Mental illness

We are in the midst of a ‘psychedelic renaissance’. Not since the 1950s and early 1960s has there been so much interest in researching the therapeutic potential of psychedelics. The FDA approved a ketamine derivative for medicinal use in 2019, and has given both MDMA and psilocybin (the psycho-active ingredient in magic mushrooms) ‘breakthrough therapy’ status, putting the drugs on a fast track to approval in the US, with the UK likely to follow suit. Professor David Nutt is a neuropsycho-pharmacologist (say that three times fast) and head of the Centre for Psychedelic Research at Imperial College, London. He was the UK’s ‘drug tsar’ before getting sacked in 2009 for

There is more than one way to read the title of Mona Simpson’s seventh novel Commitment, a multigenerational family saga set mainly in California in the 1970s and 1980s. There is the ‘hospital commitment’ Diane Aziz, a single mother of three teenage children, needs after sinking into a deep depression shortly after her eldest, Walter, starts at UC Berkeley. Then there is the commitment Diane’s children show to their mother – and to one another, as they struggle through life, love and loyalty to each other while hoping Diane will one day leave her hospital compound. And there is also the deeper commitment between Simpson, who was born in Wisconsin

A friend who works in social care speaks to me earnestly about a troubled young colleague: ‘Of course, she’s got a borderline personality disorder…’ I check her there: ‘What do you mean by that?’ She thinks for a moment and continues: ‘Well, she’s very emotional, she can’t maintain relationships, and she’s very defiant…’ I wait for a moment to see if there’s anything else before I say my bit: ‘Perhaps she just has a bad character — because fundamentally that’s all a personality disorder is: epithetic psychiatry. There’s no defined organic basis for these so-called disorders, no psycho-dynamic aetiology either, no progression — and, of course, no cure.’ My friend

Having a breakdown? Try this pill, or that — or these? Built on the 1950s myth of a chemical imbalance in the brain, long since debunked, modern psychiatry still pours pills on trauma. While their general mechanisms are hypothesised, the specific consequences of different psychotropic drugs for individual brains remain haphazard. ‘We prescribe by side-effect, by trial and error,’ one consultant psychiatrist told me. ‘But I’ve seen all these drugs working,’.The problem is that pills alleviate symptoms of mental illness while doing nothing for causes. Psychiatry’s dilemma mirrors that of Tom Tuplow, the hero of Jasper Gibson’s magnificent novel, a delightfully intelligent man from a broken home who took too