The homeopathic treatment of bipolar is unethical and dangerous

I'm with Jane. I have been planning to write this post for about a year. It has taken me this long to calmly put words to paper, as the topic of this article is sensitive for those of us who know someone, or who themselves, suffer from bipolar disorder.

About ten months ago, a naturopath by the name of Dorothea Cist commented on my article about ND education and training, claiming:

I have many other cases of, and letters of testimony from, patients who were treated successfully by naturopathic medicine, and often by homeopathy alone. These magnificent cures, by treatments completely unsupported by any double-blind, placebo-controlled clinical trials, were from pathologies as varied as rheumatoid arthritis, ulcerative colitis, grand mal seizures, interstitial cystitis, and bi-polar [sic] disorder.

I asked Cist to clarify. Is she claiming she can cure bipolar disorder with homeopathy?

She didn’t respond, but she didn’t need to. Yes, Cist was asserting she can use magic to cure a mental illness, along with a slew of other complicated diseases.

Statements like Cist’s infuriate me. And they also break my heart. I am sad for the patients, and their families, who have fallen prey to false claims regarding the safety and efficacy of treating mental illness with naturopathy and homeopathy. Naturopaths are terribly under-qualified to treat mental illness.

I happen to know several people with bipolar disorder. One of these people is very close to me. I have held her hand and wiped away tears while listening to harrowing tales of mania, suicidal ideations, and depression. I have been privy to the fear, the anger, the delusions, and the hopelessness that often accompanies bipolar disorder. I am in awe of my friend everyday, who bravely gets up, takes her medication, and carries on, despite the enormous challenges that lie ahead for her.

If there was a cure as simple as homeopathy, high-dose vitamins, or diet changes, trust me, my friend and I would pursue it. But bipolar management is far from simple, and homeopathy will never cure any disease.

A disease with no cure

There is no such thing as a cure for bipolar disorder. There is only bipolar disorder management. The evidence is clear on this point: bipolar disorder is a life-course illness that is managed best with the help of a qualified medical physician and psychiatrist. The exact causes of bipolar have not yet been pinned down. We know multiple factors contribute to the disorder. The specific combination of these factors likely differ person to person. And, genetics probably play a big role in the cause. [1, 2, 3] Given the lack of knowledge around the cause, it makes sense no cure exists.

More often than not, medications offer bipolar patients relief from the disease’s troublesome  symptoms, which include alternating episodes of mania and depression, delusions, insomnia, anxiety, and migraines. The use of herbs and diet to control these symptoms is not well-researched, and generally not recommended by leading organizations, such as the National Institute for Mental Health. Certain herbs and nutrients can trigger mania, such as St. John’s Wort or 5-HTP (an intermediate in the serotonin pathway.) Since we still do not understand the effects of combining pharmaceutical medication with herbal supplements and high-dose vitamins, it is safest to avoid these combinations. Even seemingly benign therapies, such as fish oil, have had mixed results for patients with bipolar. [1, 2, 3]

I was surprised when I could not find unambiguous statements from reputable medical organizations that could help steer bipolar patients away from alternative medical therapies for disease management. Of all the websites I perused, Mayo Clinic offered the most straight-forward and clear advice: [4]

Don’t stop taking your prescribed medications or skip therapy sessions. Alternative medicine is not a substitute for regular medical care when it comes to treating bipolar disorder.

Be honest with your doctors and mental health providers. Tell them exactly which complementary treatments you use or would like to try.

Be aware of potential dangers. Just because it’s natural doesn’t mean it’s safe. Before using alternative or complementary medicine, find out the risks, including possible interactions with medications.

This is a good start. But I’d really like to see a stronger statement that gets to point about using naturopathic, specifically homeopathic, treatments for bipolar disorder. Let me be the first.

No natural remedy, including vitamins, herbs, dietary changes, or energetic therapies such as homeopathy, has been clinically proven to be safe and effective for managing bipolar disorder. It is strongly recommended that patients suffering from bipolar disorder make treatment decisions with the help of a qualified medical physician and psychiatrist. In the interest of your well-being and safety, please do not employ a naturopath and/or homeopath to assist in your treatment, as these providers are not adequately trained to diagnose or manage mental illness.

I was not aware of bipolar disorder until college, when two acquaintances each committed suicide, just a few months apart, after quietly struggling for years with the disorder. My childhood acquaintance took his life violently, characteristic of most men attempting and/or committing suicide. My girlfriend from college also chose a gender-based stereotypical method; she overdosed on Tylenol. [5,6]

These incidents were seminal in my life. After they occurred, I was very sad, but also very curious about bipolar disorder and what drives these patients to the brink of suicide, and often over the edge. Seeking answers, I turned to the book An Unquiet Mind: a memoir of moods and madness, written by Kay Redfield Jamison, PhD.

A literary description of bipolar

Dr. Jamison is a clinical psychologist who also suffers from bipolar disorder herself. She was diagnosed with the disorder as a young adult. Since this time, she has written extensively about her personal experiences with the disorder, and its treatment. In her 1995 memoir detailing her personal struggles with bipolar, she describes mania like this:

There is a particular kind of pain, elation, loneliness, and terror involved in this kind of madness. When you’re high it’s tremendous. The ideas and feelings are fast and frequent like shooting stars, and you follow them until you find better and brighter ones. Shyness goes, the right words and gestures are suddenly there, the power to captivate others a felt certainty. There are interests found in uninteresting people. Sensuality is pervasive and the desire to seduce and be seduced irresistible. Feelings of ease, intensity, power, well-being, financial omnipotence, and euphoria pervade one’s marrow. But, somewhere, this changes. The fast ideas are far too fast, and there are far too many; overwhelming confusion replaces clarity. Memory goes. Humor and absorption on friends’ faces are replaced by fear and concern. Everything previously moving with the grain is now against– you are irritable, angry, frightened, uncontrollable, and enmeshed totally in the blackest caves of the mind. You never knew those caves were there. It will never end, for madness carves its own reality.

