No longer content with just wilful ignorance, Dr Caroline Leaf has stooped even further by using the death of a beloved actress as a sick segue against psychiatric medications.
Dr Caroline Leaf is a communication pathologist and self-titled cognitive neuroscientist. She markets herself as an expert in neuroscience and mental health despite not knowing how genes work (https://cedwardpitt.com/2014/09/27/dr-caroline-leaf-and-the-genetic-fluctuations-falsehood/ and https://cedwardpitt.com/2017/01/07/dr-caroline-leaf-the-christian-churchs-anti-vaxxer/).
In her latest “Mental Health News – January 2017” e-mail newsletter, Dr Leaf makes some astounding and outlandish statements about mental health.
She starts by claiming that Carrie Fisher’s death was ultimately caused by the psychiatric medications she was taking.
“Few people, however, are talking about the possible link between her heart attack and her psychiatric medication. As mental health activist Corinna West shows, ‘new antipsychotics cause weight gain, diabetes, and a bunch of other risk factors associated with heart disease.’ We have to take these risk factors seriously. We are not merely talking about statistics—we are talking about real people, people like Carrie Fisher.”
Dr Leaf, no one’s talking about the possible link between her heart attack and her psychiatric medication because we respect the Carrie Fisher too much and would rather celebrate her life and achievements, not perform a hypothetical post-mortem motivated by prejudiced speculation.
No one’s talking about the possible link between her heart attack and her psychiatric medication because no one really knows what caused Carrie Fisher’s heart attack. No one knows if she had any other risk factors for heart attacks, or what medications she was on. There could be a dozen other reasons why she had a heart attack. No one else is asking because it’s none of our business.
No one’s talking about the possible link between her heart attack and her psychiatric medication because we know that psychiatric medications do much more good than harm.
No one is talking about the possible link between her heart attack and her psychiatric medication because it’s highly disrespectful to use someone’s death to promote your political or ideological position. Using Carrie Fisher’s death as a segue to your soapbox about psychiatric medications is like someone using Princess Diana’s death as an opportunity to talk about the dangers of speeding in tunnels. It’s ungracious, unbecoming, and in poor taste.
What’s even more dishonouring to Carrie Fisher is that Dr Leaf’s claims about psychiatric medications are not accurate.
“Sadly, individuals suffering from mental health issues ‘die, on average, 25 years earlier that the general population.’ These medications are incredibly dangerous, and we have to start asking ourselves, as the investigative journalist and mental health campaigner Robert Whitaker notes, if the benefits of these drugs truly outweigh the risks.”
Notice the giant hole in her argument? She assumes that the increased risk of death in those with mental illness is the medications they’re on, just like she’s assumed that Carrie Fisher died because she was taking psychiatric medications.
That’s confirmation bias, not science.
Real mental health experts – the ones with training, clinical experience and research acumen – directly contradict Dr Leaf. Experts like Correll, who say that, “Although antipsychotics have the greatest potential to adversely affect physical health, it is important to note that several large, nationwide studies providing generalizable data have suggested that all-cause mortality is higher in patients with schizophrenia not receiving antipsychotics.” [1]
In other words, the life expectancy of people with schizophrenia is shorter than the rest of the population, but it’s much shorter in schizophrenics not on meds. Psychiatric medications help people with schizophrenia live longer.
In fact, the use of any anti-psychotic medication for a patient with schizophrenia decreased their risk of dying by nearly 20% [2] whereas the risk of dying for schizophrenics who didn’t take anti-psychotics was nearly ten times that of the healthy population [3].
This is the same for other psychiatric medications as well, “clozapine, antidepressants, and lithium, as well as anti-epileptics, are associated with reduced mortality from suicide.” [1]
Psychiatric drugs aren’t “incredibly dangerous”. Like any tool, when used in the right way, they can bring radical transformation. What IS incredibly dangerous is the disingenuous and ill-informed making libellous and inaccurate statements about medications they don’t understand.
Not content to just insult Carrie Fisher’s memory, Dr Leaf went on to claim that psychiatric labels are also as harmful as psychiatric drugs. “These risks are not limited to taking medication. Psychiatric labels can also harm the individual involved. Child psychiatrist Sami Timimi recently discussed the adverse effect the autism label can have on children and adults alike. Labels can lock people in, taking away their hope for recovery, affecting their ability to perform everyday tasks and crippling their determination to live above their circumstances. Words can harm people as much as “sticks and stones” do, as psychologist Paula Caplan notes in her talk on psychiatric survivors and diagnoses.”
