Iatrogenic Insanity.  You are a Survivor 


"You are a survivor" said a psychiatrist whom I had consulted eight years previously for a second opinion.  He remembered me.  I did not remember him.  My memory of the past eight years is wobbly.  The 20 years before that are almost totally blank.  "You are a survivor" is the only positive thing a doctor has said about me.  One should not have to ‘survive’ going to a doctor. This is my letter to my doctors.  I have written it from my notes, my emails, and my medical records.


You Call Yourselves Doctors.  You Once Took an Oath to Do No Harm


I had been prescribed a benzodiazepine [a tranquillizer (Ativan)] for a sleep disorder subsequent to an adverse reaction to a cluster of immunizations.  I had taken a low dose from time to time for several years.  It seemed to help but I was becoming anxious.  Everyone put it down to stress.  At that time I did not know that anxiety was a possible adverse effect of the benzodiazepine.  Nor did I know about interdose interval withdrawal – many benzodiazepines are so short-acting they cause withdrawal symptoms between doses.  I had no idea that I had become addicted.  I knew only that when I took it, I felt less ‘wired.’


Benzodiazepine Withdrawal


When my elderly mother died, my sleep worsened and I started taking the benzodiazepine regularly.  Within a very short time the problem became much worse and I also became jittery.  I tried to withdraw from the benzodiazepine.  I felt horrible.  You insisted I was "depressed."  You said it was because of my traumatic childhood.  My childhood was not the issue.  The issue was your drugs.  


Anxiety Disorder, Major Depression With Agitation


You didn’t recognize my adverse reactions to the benzodiazepine.  And you didn’t recognize the withdrawal syndrome.  You diagnosed me with 'Anxiety Disorder' and 'Depression.'   You gave me an antidepressant.  When I became agitated and developed a tremor as drug effects, you said I had 'Major Depression with Agitation.'   When the agitation became so severe that I lost my sleep entirely, you gave me even more antidepressants.  You also gave me sleeping pills.


Adjustment Disorder, Vegetative Depression, Bipolar Disorder, Psychotic Depression


You said I had an 'Adjustment Disorder' – but the only things I wasn’t adjusting to, were your drugs.  I collapsed frequently, sometimes on the street, and was twice taken by ambulance to an emergency room.  You did not recognize that one of the drugs was causing my blood pressure to drop precipitously.


When I started twitching and shaking uncontrollably, you gave me more sleeping pills – to be taken three times a day and at night.  When I fell asleep during an appointment, you said I had ‘Vegetative Depression.'   When I was in constant motion, you said I had 'Bipolar Disorder.'  You then settled on ' Psychotic Depression.'


You gave me antipsychotics.  I started howling like a dog.  I marched in place.  My body movements became chaotic.  My face twitched, and my tongue darted in and out of my mouth.   


You gave me 35 different psychiatric drugs. You gave me a new drug almost every week.  You said you were 'unmasking' mental disorders.  You didn’t allow for a wash-out period between drugs.  You were treating the adverse effects of pharmacy and polypharmacy with more polypharmacy.  Why did I accept all those drugs?  I would have done anything, agreed to anything, ingested anything to stop the horrendous agitation - it’s called akathisia.   


A Diagnosis of Dementia.  A Living Will and a Do Not Resuscitate Directive


I couldn’t stop moving.  You said it was a symptom of my mental illness. You told me I was demented.  I was afraid I would kill myself.  I was afraid I wouldn’t kill myself.  I wrote a Living Will and a Do Not Resuscitate directive.  I gave away my belongings.  I wrote farewell letters.  I detailed how my ashes were to be disposed.  I asked my husband to shave my face – one of your drugs caused the growth of facial hair.  My husband watched in helpless disbelief, horror and grief.  It was truly Kafkaesque.


Dissociative Identity Disorder, Somatization Disorder, "An Excellent Candidate for ECT"


I wanted to withdraw from the drugs and went to a psychiatric facility for help.  You seized me and kept me there forcibly.  You said I had ' Dissociative Identity Disorder' and 'Somatization Disorder.'  You said I was 'delusional, self-absorbed, and violently agitated.'  You cold-turkeyed me off many of the drugs and wrote that I was 'an excellent candidate for ECT.' 


I refused treatment, but you coerced my husband into signing.  You told him electroshock was the last and only option.  You held me for 10 weeks and treated me to 25 general anesthetics and 25 bilateral, grand mal seizures.  I don’t remember much except the assembly line of gurneys on shock days.  I shook from terror as I looked up at your cold, matter-of-fact faces and waited for merciful oblivion as the anesthetic hit.  You kept me on the sleeping pills – three times a day, once at night and you added new drugs.  You told me I would require institutionalization, medication for the rest of my life, and weekly maintenance electroshock treatments. I did not go back for maintenance ECT and I gradually tapered myself off all drugs. For years I lived with the fear that you would have me returned to your facility and committed for more electroshock.  I was no longer a human being.  You could not have been more destructive.