As for suicidal ideations, Jamison writes:

If I can’t feel, if I can’t move, if I can’t think, and I can’t care, then what conceivable point is there in living?

Reading these excerpts again, I can make sense of the pain and the fear present in bipolar patients. I can understand the desire for simple treatment answers. I can also see how patients, possibly in the midst of a manic moment or dark depression, could be swindled into believing that something energetic, like a “vital force” said to be present in ourselves and the universe, is the answer to ridding them of all their suffering. In fact, mania is hallmarked by impulsive and often irrational decision-making along with extravagant ideas and beliefs. Delusions are common, and can accompany hyper-religiosity, grandeur, or feelings of persecution. [1-4] In this context, it seems relatively easy for naturopaths to successfully persuade manic-depressive individuals to denounce the evils of Big Pharma and to believe in “the healing powers of nature.”

Jamison is an outspoken advocate for pharmacological intervention and psychotherapy as the best, and only, approaches for effectively managing the symptoms of bipolar disorder. Anything else, Jamison argues, is dangerous and life-threatening for the bipolar patient. This seems stark, but it is estimated that anywhere from 25% to 50% of bipolar patients will attempt suicide at least once. The drug lithium (derived from the naturally-occurring chemical element for which it is named) remains the “most demonstrably effective treatment against suicide” in bipolar patients. [5-7]

Despite her resolute stance on pharmacological intervention as part of responsible bipolar management, Jamison understands the desire to find cures and answers in something other than a pill. She says,

No pill can help me deal with the problem of not wanting to take pills; likewise, no amount of psychotherapy alone can prevent my manias and depressions. I need both. It is an odd thing, owing life to pills, one’s own quirks and tenacities, and this unique, strange, and ultimately profound relationship called psychotherapy.

Years after reading this book, my dear friend (let’s call her Jane) was diagnosed with bipolar disorder. I was already well into my naturopathic cult phase when the diagnosis came. Thankfully, Jamison’s words stuck with me. I knew we needed medication on board, and the skills of a psychiatrist. Even though I was a naturopath, I knew that no naturopathic therapy could effectively or safely manage bipolar’s mania and depression. Perhaps this was because I had already seen the devastating effects of bipolar illness. Or maybe the writing was already on the wall regarding my future relationship with naturopathy. Regardless, steering my loved one away from naturopathy and toward real medical care was one of my best acts as a naturopath. Surprisingly, not everyone felt that way.

“Go Hug a Tree”

I was taken aback by the amount of social villainization Jane experienced after the diagnosis of bipolar. The problem for Jane’s peers was not the fact that she had bipolar disorder; it was how she was choosing to treat bipolar with lithium and lots of therapy, that caused problems.

Given our draw to naturopathic woo, I was surprised that Jane was receptive to my recommendation that she avoid naturopathic care for bipolar disorder. After planting the seed, I equipped her with a copy of Jamison’s book. Jane devoured the book in a matter of hours. She called me crying, “I feel like Jamison is narrating my life.” I was weirdly happy about this. This meant Jane was going to follow Jamison’s advice, and start medication. And she did.

Shortly after starting lithium, Jane began to feel significantly better. Yes, the lithium had side effects; most of them still persist. Jane suffers from severe dry mouth constantly. She gets headaches and experiences dehydration and nausea from time to time. But this cost, she says, is worth the treatment.

I remember her describing the experience of starting lithium as a feeling of gaining control of her life again. She knew she would likely be on lithium forever, or for as long as possible given the long-term side effect of kidney failure, but this was okay, because she now had a future she could believe in and plan.

Feeling good about starting the appropriate treatment stopped short for Jane when a fellow “friend” and believer in naturopathy suggested Jane was poisoning her body with lithium. This friend went so far as to say that Jane actually didn’t suffer from bipolar at all, because the disease doesn’t really exist. This diagnosis was a way for pharmaceutical companies to take advantage of patients and brainwash them into thinking they need medication for life. In reality, this friend proclaimed, Jane was just out of touch with nature. Her chakras were off. The only treatment necessary was to get outside more and hug a tree. While shocking, I can see how a naturopathic devotee would believe such nonsense.

For some inexplicable reason, naturopaths, like Dorothea Cist, believe they are qualified to treat mental illness. Naturopathic students at Bastyr do take a course called “Addictions and Disorders,” which touches on a variety of mental illness disorders. The course was taught by someone pursuing her PhD in psychology (I think). As many readers know, I also took one class in pharmacology. We may have covered the prescribing and management of anti-psychotic drugs and others, like lithium. I’d have to comb through my notes to know for certain. But I don’t need to do this. Any reasonable person understands that one class in mental health, followed by one class in pharmacology, does not make a provider competent in mental health care. To claim otherwise is preposterous.

On the other hand, naturopaths have extensive training in homeopathy. Students spend far more time memorizing remedies and homeopathic keynotes compared to learning drug names, dosing schedules, and medical indications. Some of the best homeopathic keynotes allude to mental illness, such as: (homeopathic remedy listed in parentheses) [8]

  • Hysterical personality who longs for amusement (Sumbulus)
  • Haughty, ungrateful, and easily bored philosopher, who hates changing his clothes or washing them (Sulphur)
  • Extremely nervous and restless personality; lack of concentration; tantrums; hard to convince that her ideas are unrealistic (Tantal)
  • Sensitive to the slightest touch; if it was possible, he would wear nothing; friendly person who lets his dog howl instead (Anthrax nosode)
  • Simple minded and very shy person, who suffers from severe memory problems and should never be forced to pick up the phone (Ambra)
  • Mentally confused and very irritable person with persisting thoughts and suffering from weary and swollen feet (Aesculus hippocastanum)

Perhaps this is why so many naturopaths feel they are qualified to treat mental illness using homeopathy.