It’s witless to suggest that labels harm people or that they somehow lock people in and take away their hope. The right label, which doctors call a diagnosis, doesn’t lock people in at all, it does the exact opposite:
* The right diagnosis gives hope – hope that comes from receiving the right treatment and not wasting time, money and energy pursuing the wrong treatment.
* The right diagnosis gives power – it empowers people by giving them the ability to make accurate decisions about what’s best for themselves and their loved ones.
* The right diagnosis gives certainty – in many situations, knowing what the diagnosis is reduces unnecessary anxiety and fear.
Imagine that you had a freckle on your arm, and it started growing suddenly. You go to the doctor, and the doctor says that the freckle is actually a skin cancer. Does that label lock you in and take away your hope? Of course not. It gives you the certainty of knowing that treatment is needed, and the power to decide if you want that treatment. And it gives you hope that with the right treatment, you can continue to live a healthy life.
In the same way, a psychiatric diagnosis doesn’t lock people in and remove their hope. A child who understands that they have autism can stop beating themselves up for being ‘odd’ and instead, they can understand that their different wiring gives them special powers that other kids don’t have.
Psychiatric labels do not harm an individual, it’s the backwards opinions of so-called mental health experts that harm individuals with psychiatric illness. The stigma of a diagnosis is related to the way in which society treats individuals with that diagnosis, not the diagnosis itself. Perpetuating the myth that that ‘depression and autism aren’t really diseases’ reduces the acceptance of society for those who suffer from those conditions. That’s what causes harm.
Dr Leaf should apologise to her followers for showing such disrespect for Carrie Fisher, and to all those who take psychiatric medications. Carrie Fisher spent her life supporting people with mental illness, trying to break down the stigma of psychiatric illness and treatment. Her life’s work should be celebrated, not defaced by Dr Leaf and her unscientific opinion.
References
[1] Correll CU, Detraux J, De Lepeleire J, De Hert M. Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder. World psychiatry : official journal of the World Psychiatric Association 2015 Jun;14(2):119-36.
[2] Tiihonen J, Lonnqvist J, Wahlbeck K, et al. 11-year follow-up of mortality in patients with schizophrenia: a population-based cohort study (FIN11 study). Lancet 2009 Aug 22;374(9690):620-7.
[3] Torniainen M, Mittendorfer-Rutz E, Tanskanen A, et al. Antipsychotic treatment and mortality in schizophrenia. Schizophrenia bulletin 2015 May;41(3):656-63.
Dr C. Edward Pitt 
Thank you for taking the time to articulate your concerns with this latest post by Dr. Leaf! She went next level. I was outraged by her sweeping statements and to use the death of much-loved Carrie Fisher to carry her own agenda is truly mind blowing. Furthermore, how on earth can anyone in their ‘right’ mind make such a claim between her psychiatric medication and heart attack?? My jaw was on the floor when I read this. Actually in total disbelief. For someone who claims to be so well educated and up to date with science, this was a truly foolish comment! I could go on, but you have said everything I have thought. I feel especially angered about the potential damage caused to those taking psychiatric medication – so THANK YOU for clearing that up one. The use of medication when appropriate actually saves lives and helps to improve health and prognosis. For example. someone experiencing acute mania absolutely has to receive intervention (medication and usually an inpatient admission)…this is not dangerous or harmful. It’s ethical and humane. I would suggest that it even gives someone in this position or similar some level of dignity whilst they recover. Diagnosis is not synonymous with a ‘trapping’ label that Dr. Leaf states can “lock people in”…in fact, patients can feel relieved to give their experience a name, understanding their condition might actually be relatively common, and as you said, hopeful to receive some answers and go on to treatment.
I’ll sign off now before I take over your page with any more comments 🙂
Thank you again.
Your comments are always welcome Dr Kate! 🙂 Always great to hear from you.
Hi, I happen to believe drug medications they give to people with mental disorders are very dangerous. My niece had bipolar and the doctor had prescribed four different meds for her. She died the autopsy said her heart was so swollen it just gave out. She was only twenty years old, they didn’t bother to check the whole body out, maybe brain scan try a milder treatment before dosing her up with these drugs.
Hi Janet,
Thanks for your comment. I’m sorry to hear about your niece and I don’t want to invalidate her tragic loss, and like everyone, you’re welcome to your opinion.
I can’t say anything specific about your experience. All I can say is that in people who need them, anti-psychotics are beneficial overall.
