Germanwings pilot: To save depressed individuals use tools of psychiatry more, not less

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Dr. Theodore Dalrymple (the pen name for Dr. Anthony Daniels) makes assertions in search of facts in an op-ed for when he states that Andreas Lubitz, the Germanwings pilot who killed himself and 149 others, was not depressed, but rather characterologically disordered—a bad man, plain and simple.  And the good doctor’s assertion that modern psychology and psychiatry may well have made Lubitz sicker, and that they are making us all sicker, is not well thought out.

Andreas Lubitz did not receive too much help from psychiatry; he received too little.

Consider this: Dr. Dalrymple wonders whether psychiatric medications might have fueled Andreas Lubitz’s destructive acts, while at the same time noting that “10 percent of the population is taking these medications.” In fact, nearly one in four woman ages 50 to 64 is taking an antidepressant. Certainly, if these medicines were responsible for horrific violence, we would be seeing some middle-aged women engaged in carnage.

Andreas Lubitz did not receive too much help from psychiatry; he received too little.

An estimated 387 million people around the world have diabetes. We really should not be shocked that major depression and panic disorder and post-traumatic stress disorder and schizophrenia are also widespread.

Are psychiatric medications often used without the essential dose of gold standard psychotherapy? Yes.

Have we as human beings lost our respect for the examined life? Yes.

Are too many internal medicine physicians and psychiatrists ready to prescribe and not ready to listen? Yes.

Is it worth noting that a psychologist as experienced and reflective as Anthony Daniels (aka Theodore Dalrymple) has retired from his profession, only to issue a scathing indictment of it?  Yes.

But it is also true that tens of millions of Americans take psychiatric medications, and often in conjunction with receiving insight-oriented psychotherapy, because they help relieve them of suffering—like unremitting insomnia, persistently low mood, paralyzing panic attacks, paranoid delusions, hallucinations, suicidal ideation and homicidal ideation.

Dr. Dalrymple has met violent men in prison who are bent on destructive, horrific acts.  Well, I have, too.  Many. One, who had carved a Nazi swastika into his forehead, tried to kill me in a jail.  But, unlike Dr. Dalrymple, I never for a moment believed my assailant was not ill. And I never believed that he might not have benefited psychiatric medication—or more of it—to contain his aggression.

When, years later, he killed himself in prison, I didn’t wonder whether he had failed to get needed treatment; I knew it for sure.

In fact, if we were willing to treat violent offenders as patients, and treat them with psychotherapy and psychiatric medications (when needed), I am utterly convinced that we would see recidivism to prisons plummet. We need a lot fewer prisons and a lot more psychiatric hospitals. And anyone who suggested that those hospitals would be better ones without using any psychiatric medications would be wrong.

Even antisocial personality disorder is an illness. Even narcissistic personality disorder is an illness. No baby is born into the world with either. No one would want to suffer with either. And if we could find medications to augment our use of psychotherapy to combat either or both, then that would be a gain, not a loss, to patients, to our culture and to our species.

Andreas Lubitz did not receive too much help from psychiatry; he received too little.  Otherwise, he would not have crashed a plane full of people into the Alps.

Modern psychology and psychiatry are a miraculous set of healing tools that help millions of people rid themselves of symptoms that would, otherwise, circumscribe or completely obliterate their potential to lead full lives.  These tools need to be deployed expertly, with due respect for the brain and mind and soul.  But the tools themselves, and all the health care practitioners who use them judiciously, are a treasure, not a scourge.