For example, the licensed naturopaths Mark Janikula and Brooke McNeal at Fountainhead naturopathic mental health clinic in Santa Cruz, CA, claim their own “innovative” system of treating bipolar is superior to the care offered by real medical professionals. They use homeopathy followed by other “supportive therapies” to help the homeopathy work better. As for medication, they hope to take patients off of their bipolar prescriptions altogether.

Using an old system of debunked medicine to cure mental illness hardly calls to mind innovation. It seems far more archaic, in my opinion, to let the patient suffer, when there are real and effective treatments at hand. I am also fascinated that the naturopathic/ homeopathic treatment plan doesn’t mention counseling, which is a mainstay of naturopathic care.

These folks are not the only licensed charlatans offering magical pills and high-dose vitamins (commonly called orthomolecular medicine) for bipolar disorder. There are many other examples, easily accessed via a Google search.

Tara Peyman writes about homeopathy for bipolar disorder in Natural Healing News and markets herself as an expert in bipolar treatment on her practice website. Her practice is located in Scottsdale, AZ.

Jennifer Bahr promotes herself as an integrative mental health care specialist in Del Mar, CA. I fail to see the integrative aspect of her care, as she primarily uses homeopathy to treat bipolar, which she describes as “the most comprehensive medicine available.” Providing homeopathic care for mental illness is not integrative. It is care-less. But Bahr really shows off her ineptness when she describes bipolar disorder as “a disorder of the circadian rhythm.” I am left speechless.

Final thoughts

I am not arguing that the current evidence-based treatment protocols for managing bipolar disorder are perfect. They are not. This is precisely why there is a market for alternative bipolar therapies. But the shortcomings of pharmacology does not mean we should allow outright unethical practices, like using homeopathy to “cure” bipolar, to persist. Patients’ lives are literally at risk.

I have learned a great deal about bipolar disorder over recent years while experiencing so much of it through the eyes of Jane. From time to time, she gets sick of taking pills, and questions about naturopathy resurface. Should I see a naturopath for dietary advice? Should I consider this supplement? The answer is always the same: no. Thankfully, she (tends to) listen to me.

I am expecting to get slammed for this article. I am going to hear critiques about psychiatry, in general. Many readers have written to me stating they believe that the fields of psychology and psychiatry are quackery, and will I write about these fields, too? (No, I won’t.) I have also heard many arguments that psychiatric intervention involves the swapping of drug side effects for mental illness symptoms. These folks argue that simply “medicating away” mental symptoms is not real treatment.

Fine. But here is the key difference for me, distilled down perfectly by Jane. One group of symptoms, specifically the drug side effects, are annoying and bothersome, but tolerable given the tremendous benefit. The other group of symptoms, which include delusions, dangerous behaviors, suicidal thoughts, and depression, are not. She’d rather risk kidney failure due to lithium, than risk her life due to bipolar disorder.

I’m with Jane. The risks associated with bipolar are too great to not demand anything but the safest, most effective medical care. In the interest of doing no harm above all else, naturopaths should be prohibited from treating bipolar disorder.

I’d give anything to keep Jane, and others like her, safe. I’ll take this heat for this blog post. And if the time ever comes, I’ll give her a kidney. Keeping her away from quackery is worth more than an organ. It’s worth her whole life.

References:

  1. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml#part_145406 Accessed 31 Mar 2016.
  2. National Alliance on Mental Illness. https://www.nami.org/Learn-More/Mental-Health-Conditions/Bipolar-Disorder Accessed 31 Mar 2016.
  3. WebMD.com http://www.webmd.com/bipolar-disorder/guide/bipolar-diet-foods-to-avoid Accessed 31 Mar 2016.
  4. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/bipolar-disorder/basics/alternative-medicine/con-20027544 Accessed 31 Mar 2016.
  5. Schrijvers, Didier. “The gender paradox in suicidal behavior and its impact on the suicidal process”. Journal of Affective Disorders 138 (2): 19–26. doi:10.1016/j.jad.2011.03.050.
  6. Varnik, A; et al. “Suicide methods in Europe: a gender-specific analysis of countries participating in the European Alliance Against Depression. Journal of Epidemiology and Public Health 62 (6): 545–551. doi:10.1136/jech.2007.065391
  7. Baldessarini, R. J., & Jamison, K. R. (1999). Effects of medical interventions on suicidal behavior. Summary and conclusions. The Journal of Clinical Psychiatry, 60 Suppl 2, 117–122.
  8. Jamison, K. R. (2000). Suicide and bipolar disorder. The Journal of Clinical Psychiatry, 61 Suppl 9, 47–51.
  9. Simpson, S. G., & Jamison, K. R. (1999). The risk of suicide in patients with bipolar disorders. The Journal of Clinical Psychiatry, 60 Suppl 2, 53–56; discussion 75–76, 113–116.
  10. Miller, G. (2014). 333 Homeopathic Keynotes composed in Twitter Style. Books on Demand GmbH. Excerpts retrieved from https://goo.gl/Bck3vE Accessed 31 Mar 2016.
  • StThomas

    You will get this a lot, but I was moved by your courage, in changing career. I have followed your blog since it came out, and some of what you have written has informed advice I have given my own patients. Keep up the good work.

    A link to a “nine-minute beat poem”: https://www.youtube.com/watch?v=HhGuXCuDb1UYou may have come across it before, but if you haven’t I think you will enjoy it very much.