Second Opinions


You had medicated me to insanity.  From my medical records I see that I had requested second and third opinions.  Some of your comments are of interest:   “The current symptoms began within several weeks of stopping the Ativan.”  "A sense that the benzodiazepines were contributing to instability through withdrawal/rebound effects."   “Nervous system hyperarousal.”  “I support the current therapeutic recommendations involving minimal use of medication.” 


Apparently a trial of discontinuing medication had been instituted (at the suggestion of the psychiatrist I refer to in the first paragraph), but the prescribing psychiatrist wrote it "had been unsuccessful as it resulted in her symptoms worsening."  He was obviously ignorant of drug withdrawal effects.  No one cared enough to follow up. 


The Worst of Modern Medicine:  The Prescription Pad


You were puzzled by my uncontrollable body movements.  You used the best of modern medicine.  You sent me for a sleep study, an EEG, a CT scan, and an MRI.  The cause of the agitation, however, was sitting right there in your own office, on your own desk – your prescription pad – the worst of modern medicine. 


The 35 Pharmaceuticals


Here are my drugs as recorded in my medical and pharmacy records – 35 or so of them in an eight-month period, most of them prescribed in rapid succession in a four-month period by one psychiatrist.  Several were flipped back and forth.  Some were given in different strengths.  Some I might have missed.  Some others (not listed) were given as “samples” provided by pharmaceutical sales representatives.  All of these were prescribed:


Ativan (Lorazepam), Rivotril (Clonazepam), Xanax (Alprazolam), Clonazepam (Rivotril), Valium (Diazepam), Celexa (Citalopram), Novo Pranolol (Propranolol), Amitriptyline (Elavil), Propranolol, Imovane (Zopiclone), Effexor (Venlafaxine), Lithium Carbonate (Lithium), Moclobemide (Manerix), Imovane (Zopiclone), Seroquel (Quetiapine), Wellbutrin (Bupropion), Imovane (Zopiclone), Nortriptyline (Aventyl), Nortriptyline (different strength), Perphenazine (Amitriptyline), Gabapentin (Neurontin), Ativan-sublingual (Lorazepam), Trazodone (Desyrel), Ritalin (Methylphenidate), Fluvoxamine (Luvox), Oxycontin (Oxycodone), Methotrimeprazine (Nozinan), Paxil (Paroxetine), Remeron (Mirtazapine), Zyprexa (Olanzapine), Risperdal (Risperidone), Parnate (Tranylcypromine), Haldol (Haldoperidol), Aventyl (Nortriptyline), Cogentin (Benztropine), Loxapine, Chlorpromazine (Largactil), Starnoc (Zaleplon.)


One of you even wrote:  "The list of previous psychotropic trials is impressive in its breadth."  And he hadn’t even seen the whole list! 


Admit No Harm, The Oath of Silence


I submitted a complaint to the medical governing body of our province about the psychiatrist who did most of the prescribing.  I backed up my complaint with monographs for all the pharmaceuticals I had been given – most with similar adverse effects of agitation, insomnia, depression, suicidal thoughts.  Several have 'black box' warnings.  My complaint was considered and dismissed by four people who never met me.  One is a ‘specialist’ whose name was blacked out. 


The governing body found that the psychiatrist’s documentation of our initial consultation, the medication trials, and the "conversations of informed consent" was "insufficient.“ They found that the use of lithium fell "below the standard of care."  They wrote that he had made changes to "fully comply with the standard of his profession," that he had "initiated considerable measures to address the noted deficiencies in his practice" and that he has "attended a medical record-keeping and psychiatry courses."


At the same time they decided that the diagnosis of ”major depression with agitation" was "clearly supported."  They dismissed akathisia.  They found there was "no evidence of unreasonable polypharmacy or excessive medication."  They found that medications were "switched in accordance with standard algorithms, guidelines and evidence."  They decided it was "quite proper and standard to switch from one antidepressant to another without a washout."  “As to the total number of medications used, although on paper this seems a lot over a relatively short period of time, the reason for this is essentially the presence of severe and on-going worsening symptoms and the lack of clinical response along with the complaints of side effects." They decided that the "appropriate disposition was to take no further action against the complaint." 


