on mental and physical health. His research has shown an increased risk of cardiovascular events, as well as death among those who use antidepressants. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. https://www.madinamerica.com/donate/ To find the Mad in America podcast on your preferred podcast player, click here: https://pod.link/1212789850 © Mad in America 2024. Produced by James Moore https://www.jmaudio.org

In this interview, Brooke Siem, who is the author of a memoir on antidepressant withdrawal, May Cause Side Effects, interviews her mother, Dee Barbash, to discuss the circumstances that led to Brooke being prescribed a cocktail of antidepressants at the age of 15. Today, her mother is a therapist who helps her clients taper from psychiatric medications – a profession that she took up after she came to understand the harms that Brooke suffered from having been prescribed these drugs for 15 years. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here © Mad in America 2024. Produced by James Moore

Daniel José Gaztambide is an assistant professor of psychology at Queens College and the director of the Frantz Fanon Lab for Decolonial Psychology. His research and clinical work focus on Puerto Rican and Latinx populations, ethnic minority identity, psychotherapy, and the social determinants of health. Daniel is the author of A People’s History of Psychoanalysis: From Freud to Liberation Psychology and the newly published Decolonizing Psychoanalytic Technique: Putting Freud on Fanon’s Couch. He earned his doctorate from Rutgers University, where he specialized in multicultural psychology, anxiety, and trauma. Beyond his clinical practice, Daniel is deeply committed to addressing racial injustice through his writing and activism. He has served as a liaison to the American Psychological Association (APA) on racial and ethnic minority issues and contributed to the APA’s 2020-2021 Taskforce on Strategies for the Elimination of Racism, Discrimination, and Hate. In our conversation, Daniel highlights the importance of cultural humility and understanding the impact of marginalization across race, class, gender, and ability on psychotherapy. His latest book provides a blend of clinical techniques and political strategies to address these complex issues through a decolonial psychoanalytic lens. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here © Mad in America 2024. Produced by James Moore ***

Our guest today is Banning Lyon, author of The Chair and The Valley: A Memoir of Trauma, Healing, and The Outdoors. An account of the abuse he suffered after being hospitalized in a psychiatric facility at age 15 and the long journey toward joy and awe that followed, his memoir was published this spring by Penguin Random House. He first wrote about his experiences in 1993 for The New York Times and, more recently, for the Washington Post. Based in California’s bay area, Lyon is an outdoor educator and backpacking guide whose engagement with nature was a key force in his recovery. His website is banninglyon.com. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here © Mad in America 2024. Produced by James Moore

Jazmine Russell is the co-founder of the Institute for the Development of Human Arts (IDHA), a transformative mental health training institute, and the host of the Depth Work Podcast. As a writer, educator, and scholar, Jazmine works at the intersection of mad studies, critical psychology, and neuroscience. Her work is deeply informed by her lived experiences surviving complex trauma, psychosis, and an autoimmune disease. Jazmine's focus extends to the intersection of mental health and chronic illness, particularly exploring the overlap of psychosis, trauma, and autoimmunity. This has led her to bridge critical neuroscience communities with the mad movement. In addition to her scholarly pursuits, Jazmine continues to see clients as a trauma-informed holotropic breathwork practitioner. She is also a co-editor of the forthcoming Mad Studies Reader: Interdisciplinary Innovations in Mental Health (Routledge, 2024). Today, we will delve into her background, her journey to co-founding IDHA, her current work and podcast, and the insights she offers in the upcoming Mad Studies Reader. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here © Mad in America 2024. Produced by James Moore