    • https://www.naturopathicdiaries.com Britt Hermes

      Yes! I love it- only read it, didn’t know there was a video. Thanks for sharing =)

    • Marcel

      Maybe someone can fix the link; it’s not working.

      • https://www.naturopathicdiaries.com Britt Hermes

        I thought this was just for me, since DE doesn’t allow most youtube links to work. I just googled it and found another video. @disqus_jGr3t28oNN:disqus maybe there is an error in the link posted?

      • https://www.naturopathicdiaries.com Britt Hermes

        I thought this was just for me, since DE doesn’t allow most youtube links to work. I just googled it and found another video. @disqus_jGr3t28oNN:disqus maybe there is an error in the link posted?

  • JGC

    “These magnificent putative cures, by treatments completely unsupported by any double-blind, placebo-controlled clinical trials for which there’s no actual evidence demonstrating safety and efficacy, were [foisted off on subjects suffering] from pathologies as varied as rheumatoid arthritis, ulcerative colitis, grand mal seizures, interstitial cystitis, and bi-polar [sic] disorder.”

    FTFY, Dorothea. No need to thank me.

    • https://www.naturopathicdiaries.com Britt Hermes

      brilliant.

  • knotfreak

    Thanks for venturing into mental health and for addressing the subject head on. I’ve read Jamison’s book and some others I liked even better. Jamison came off as a bit elitist to the loved one I interact with, so I searched for other sources. Patty Duke’s book resonated more with him (RIP, Anna). I do not think you are being too harsh to suggest that ND’s be prohibited from treating bipolar illness. Most people do not realize how high the risk for suicide is with this illness.

    • https://www.naturopathicdiaries.com Britt Hermes

      Ah yes I thought of looking for one of her book’s the other day (with the news reports of her passing.) Now I will be sure to hunt one down. Thanks! The more resources, the better.

      • knotfreak

        It’s called “Call Me Anna” 😉

  • Sassy

    YES!

  • Marcel

    I would be surprised if anyone sufficiently knowledgeable about mental health would disagree with you that “one class in mental health, followed by one class in pharmacology, does not make a provider competent in mental health care.” Nor does it make one a competent provider of any health care. Indeed, any naturopath claiming successful treatment of bipolar disorder needs to have their head examined, if not also their moral aptitude. More than that, it is entirely unethical to treat the disorder without first having established the efficacy and safety of a treatment protocol in well randomized double-blind, placebo-controlled clinical trials. Contrary to the current popular propaganda being spread by the likes of the Council for Responsible Nutrition, among others, such well controlled trials are not only applicable to the evaluation of pharmaceuticals, as anyone who has studied and worked with natural products for decades will attest.

    Like you, I have lost a number of friends to suicide. Off hand, I can think of around 7 and know others who have made attempts. Among my friends and acquaintances with bipolar disorder or chronic depression, most of whom are highly intelligent, including a natural products chemist and a psychopharmacologist specialising in plant-derived products, each one is managing or managed their illness with pharmaceutical drugs. Since they have studied their respective conditions more than most, I can turn to them for reliable information on treatments. What many are not aware of is that, in some cases, both chronic and bipolar depression will remit for many years—even as long as decades. Asked whether there was anything to which they would attribute their remissions, patient’s answers range from dietary changes to childbirth, steady work/employment, marriage, drug treatment, and nothing in particular. In other cases, patients have claimed that alternative treatments reduced the extreme highs and lows of bipolar disorder and eliminated the low mood of chronic depression. Whereas regular depression can be situational, it is also highly susceptible to placebo and relapses are common. For those with bipolar disorder, placebo can also come into play, but not without subsequent relapse, which can be extremely dangerous. As one friend with bipolar disorder explained, “It’s not a disease you mess around with; maintaining stability of mood is critical to survival and it needs to be maintained on an ongoing basis.”

    Finally, for those who know little about bipolar disorder, I recommend Stephen Fry’s documentary, The Secret Life of Manic Depression, parts 1 and 2. His documentary is freely available online.

    • https://www.naturopathicdiaries.com Britt Hermes

      Hi Marcel, you are probably right. Most probably won’t disagree with me about being competent after just a few courses. Your comment made me realize something that I failed to express properly in my post.

      After taking just a couple classes, naturopaths head off into practice believing that they have received a sufficient foundation of knowledge to build off of. And since NDs are not required to complete a residency (except for in UT), this is legally and ethically acceptable by the profession. In practice, ND’s start self-selecting patient populations, like those with mental illness, fertility issues, or cancer. These ND’s then take a few CME courses, read online information, go to NatChat every day to publicly discuss patient cases and get feedback/ advice (because they have NO idea what they are doing), and inevitably, end up experimenting on patients with different naturopathic-y stuffs. They rationalize the use of non-standard treatments with arguments that these remedies have been used traditionally for years by healers, or because Dr. So-and-so on NatChat said it was his “favorite” supplement. And since so many damn naturopaths practice this way, no naturopath “on the inside” steps up to say this is wrong.

      This is one reason why I chose to ex-communicate myself, and not “try to make changes from within the community.” Many ND’s believe I would have been more effective, and seen as having more honor, if stayed an ND and advocated for changes not-so-publicly and within the inner circle. I disagree.

      Naturopaths have built an entire professional community that allows the unethical practice of medicine. I want nothing to do with a profession that condones, directly or indirectly, blatantly deceiving patients.

      • Marcel

        Hi Brit. Those are excellent points. Frankly, I was stunned by the fact that you only received a single course in pharmacology, let alone the same on mental health. Attempting to change the practices of naturopaths from within their community would be tantamount to eliminating most of what they profit by, without the benefit of you being able to successfully diagnose and treat your patients. Just considering the lack of knowledge attending the mechanisms, efficacy, and safety of sundry medicinal plants, the honorable position is the one you took. Rest assured that you are not the first to leave naturopathy in the pursuit of medicine, and you won’t be the last.