I was naïve to believe that the governing body was there to protect the public from harm.  I now realize it is there to protect those who harm the public.  It is acceptable to electroshock patients who have been medicated to insanity and still be in compliance with the standard of the profession. 


When you promise to do no harm, you should acknowledge when it happens, and share so that it does not happen again.  You will never admit that you did harm and no one will ever learn from your mistakes.  The oath you took was ‘to admit no harm.'   You also took ‘the oath of silence.’



A Spontaneous Remission, Libel, "Paranoid Ideation"


I have been drug-free for many years and see no psychiatrists.  I had a 'spontaneous recovery' from every label I had been given when I withdrew from the pharmaceuticals.  Well, not quite.  When I tried to get help for the trauma I experienced at the hands of doctors, I was told what I was saying was libelous and that I had "Paranoid Ideation."


Doctors systematically destroyed my brain and nervous system with drugs and electroshock.  I have amnesia.  More than 20 years of my life are missing.  Most of the memory of my life with my husband is gone.  I also have anterograde amnesia the loss of the ability to create new memories.  I have cognitive impairments, optic nerve damage, tremors, seizures, vocal tics, diminished lung capacity, poor working memory and poor organizational skills.  I function with a wall of 'sticky note' reminders.


In Closing


Most of my friends are gone.  I was too much for them.  They weren’t enough for me.  Mental illness has a stigma.  Psychiatric labels stick.


I live in terror of those who forgot they once took an oath to do no harm.  However, if I met any one of you, my doctors, on the street, I would not recognize you.  You stole my memory.


Here is Iatrogenic Insanity's story on Youtube as part of a series:"Watch the Stories of Harm the American Psychiatric Association Refused to Hear: Lee's Story"  http://www.youtube.com/watch?v=S83aAvWoJMk


T       The College says 'No Harm' - readers of Iatrogenic Insanity's story provide the appropriate outrage here

HPARB DECISION issued on July 12th, 2013
None of the Board members met me - I had opted for a written investigation because of my cognitive difficulties, my ongoing tremors, my fear of having a seizure, and my anesthetic-related frozen-diaphragm-related breathing difficulties.
I supported my submission with excerpts from books and articles (and emails) by internationally known and respected psychiatrists Peter Breggin (Your Drug May be Your Problem), David Healy (Pharmageddon) and Jay Cohen (Over Dose.)  I even had a consult with Dr. Jay Cohen who is an akathisia expert. He said I was not depressed and that I most certainly did have akathisia. 
I will now do what my hero Sholom Glouberman (Patients' Association Canada ) did  - write a book and publish my medical records and the readers will provide the outrage. The CPSO and the HPARB in effect decided it is perfectly acceptable for a psychiatrist to be unaware of drug adverse effects and to drive a patient insane by prescribing a new drug each week -  as long as they don't cheat on OHIP.
July 18, 2013
Excerpts from the HPARB decision:
Pursuant to section 35(1) of the Code, the Board confirms the Committee's decision to remind the Respondent to:
i) perform appropriate documentation, including a patient's informed consent;
ii) ensure he has a proper understanding of lithium's clinical indications,appropriate dosages, response times, and possible side effects:
iii) avoid fraudulent OHIP billing practices and to refer this matter to the General manager of OHIP for further review: and to,
iv) take no further action on the complaint.
Signatures follow:
1)  A lawyer - family and divorce law, commercial litigation, business law lecturer, Assistant Crown Attorney 
2)  A chartered accountant, university lecturer, board member of several not-for-profits, particularly in the healthcare sector.
3)  An educator/professor for more than thirty years 
12.  After conducting a review of a decision of the Committee, the Board may do one or more of the following:
a) confirm all or part of the Committee's decision;
b) make recommendations to the Committee;
c) require the Committee to exercise any of its powers other than to request a Registrar's investigation.
13. The Board cannot recommend or require the Committee to do things outside its jurisdiction, such as make a finding of misconduct or incompetence against the member, or require the referral of allegations to a discipline hearing that would not, if proved, constitute either professional misconduct or incompetence.
There is no indication of further information that might reasonably be expected to have effected the decision, should the Committee have acquired it.  Accordingly, the Board finds that the Committee's investigation was adequate
31.  The Committee accepted the IOP's conclusion that the Applicant did not experience medication-induced akathisia and the Board is again of the view that the Committee was entitled to do so. The Board concludes that the Committee's decision to take no further action regarding this aspect of the Applicant's complaint is reasonable.
38 ...the Board finds the Committee's decision that the Respondent did not misdiagnose the Applicant to be reasonable.
and so it goes ...and no one will learn from my experience...and the psychiatrist's reputation and record remains untarnished.