In this interview for MIA Radio, Brooke Siem speaks with David Taylor and Mark Horowitz about their publication of the Maudsley Deprescribing Guidelines, which is of particular note since the Maudsley Prescribing Guidelines is a leading text in medicine worldwide. David Taylor is the Director of Pharmacy and Pathology at Maudsley Hospital and a Professor of Psychopharmacology at King's College in London. He is also the editor-in-chief of the journal Therapeutic Advances in Psychopharmacology. Beyond academia, he contributes significantly to public health policy as a member of the United Kingdom's Department of Transport expert panel that introduced drug-driving regulations. He is also a current member of the UK government's Advisory Council on the Misuse of Drugs and is the only pharmacist to have been made an honorary fellow of the Royal College of Psychiatrists. David is the lead author of the Maudsley Prescribing Guidelines, a role he has held since their inception in 1993. The Maudsley Prescribing Guidelines have achieved significant success, with over 300,000 copies sold across 14 editions and translations into 12 languages. David has also authored 450 clinical papers published in prominent journals such as The Lancet, BMJ, British Journal of Psychiatry, and Journal of Clinical Psychiatry. His work has been cited over 25,000 times. Mark Horowitz is a clinical research fellow in psychiatry at the National Health Service (NHS) in London. He is a Visiting Lecturer in Psychopharmacology at King's College London and an Honorary Clinical Research Fellow at University College London, in addition to being a trainee psychiatrist. Mark holds a PhD from the Institute of Psychiatry, Psychology, and Neuroscience at King's College London, specializing in the neurobiology of depression and antidepressant action. He is the lead author of the Maudsley Deprescribing Guidelines and an associate editor of Therapeutic Advances in Psychopharmacology. Mark co-authored the recent Royal College of Psychiatry's guidance on stopping antidepressants, and his work has informed the recent NICE guidelines on the safe tapering of psychiatric medications, including antidepressants, benzodiazepines, and z-drugs. He has collaborated with the NHS to develop national guidance for safe deprescribing for clinicians and has been commissioned by Health Education England to prepare a teaching module on how to safely stop antidepressants. Mark has published several papers on safe approaches to tapering psychiatric medications, with contributions in The Lancet Psychiatry, JAMA Psychiatry, and Schizophrenia Bulletin. His interest lies in rational psychopharmacology and the deprescribing of psychiatric medications, which is deeply informed by his personal experiences of the challenges associated with coming off psychiatric medications. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. https://www.madinamerica.com/donate/ To find the Mad in America podcast on your preferred podcast player, click here: https://pod.link/1212789850 © Mad in America 2024. Produced by James Moore https://www.jmaudio.org

Carl Elliott is a distinguished professor at the University of Minnesota with joint appointments in the Department of Philosophy and the School of Journalism and Mass Communications. An influential voice in bioethics, Elliott is known for his critical examination of the medical and pharmaceutical industries. His latest book, The Occasional Human Sacrifice: Medical Experimentation and the Price of Saying No,describes the harrowing experiences of whistleblowers who expose corruption and malpractice in clinical trials and psychiatric research. Originally from South Carolina, Elliott's diverse academic background includes a medical degree and a PhD in philosophy from Glasgow University in Scotland. His extensive postdoctoral work has taken him to institutions such as the University of Chicago, the University of Otago in New Zealand, and the Nelson Mandela School of Medicine in South Africa. Elliott is the author and editor of several influential books, including Better than Well: American Medicine Meets the American Dream and White Coat and Black Hat: Adventures on the Dark Side of Medicine. His articles have been featured in prestigious publications such as The New Yorker, The Atlantic Monthly, Mother Jones, and The New England Journal of Medicine (as well as Mad in America). Elliott's critical work in bioethics has earned him numerous accolades, including the Erikson Prize for Excellence in Mental Health Media and a fellowship at the Safra Center for Ethics at Harvard University. His investigative work has shed light on numerous scandals, including the tragic case of Dan Markingson, a young man who died during a controversial clinical trial at the University of Minnesota. In this interview, Elliott discusses the systemic issues that protect wrongdoers, the personal and professional toll on those who speak out, and the broader implications for ethics in medical research and practice. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here © Mad in America 2024. Produced by James Moore

Neil Gong is an assistant professor of sociology at UC San Diego, where he researches psychiatric services, homelessness, and how communities seek to maintain social order. Neil's new book, "Sons, Daughters, and Sidewalk Psychotics: Mental Illness and Homelessness in Los Angeles," published by the University of Chicago Press, offers a detailed look into the starkly different worlds of mental health care in Los Angeles. He contrasts the public safety-net clinics, which strive to keep patients housed and out of jail, with the elite private care centers that cater to the wealthy. He finds that while the public system focuses on survival and containment, often providing only minimal care, the private system aims at rehabilitation and respectability, albeit sometimes at the cost of personal freedom. Neil’s extensive fieldwork included spending nights in homeless encampments, shadowing social workers, and engaging with patients and families across the socioeconomic spectrum. His work highlights systemic failures and societal indifference but also the humanity of those working and living within these disparate treatment systems. In our conversation, we unpack the critical insights from his book and explore the broader implications of his research. How do these disparate systems reflect our societal values? What can we learn about the intersection of mental health, homelessness, and social policy? And perhaps most importantly, how can we move towards a more equitable and humane approach to mental health care? *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here © Mad in America 2024. Produced by James Moore