      • Thomas Mohr

        Hi Britt, just a few thoughts after a long day writing on some aging paper. First, I would not say that psychology and psychiatry is quackery. In psychology and psychiatry we are at the point where internal medicine stood at the 19th century. We are just discovering the mechanisms and since the most complex organ of the body is involved things are extremely complicated.

        Second, the case of naturopaths “specializing” in certain diseases highlights an much bigger problem. As a medical doctor you are either an general practicioner or a specialist. With the exception of everyday diseases, GPs are a triage instance to refer to a specialist and later executioner or supervisor of the treatement conducted by a specialist. In order to become a specialist an MD has to have at least 6 years post graduation training plus an exam that is one of the toughest exams I have ever seen – basically a 1000 pages book one has to know by heart. My best friend is a dermatologist and when she did that exam she was four months incommuncado – except for an occasional dinner after work.

        This is the huge difference between “specialized” NDs and MDs – NDs do not even remotely do anything like that and are taught by people who haven’t done anything like that. The result is a massive Dunning Kruger effect which was characterized by John Cleese in his unique way as following:

        “The problem with people like this is that they are so stupid, they have no idea how stupid they are. In order to know how good you are at something requires exactly the same skills as it does to be good at that thing in the first place, which means — and this is terribly funny — that if you are absolutely no good at something at all, then you lack exactly the skills you need to know that you are absolutely no good at it.”

        Bipolar disorder is a largely incurable, poorly understood, extremely burdening and potentially deadly disease with few to no warning signs that something very tragic is going to happen. I think your decision to quit was very wise. To quote Richard Dawkins on “alternative” Medicine (paraphrased): “As soon as a treatment shows it is efficient it becomes per definition part of the canon of classical medicine.” This leaves “alternative” medicine with treatments that are ineffective, unproven and for a large part unethical – which is especially true for bipolar disorder.

        With regard to reform from within, nobody prevents a medical student interested in the useful parts of naturopathy, i.e. probably phytomedicine, nutritional things etc. to do postgraduate courses in phytomedicine, whatever. In contrast to NDs this would result in people trained in real medicine with the additional knowledge of potential new therapeutic approaches and not people with a superficial medical training and strange ideas about how medicine works.

        In conclusion, the useful parts of “alternative” medicine will absorbed by classical medicine eventually, leaving the crap behind. That renders NDs superflous. In this scenario reform from within is useless. This reform can only be visit medical school and specialize in nutrition, phytomedicine, etc…..

        • medmonkey

          Hi Thomas, I’m a second-year medical student in Canada. Funnily enough, we had a naturopath come in to speak to us regarding complimentary health care a few weeks ago. One of the things he said was that “(MDs) don’t know what they don’t know”- but he also proceeded to talk about the studies we (purportedly) didn’t have access to that showed benefits from alternative treatments… and many other things. I couldn’t help but think he sounded like he knew what he was talkign about at some points, but then it was clear that he didn’t know what he didn’t know! I’m not sure how the talk benefited us as future physicians, but I’m just replying to you because it’s interesting how the NDs use the same term to characterize us.

        • medmonkey

          Hi Thomas, I’m a second-year medical student in Canada. Funnily enough, we had a naturopath come in to speak to us regarding complimentary health care a few weeks ago. One of the things he said was that “(MDs) don’t know what they don’t know”- but he also proceeded to talk about the studies we (purportedly) didn’t have access to that showed benefits from alternative treatments… and many other things. I couldn’t help but think he sounded like he knew what he was talkign about at some points, but then it was clear that he didn’t know what he didn’t know! I’m not sure how the talk benefited us as future physicians, but I’m just replying to you because it’s interesting how the NDs use the same term to characterize us.

  • StThomas
  • StThomas
  • ffs

    While shonky cancer treatments and the like understandably attract a lot of the the anti-woo ire, alt-med mental health ‘therapies’ can be just as dangerous and thanks to Britt for bringing this up. I’m very tangentially connected to people in woo-world and I’ve seen a few other stomach churning examples worth sharing. They aren’t naturopaths but there’s often a lot of crossover in treatments.

    One practices a variation of kinesiology to ‘clear’ people of their mental issues and blocks and claims to have successfully treated eating disorders and someone apparently exhibiting multiple personalities.

    Another offers myofascial release and ‘energetic healing’. Amongst her client base are people suffering PTSD and other conditions brought on by sexual assault and abuse.

    Both not only claim to be effective but that their therapies can achieve results in a much shorter timeframe than counselling and other standard approaches. They also frequently offer their services to friends and family. #soethical

    Aside from the obvious risk to clients, I wonder about potential dangers of dealing with vulnerable people who could become very unstable if they stop taking medication, for example. As well as having wholly inadequate skillsets to diagnose and treat problems, I’m almost certain these ‘quackitioners’ also lack the protocols and back up to deal with crisis situations. They should be prosecuted for stating/implying that they can do anything for serious mental health issues.

  • ffs

    While shonky cancer treatments and the like understandably attract a lot of the the anti-woo ire, alt-med mental health ‘therapies’ can be just as dangerous and thanks to Britt for bringing this up. I’m very tangentially connected to people in woo-world and I’ve seen a few other stomach churning examples worth sharing. They aren’t naturopaths but there’s often a lot of crossover in treatments.

    One practices a variation of kinesiology to ‘clear’ people of their mental issues and blocks and claims to have successfully treated eating disorders and someone apparently exhibiting multiple personalities.

    Another offers myofascial release and ‘energetic healing’. Amongst her client base are people suffering PTSD and other conditions brought on by sexual assault and abuse.

