Cruising for a bruising.

Perhaps I best not mention his name; his lawyers, after all, are much more familiar with The Color of Money than mine will ever be. Nevertheless, these outrageous rantings by one of Hollywood’s alleged Top Guns—denouncing psychiatry and challenging the legitimacy of psychiatric illness—has got to stop. Claiming he has a Firm grip on the facts, he defends an ideology that refers to psychiatry as a “Nazi Science”; one can only imagine how Holocaust survivor and psychoanalyst, Victor Frankl— author of “Man’s Search for Meaning”—might have responded to such a vile claim. He further describes psychiatry as a pseudoscience; that the key to beating depression, attention deficit disorder, and psychotic disorders is not some evil drug Cocktail, but rather proper exercise, ample vitamins, and plain good living. Now, I wasn’t Born on the 4th of July, or yesterday for that matter, but surely, the ability to play the role of an authority does not confer authority status or authority knowledge. Conf lating one with the other is Risky Business, with the potential for much Collateral damage. For example, 154,000 people apparently wrote their thanks for his public diatribe; he did not, however, disclose how many bothered to register their objections. Let us imagine that each of those correspondents was someone with a chronic major mental illness. According to his prescription, All the Right Moves would include stopping medication, abandoning psychiatric support, popping vitamins, and perhaps taking up an exercise class. Now I don’t mean to Rain, Man, on your parade, but do you understand the despair of profound, soul crushing depression, the anguish of feeling one’s mind spinning out of control, or the terror of entering into a mental space well past Losin’ It? The judicious use of psychopharmaceuticals, as part of comprehensive psychiatric care, can make the difference between life and death, and while this may not jive with your picture of “the ideal scene for life,” whoever said life was ideal—except perhaps in the movies. Over the past few decades, more than a Few Good Men and women have amassed evidence, within the fields of epidemiology, psychiatry, psychology, neurochemistry, pharmacology, neuroimaging, and genetics, establishing the validity of various psychiatric disorders. As you correctly point out, there is no simple “blood test” to confirm these diagnoses, but the same could be said of many medical conditions. Pain, for example, can not be diagnosed on the basis of a blood test, and yet clearly exists. In my field of end-of-life care, the skillful application of analgesic medication, along with comprehensive palliative care well before the time to play Taps can make all the difference between anguish and good quality of life. So why bother embarking on this Mission: Impossible, by taking issue with this Young Gun? It is because most of us will forever remain Outsiders to the experience of being a mega-celebrity. This rarified status confers power and inf luence, including the Endless Love and adoration of fans and followers worldwide. The likes of Bono, Geldolf, and Jolie are using their celebrity to try and reshape the world into a place that is Far and Away from a planet plagued by poverty, pandemics, and strife. So why squander the opportunity of your celebrity? Worse yet, why use it to do a disservice to people whose suffering renders them so vulnerable? I know, I know, you have read the history of psychiatry, and you have reviewed the literature. But alas, you must have done so with your Eyes Wide Shut.