People occasionally die from reactions to antibiotics. Should we say that antibiotics are very dangerous? Should we demonise them? Overall, when used correctly, antibiotics improve our lives and often save lives.
Psychiatric medication is no different – it does much more benefit than harm. Dr Leaf demonises psychiatric medications to tap into fear and uncertainty of our society. She is promoting and enhancing their stigma, not trying to allay it, which is the direct opposite of what the church really needs from a mental health expert – a sad reflection of both the modern Christian church and Dr Leaf herself.
All the best to you.
As someone who is diagnosed with bipolar and can not come off the medication to try something like ECT(I can’t sleep with out an antipsychotic now). I think Dr. Caroline Leaf has a point although poorly written.
Hi Green Rockz. Sorry to hear about your experience with the medication. I hope that your doctors can find a better alternative for you. No drug is perfect, and unfortunately there are people for whom medications don’t work perfectly or at all. My issue with Dr Leaf’s article is not that she is discussing the issues with medications, but her conclusions are either inappropriate and/or flat out incorrect. Her article doesn’t help reduce the stigma of mental health, it increases it. She doesn’t add to the discourse about medications, she simply dismisses them. This is counter-productive in my view. I understand you may see it differently, and that’s ok. We certainly need to have a discussion about the role of medications in mental health, but with an open mind, not a narrow one demonstrated by Dr Leaf. All the best to you.
I’m assuming you have read the European Heart Journal that shows how people die 25 years earlier. That’s her point in my opinion.
I have heard many claims like they are “throwing the baby out with the the bath water.” and stuff like. I was medicated for years in my parents home to young to determine or find out information myself and now I am stuck on medication that is no longer needed(My MD agrees).
Mental Health is in my opinion a catch all for certain people in society.
Hi Green Rockz,
I’ve read Dr Leaf’s opinion but I think she’s wrong. She, like her heroes at Mad In America, are cherry picking to cast the medications in a bad light. There is a higher mortality rate amongst people with schizophrenia and other forms of psychosis, no one is denying that. Dr Leaf and MIA claim that it’s the anti-psychotics, and they point to studies like the one whose graph you linked to (Honkola J, Hookana E, Malinen S, et al. Psychotropic medications and the risk of sudden cardiac death during an acute coronary event. Eur Heart J 2012 Mar;33(6):745-51), but those statistics needs to be read in context.
First, that 18-fold increase is an association, not a cause, and secondly it’s specifically the association between the combined use of phenothiazines and any antidepressant with sudden cardiac death during a heart attack. Looking at the table, the only statistically significant results were for old anti-psychotics, phenothiazines, tricyclic antidepressants and butyrophenones, none of which are first line medications for psychosis or depression anymore. Newer anti-depressants and the newer atypical anti-psychotics did not have a statistically significant association. And, like I said before, this study is looking at the association between sudden cardiac death in people having a heart attack, which is a very specific form of mortality. It’s not particularly applicable to everyone on the medications, so even if the 18-fold increase is rock solid, you can’t translate that statistic to everyone on anti-psychotic medications or anti-depressants.
A more useful thing for me to know would be the benefit or harm of anti-psychotics on all-cause mortality. If there was a clear harm in them, then all-cause mortality would be much higher in those exposed to the drugs versus those who were never exposed to the drug, which is why this study is particularly interesting: Torniainen M, Mittendorfer-Rutz E, Tanskanen A, et al. Antipsychotic treatment and mortality in schizophrenia. Schizophrenia bulletin 2015 May;41(3):656-63 and in particular, this graph – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4393693/figure/F1/
In their sample, the all-cause mortality was significantly higher in those people with schizophrenia who were never treated with anti-psychotics.
Does this answer the question why there is a lower rate of mortality with anti-psychotic use? Not really, it’s just an association and doesn’t specifically prove causation.
Does it show that we should throw anti-psychotics around like lollies, or that they’re wonder drugs without any associated harm? No, they are medicines and need to be used responsibly.
It does show that while there are specific conditions where mortality may be worse with anti-psychotics, there is a general benefit overall to them and certainly they’re not the killers that Dr Leaf and MIA make them out to be.
I am sorry to hear about the problems you’re having in your particular case. I understand why you’re not the biggest fan of the medications, but your case is a reminder that while the medications might be helpful generally, doctors need to be judicious in their use of the medications, not just prescribe the medication for the sake of it.
Good luck, and all the best to you.
Pingback: Where are all the shepherds? | Dr C. Edward Pitt
Pingback: Dr Caroline Leaf – stop spreading ADHD stigma and ignorance | Dr C. Edward Pitt