Mad in America: Rethinking Mental Health

A practicing Serbian psychiatrist discusses challenging norms in psychiatry, critiquing genetics research in depression and advocating for de-medicalizing experiences rather than immediate diagnoses or treatments. Topics include the impact of biological narratives on patients, complexities of drug dependency, and effects of psychiatric diagnoses on identity.

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

Lisa Cosgrove and Brian Piper discuss undisclosed financial conflicts of interest in the DSM-5, exploring the impact on psychiatric diagnoses and treatment guidelines. They highlight the prevalence of conflicts among key opinion leaders in psychiatry and the implications for patient care. The conversation also touches on industry funding in medication-induced movement disorders, the medicalization of emotional distress, and the importance of transparency and skepticism in mental health research.

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

Philosophy professor Justin Garson discusses madness as a designed feature, challenging the view of madness as a defect. The podcast explores depression as a functional signal and critiques the biomedical narrative of mental illness. It advocates for empowering individuals to lead their recovery and prioritize non-pathologizing approaches in mental health.

Deborah Kasdan is author of Roll Back The World: A Sister’s Memoir, in which she describes her extraordinary late sister Rachel–poet, musician, free spirit–and her decades-long journey through psychiatric treatment until, finally, she found a place of peace and community.  Kasdan is a longtime business and technology writer who pivoted to memoir writing on a quest to tell her sister’s story, joining the Westport Writers’ Workshop. Her book, published in October by She Writes Press, is a moving and nuanced portrait filled with love and grief, candor, and complexity.  *** 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

Hello and welcome to the Mad in America: Rethinking Mental Health podcast. If you are new here, hello. My name is James and I will be your host as we ask critical questions about the state of psychiatry and psychology in the 21st Century. In this podcast, we examine mental health with a critical eye by speaking with psychologists, psychiatrists, researchers, journalists and people with lived experience. When you hear such conversations, you realise that much of what is believed to be settled in mental health is actually up for debate. Is mental health a matter of faulty biology or is there more to it? Are the treatments used in psychiatry helpful or harmful in the long term? Are psychiatric diagnoses reliable? With the help of our guests, we examine these questions and so much more. I think you will find the podcast insightful, informative, and, most of all, thought-provoking. It’s available on all major podcast platforms like Spotify, Apple or Google podcasts and YouTube. Just search for Mad in America: Rethinking Mental Health. Please join us for these important conversations. *** Mad in America 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

Mark Freeman is a renowned author and a pioneering voice in the emerging field of the psychological humanities. He serves as Distinguished Professor of Ethics and Society in the Department of Psychology at the College of the Holy Cross. His body of work, including the critically acclaimed Toward the Psychological Humanities: A Modest Manifesto for the Future of Psychology (Routledge, 2023), offers a profound reimagining of psychology, interweaving it with the arts and humanities to better understand the human condition. He is the author of numerous additional works, virtually all of which, in one way or another, speak to the emerging field of the psychological humanities. These include Rewriting the Self: History, Memory, Narrative (Routledge, 1993); Finding the Muse: A Sociopsychological Inquiry into the Conditions of Artistic Creativity (Cambridge, 1994); Hindsight: The Promise and Peril of Looking Backward (Oxford, 2010); The Priority of the Other: Thinking and Living Beyond the Self (Oxford, 2014); and Do I Look at You with Love? Reimagining the Story of Dementia (Brill | Sense). Along with David Goodman, he has also co-edited Psychology and the Other (Oxford, 2015) and, with Hanna Meretoja, has co-edited the recently published The Use and Abuse of Stories: New Directions in Narrative Hermeneutics (Oxford, 2023). He also serves as Editor for the Oxford University Press series “Explorations in Narrative Psychology.” In this interview, we'll explore his personal journey toward the psychological humanities, delve into his work in narrative psychology, and discuss his approach to the concepts of 'self' and the 'Other.' We'll also touch upon how his perspectives guided him as he navigated his mother's journey through dementia, a deeply personal narrative shared in his book. *** 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 Mad in America podcast this week, we continue our reader Q&A with Mad in America founder Robert Whitaker. In Part 1, we discussed Mad in America, the biopsychosocial model and the history of psychiatry. For Part 2, we will be covering reader questions on pharmaceutical marketing and issues with psychiatric treatments including psychiatric drugs and electroconvulsive therapy. Thank you to all of you who took the time and trouble to send in your questions. *** 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