    Both not only claim to be effective but that their therapies can achieve results in a much shorter timeframe than counselling and other standard approaches. They also frequently offer their services to friends and family. #soethical

    Aside from the obvious risk to clients, I wonder about potential dangers of dealing with vulnerable people who could become very unstable if they stop taking medication, for example. As well as having wholly inadequate skillsets to diagnose and treat problems, I’m almost certain these ‘quackitioners’ also lack the protocols and back up to deal with crisis situations. They should be prosecuted for stating/implying that they can do anything for serious mental health issues.

  • Ander Elessedil

    Really wonderful blog post.
    Keep going in your venture.

  • PrimaryCareDoc

    I have had an issue with naturopaths telling people with documented mental illness that they don’t really have bipolar or depression or what have you…rather that it’s “Chronic Lyme” or vitamin D deficiency or MTHFR or systemic candida. Britt, have you seen this at all?

    It’s very, very frustrating. I’ve had people stop their psych meds and spend thousands of dollars on quackery…and then they’ve decompensated very quickly. It’s horrifying.

    By the way, I’m a board certified internist. I did a residency. I have many, many years of experience…and I STILL don’t consider myself qualified to treat bipolar disorder. These patients get referred to a psychiatrist.

    • https://www.naturopathicdiaries.com Britt Hermes

      Hey PCD, I cannot recall how often I encountered this mislabeling/ misdiagnosing. I definitely frequently saw NDs trade depression and anxiety diagnoses for MTHFR mutations.

      It is absolutely terrifying that NDs are treating bipolar disorder, without or with homeopathy. It is infuriating that the choice treatment is homeopathy. Probably because the ND needs a way to blame the patient when the homeopathic treatment fails (which it always will, of course.) Commonly, NDs have multiple “excuses” for why the homeopathy doesn’t work. My favorite? The peppermint and menthol flavoring in toothpaste inactivates the homeopathic remedy.

  • BatwingCandlewaxxe

    I have a diagnosed mental disorder (endogenous depression) that I have been fighting my entire life. Growing up, my parents were heavily into the “natural health” thing. “Health food” and “food science”, holistic medicine (my mom was a big reader of Paavo Airola), herbalism, and so on. Fortunately, this back in the ’70, before the anti-vaccination movement, and my parents were old enough to remember the big epidemics, and therefore I was duly vaccinated. But except for other very obvious physical problems, and serious potentially deadly infections, they avoided modern medicine, and continue to beleive in various medical conspiracy theories.

    Because of this, they are also strong disbelievers in many other aspects of modern medicine, especially the fields of psychiatry and psychology. Not only because they were considered unnatural, but because they were considered un-godly. This despite my father having a now-deceased brother who was schizophrenic. According to my father, his brother’s schizophrenia wasn’t a real illness, it was the just the result of drug abuse (my late uncle used cannabis and other drugs to self-medicate his mental illness). They are mental-illness denialists, and developmental-disability denialists to varying degrees. Issues like depression (which I have), dyxlexia (like my brother has), and ADHD (which one of my brother’s closest friends had) were not real medical problems, they were only discipline problems. So my brother and I were routinely subjected to corporal punishment for our “bad attitudes”, instead of treatment for our illnesses and disabilities. I still suffer from a number of other health problems that have been exacerbated by not having been properly treated when I was younger. I was frequently suicidal, and made one attempt, which fortunately I was talked out of by a friend.

    I bought into the whole natural health thing when I was younger as well; and in my late-’20s, was studying on my own with plans to pursue a career in naturopathy. Fortunately, by that time the Internet had come along, and my studies brought me in touch with more skeptical resources. That, combined with the contradictions and inconsistencies I was already seeing in my own studies, turned me away from that path. Thanks to friends who were more experienced with mental disorders, I was able to get some help (financial issues still make that difficult, but at least I’m getting by for the moment). I’m never fully free of the depression, but now I have much better tools available to manage it, when I can afford them.

    I really appreciate your blog, and hope that it discourages others like me from going down this counterproductive path, and encourages them to get real effective help.

    • https://www.naturopathicdiaries.com Britt Hermes

      Thank you so much for sharing this story.

      • BatwingCandlewaxxe

        Thank you so much for sharing yours with this blog. You’re doing good work here.

  • Sycamore

    Naturopath in my exteneded family, his folks footed the bill for a $60k two to three year program to get his “Doctorate” in Woo in a now defunct school. 90% of the school time was studying coursework at home and attend class for about one month a year. For the last 15 years I’ve had to put up with his parents describing what I consider nonsense…such as putting water on a metal disc and flipping the machine on to make the water safe to drink. Holding a metal object in one hand and with a computer program he tells me what deficiencies in vitamins and minerals I need…of course he then tries to sell me from his stock. Vaccines are not safe, and on and on with the woo. He has struggled in life with some “ups and downs”. He finally went and got some forced help after a suicide idealation. Low and behold…Now he takes standard pharmacological interventions to treat his BIPOLAR condition and care from a psychiatrist! He has been more stable since treated by the mainline medical community. I don’t wish this condition on him but I smile at the irony. Thankfully, he Does not “treat” patients much anymore but sells quackery formulations online…I wish Lithium would fix that…but it’s an improvement.