Julia Hotz is a solutions-focused journalist based in New York City. She is the author of the forthcoming book, The Connection Cure: The Prescriptive Power of Movement, Nature, Art, Service, and Belonging. Her stories have appeared in The New York Times, Wired, Scientific American, the Boston Globe, Time, and more. After studying Sociology at the University of Cambridge, she joined the Solutions Journalism Network, where she helps other journalists rigorously report on what's working to solve today's biggest problems. Before becoming a journalist, Julia worked as a teacher, bartender, pizza server, and summer camp forest ranger. She enjoys hiking, biking, dancing, running, budget traveling, and building the longest road around Catan. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here © Mad in America 2024. Produced by James Moore

Jessica Schleider is a clinical psychologist, researcher, and founding director of the Lab for Scalable Mental Health (www.schleiderlab.org). She’s a leader in single-session interventions for youth mental health – an evidence-based approach that aims to provide help that’s accessible, doable, and affordable for populations around the world and is already available via open-access programs. On her own and with colleagues, she’s published a wide array of articles and book chapters and co-wrote a self-help book, The Growth Mindset Workbook for Teens. Most recently, she’s the author of Little Treatments, Big Effects: How To Build Meaningful Moments that Can Transform Your Mental Health. Currently an associate professor of medical sciences of Northwestern University, Schleider earned her PHd in clinical psychology from Harvard and completed her doctoral internship in clinical and community psychology at Yale School of Medicine. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. https://www.madinamerica.com/donate/ To find the Mad in America podcast on your preferred podcast player, click here: https://pod.link/1212789850 © Mad in America 2024. Produced by James Moore https://www.jmaudio.org

Sasha Durakov Warren is the author of the new book Storming Bedlam: Madness, Utopia, and Revolt published by Common Notions Press. Sasha is a writer based in Minneapolis. His experiences within the psychiatric system and a commitment to radical politics led him to co-found the group Hearing Voices - Twin Cities, which provides an alternative social space for individuals to discuss often stigmatized, extreme experiences and network with one another. Following the George Floyd uprising in 2020, he founded the project Of Unsound Mind to trace the histories of psychiatry, social work, and public health's connections to policing, prisons, and various disciplinary and managerial technologies. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here © Mad in America 2024. Produced by James Moore

Milutin Kostić is a practicing Serbian psychiatrist trained in the tradition of biological psychiatry who has become a new figure in the critical psychiatry movement. Affiliated with the Institute of Mental Health in Belgrade, Serbia, he is currently a Fulbright scholar working alongside Lisa Cosgrove in Boston to challenge established norms in psychiatry and psychology. Kostić utilizes his extensive training and traditional research methods to question the fundamental assumptions of his field. For example, Kostić critiques the flawed premises of genetics research in depression, arguing that it overlooks the heterogeneity of human experience. He uses analogies to illustrate how psychiatry often pathologizes normal human emotions, drawing parallels to how medical conditions are misunderstood when the context is ignored, like trying to treat the lungs alone in a society overrun by air pollution. We will also discuss his latest study, which emphasizes the benefits of de-medicalizing experiences of depression rather than quickly resorting to diagnoses and subsequent treatments with medication or psychotherapy. His research also sheds light on the effects of biological narratives on patient perspectives, the complexities of drug dependency, and the profound impact of psychiatric diagnoses on individual identity. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here © Mad in America 2024. Produced by James Moore