  • Rick

    Homeopathic treatment of bipolar is unethical and dangerous, but drugs are much safer, right! You totally fail to understand homeopathy & how to use homeopathy. You copied one question: Hysterical personality who longs for amusement (Sumbulus). That not how you find the right remedy, it’s more like:
    mind, memory, weakness of memory;
    mind, perception, incorrect judge of size, things appear smaller;
    HEAD
    head, pain, headache, pressing (see bursting, pulling), as if in a vice;
    head, pain, headache, warm room;
    head, sensation of numbness, forehead, ;
    head, pain, headache, pressing (see bursting, pulling), temples, ;
    head, pain, headache, pressing (see bursting, pulling), forehead, cramp-like;
    head, pain, headache, temples, ;
    head, sensation of numbness, temples, ;
    head, pain, headache, indoors, in crowded room, ;
    head, pain, headache, sides, one side, ;
    Sometimes 200 questions or more

    If you don’t have your own books, then ABC Homeopathy has all the questions that apply to that remedy. Been prescription free for 31 years

    • AcuSkeptic

      Rick, I think you missed the point of this article. Its purpose isn’t to argue how homeopathy allegedly works, but to argue the innate ethical issues of assigning unproven remedies to people with serious mental health disorders.

    • Thomas Mohr

      Rick, thanks for the post because it elucidates with rare clearlyness how homeopathy works. It “diagnoses” diseases using outdated criteria and “treats” them by using substances that are perceived to cause the same symptoms.

      To be more specific:

      1) Homeopathy uses diagnostic criteria used in the 19th century and has not adopted modern criteria like biomarkers, histology, etc. The reason is simple – adopting such criteria would have required extensive clinical trials with high costs and negative outcome. Therefore homeopathic drugs are still developed based on non-invasive 19th century methods.

      2) Homeopathy uses highly subjective diagnostic criteria, both in development and application of drugs. This does not fly.

      3) Homeopathy uses a lot of diagnostic criteria, most of which only produce noise. Homeopaths adhere to the false theory that the better you know your patient, the better the diagnosis. They overlook the fact that 90% of the symptoms patients report in such questionnaires are noise (another modern discovery)

      4) Taken point two and three together (wobbly criteria and tons of noise) homeopathic “diagnoses” are likely to be bullshit.

      5) Since homeopathy focuses on 19th century accessible symptoms, the claim that “homeopathy treats the cause” is bullshit. They don’t even come near to the cause of diseases.

      Finally, taken 1-5 together leads to the conclusion that homeopathy is unscientific quackery.

    • Marcel

      Homeopathy is entirely based on symptoms rather than underlying causes of diseases. I have heard plenty of equally anecdotal accounts of those who were treated by homeopaths for depression of one sort and another to no avail. Let’s see the large, well controlled, randomized double-blind clinical trials of homeopathy for depression and bipolar disorder first. Then we can evaluate whether it merits use or not.

    • Marcel

      Homeopathy is entirely based on symptoms rather than underlying causes of diseases. I have heard plenty of equally anecdotal accounts of those who were treated by homeopaths for depression of one sort and another to no avail. Let’s see the large, well controlled, randomized double-blind clinical trials of homeopathy for depression and bipolar disorder first. Then we can evaluate whether it merits use or not.

    • JGC

      Rick, can you provide any real evidence establishing that homeopathic treatments can generate outcomes that are superior to appropriately matched placebo controls when they are used as treatments for non-self-limiting injuries or illnesses?

    • https://www.naturopathicdiaries.com Britt Hermes

      Shame on you, Rick. I am not demonstrating how to assign a bogus homeopathic remedy to a patient. I am describing how unethical and dangerous it is to experiment on patients with debunked therapies.

      • Thomas Mohr

        Britt, why not ? I think following would be extremely interesting: Take two or three patients with extremely similar symptoms but very different diseases (e.g. rectal bleeding by hemorrhoids vs. colon cancer) then compare diagnostic procedures, treatment modalities in special light of the reason of the disease and likely outcome. I guess this would show better than anything else that homeopathy does not treat the reason for any disease – as naturopaths claim. If you chose cancer as one of your patients I can help you with that.

        • https://www.naturopathicdiaries.com Britt Hermes

          Why not? Well, I never thought of it, I guess. But, this sounds like a fun project, so sure, let’s give it a go. You are right- all this nonsense about treating the root cause when really it is a symptom-based modality.
          I’ll be in touch Thomas!

          • Thomas Mohr

            Cool. My suggestion is as follows. I have a case where I know the symptoms very well, the possible diagnoses range from something very trivial needing only observation resp. life style changes over something possibly requiring surgical intervention to something potentially deadly needing immediate attention. So I would just tell you the symptoms as I would tell any ND you dig into the old days, ask me the repetitorium questions and work out a homeopathic “diagnosis” and “treatment”, then we will contrast that with what real doctors would do and discuss potential outcomes. The cherry on the cake is that the discussion would include a real Hahnemann case often quoted in homeopathic circles, namely the actor Hahnemann began to “treat” on January 14th 1843.

      • Thomas Mohr

        Britt, why not ? I think following would be extremely interesting: Take two or three patients with extremely similar symptoms but very different diseases (e.g. rectal bleeding by hemorrhoids vs. colon cancer) then compare diagnostic procedures, treatment modalities in special light of the reason of the disease and likely outcome. I guess this would show better than anything else that homeopathy does not treat the reason for any disease – as naturopaths claim. If you chose cancer as one of your patients I can help you with that.

      • Petticoat Philosopher

        Dangerous for them and potentially dangerous for their loved ones too. I’ve been a loved one. When I was 20 (too young to see the shit about to hit the fan) I was in a relationship with a guy who was (is) bipolar/schizoaffective. A few months into our relationship, he changed doctors and got some bad medical advice (from an M.D. actually, just an irresponsible one who’d bought into too much woo) about tapering off the meds he’d been on to manage his illness since his diagnosis a few years back. He was so hopeful. It still makes me sad to think about it.

        Long story short, he ultimately had a psychotic break with involved a whole bunch of paranoid delusions about me. It was terrifying. He could have harmed me. He almost did. I spent a while couch-surfing at friends’ places because I wasn’t safe. There had been issues building up for a while, but that was the end of the relationship.