Rodrigo Nardi is a psychiatrist and psychologist. He obtained his psychology degree in the year 2000, and following that, he obtained a certificate in CBT, and a Master’s Degree in Clinical Psychology at Universidade Evangélica de Paraná. He obtained his M.D. degree in 2010, and in 2016, he completed his psychiatry residency at Penn State. Altogether, Dr. Nardi has worked as a Mental Health Professional for more than 20 years, covering from individual psychotherapy to inpatient and outpatient psychiatry, substance use treatment, and interventional psychiatry. His passion for teaching and learning has led to the creation of the True Psychiatry Network and the development of a mentoring program designed to address the most frequent challenges related to psychiatric training. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here © Mad in America 2024. Produced by James Moore

Arthur Kleinman is a towering figure in psychiatry and medical anthropology. He has made substantial contributions to both fields over his illustrious career spanning more than five decades. As a Professor of Medical Anthropology at Harvard University's Department of Global Health and Social Medicine and a Professor of Psychiatry at Harvard Medical School, Kleinman has profoundly influenced how medical professionals understand the interplay between culture, illness, and healing. His extensive body of work includes seminal books and numerous articles that have become foundational texts in medical anthropology. These writings explore the crucial role of personal and cultural narratives in shaping medical practices and patient care. In recent years, Kleinman has increasingly focused on critiquing the prevailing practices within psychiatry, particularly the over-medicalization of mental health issues and the neglect of broader social and personal contexts that significantly impact patient care. His critiques advocate for a more nuanced and compassionate approach to psychiatry, one that recognizes the importance of individual patient stories and the socio-cultural dimensions of mental health. In this interview, Kleinman explores critical issues facing modern healthcare. He discusses the often-overlooked narrative of patient experiences, critiques the mechanistic approaches that dominate U.S. healthcare, and offers insightful reflections on the global mental health movement. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

On the MIA podcast this week we turn our attention to conflicts of interest (COIs) and new research from the British Medical Journal (BMJ). Mad in America has previously examined the problems with conflicts of interest in research but this time we extend that to look at the potential effect of COIs on diagnostic tools such as the Diagnostic and Statistical Manual of Mental Disorders (DSM). Joining me today are Lisa Cosgrove and Brian Piper, two of the authors of a paper which appeared in the BMJ. The paper is entitled “Undisclosed Financial Conflicts of Interest in the DSM-5 TR: Cross-Sectional Analysis,” and it was published in January 2024. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

Swapnil Gupta is an Associate Professor and Medical Director of Ambulatory Psychiatry at Mount Sinai Morningside Hospital. She was trained as a psychiatrist in India and the United States, at SUNY Downstate Medical Center and Yale University, and PGI Chandigarh in India. She is known for her work on deprescribing from and discontinuation of psychiatric drugs. Dr. Gupta’s career began with research on the role of the endocannabinoid system in the pathophysiology of schizophrenia as an academic psychiatrist. Her subsequent scholarship has focused on applying deprescribing, the systematic reduction of unnecessary medications, to psychiatry by rooting it in the principles of recovery-oriented care. She has authored several peer-reviewed papers on deprescribing and co-authored a book with Rebecca Miller and John Cahill. She is an active member of two organizations that aim to enhance stakeholder engagement in psychiatric research. She is also a part of the editorial board of the Community Mental Health Journal. Currently, she is working on creating educational resources to help people discontinue psychiatric medications and gathering information on the knowledge and opinions of psychiatrists regarding the discontinuation of such drugs. In this interview, we discuss deprescribing from psychiatric drugs, the difficult decisions faced by patients, the importance of psychosocial support during withdrawal, and how deprescribing is central to recovery-oriented practices such as shared decision and patient choice. We will also tackle the complex issue of whether the recurrence of symptoms once a drug is tapered is a mark of relapse or withdrawal caused by the psychiatric medication. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

Justin Garson is a Professor of Philosophy at Hunter College and The Graduate Center, City University of New York, and a contributor for Psychology Today and Aeon. He writes on the philosophy of madness, the evolution of the mind and purpose in nature. His most recent book is Madness: A Philosophical Exploration, published by Oxford University Press in 2022. He is also the author of the forthcoming The Madness Pill: The Quest to Create Insanity and One Doctor’s Discovery that Transformed Psychiatry, which will be published by St. Martin’s Press. In this interview, Justin joins us to talk about the ways in which society has attempted to explain or categorize madness over the years. We also discuss the value of looking at madness, not as disease or defect, but as a designed feature. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here