        I’m not trying to make it all about me, or to take the focus off the suffering of the people with severe mental illness to talk about how very hard it is for everyone else. But certain mental illnesses do have broad, high-stakes implications for other people in patients’ lives.

        I understand why my ex wanted to go off his meds. Lithium (and he was on other medications too) can be rough stuff. Among other things, his side effects included visible tremors that felt so humiliating for him that he had a hard time socializing. It absolutely sucked. Managing these diseases is not pretty and the treatment can exact a high cost. Sometimes, there are no good options, only less bad ones. But if you are in a situation like that, you are ripe for manipulation by people telling you that there is another way, a way for it to all be rainbows and unicorn farts. Even an educated, scientifically literate person (my ex worked in a physics lab) can be vulnerable to that.

        When my ex and I got together, he hadn’t been in a relationship for a while and I think being in one again made him hope that he could be “normal” after all. Those hopes were exploited by an irresponsible doctor on the “integrative medicine” train that put him on a course to being dangerous to himself and to me. It took me a while to get over it because it was so scary and I was so young but I did. I don’t know about him though. To my knowledge, he hasn’t attempted a real relationship since, even though he is now back on the right meds. Shame on that doctor. People who do what he did exploit people’s misery and desperation.

        You know what? The drugs to treat some of these diseases do suck. You know what sucks more? Not having them. In the future, I desperately hope that there will be treatments that are less taxing to the patient. But there aren’t right now and medicine doesn’t promise a perfect fix for everyone. It can’t. It’s not fair that some people have health conditions where there are no paths forward that don’t involve problems. But pseudoscience and magic won’t change that. Only real science will.

        • https://www.naturopathicdiaries.com Britt Hermes

          Thank you for sharing this story, PP.
          You are right, of course. The actions of someone who is paranoid/ delusional/ etc can be dangerous for others, especially those who are closest to the patient.

          “You know what? The drugs to treat some of these diseases do suck. You know what sucks more? Not having them.”

          Yes. Yes. Yes. It’s not pretty and it is far from perfect. But the alternative option (homeopathy/ nothing/ lots of vitamins) is far, far, worse.

  • http://brainchattering.blogspot.com The Beta Female

    This hits home for me. The way I was treated by the natural health community over my mental illness is one of my post painfull memories. Shame over taking medicine overtook me…I suffered for over a decade trying to be normal using everything I was told as long as it was natural. I always felt broken and dirty and unwanted. Now in my mid thirties I am finally able to function in a happy relationship, continue my career, have friends, and not feel suicidal. I got woo free therapy, and I get meds from a university psychiatry clinic. I follow no diets or take a single supplement. No nd will admit what I describe as being possible but it is. My life is proof.

    How much you love Jane shows. You are a good human, Britt.

    • https://www.naturopathicdiaries.com Britt Hermes

      Thank you so much for sharing your perspective with us, Beta. Would you be interested in writing a blog post for me about your experience with an ND and mental health therapies? Feel free to email me naturopathicdiaries@gmail.com

  • Rick
    • Thomas Mohr

      Rick, you know that an in vitro experiment with questionable controls, a case staudy with three cases, a case report and some small reviews don’t fly with us – espeically in the face of the huge Australian Metastudy ?

    • David

      Pretty pathetic that in all the scientific literature that this is the best you can do after more than a 100 years of practice of this pseudoscience. I study glaucoma and I can quote 100s of articles with definitive significant end points.

  • Molly

    I have BP-1 and agree with you – about homeopathic… though many of those remedies may help some, there are varying degrees of illness, don’t forget. The term is very much over-used (they marketed new class of antipsychotic meds though, and drugged many folks who did not need them) and there are ROOT causes to the underlying physical illness states that can be treated and helped. This is a good article by a very reputable psychiatrist: http://kellybroganmd.com/do-5-million-americans-really-have-bipolar-disorder/

    • Marcel

      The psychiatrist you refer to raises some very important points. She suggests a number of the avenues for investigation that merit careful scientific examination, including the use of adjunctive treatments and the potential for an association between the increased use of marijuana with extremely high, unnatural levels of THC in recent decades with the increased prevalence of bi-polar disorder. In respect to “spiritual” states, there is no question in my mind that a typical psychiatrist would pathologize an enlightened individual as dissociative. Indeed, James Swartz, one of the foremost authorities on enlightenment according to the centuries-old scriptures of Vedanta—the most advanced teachings on the subject in the Indian tradition—has cautioned that if one was to describe one’s experience of enlightenment (self-realization) to a psychiatrist or psychologist, they would most likely assume you had suffered a psychotic break, or worse. However, that is not to say that marijuana either induces or is advocated for enlightenment. For those who would look to the teachings of Vedanta for parallels to depression and bipolar disorder, both are viewed as spiritual disorders predicated upon imbalances of subtle energies considered fundamental to physical and mental processes but which are not currently recognized in psychiatry.

  • Rick

    Homeopathic Treatment and Fluoxetine for Moderate to Severe Depression

    http://journals.plos.org/plosone/article/asset?id=info:doi/10.1371/journal.pone.0118440.PDF

  • Rick

    Homeopathic Treatment and Fluoxetine for Moderate to Severe Depression

    http://journals.plos.org/plosone/article/asset?id=info:doi/10.1371/journal.pone.0118440.PDF

    • Thomas Mohr

      Postmenopausal depression is a disease where psychological treatment has a considerable impact. The study did not control for that, therefore the conclusions that homeopathy is effective in such a setting are not valid.

    • Thomas Mohr

      Within this paper, the researchers got a significant result, yet the power of the study was relatively low (as they themselves admit). This is further underlined that different depression tests gave mixed results at best. This is a sure sign of lack of robustness of the result.

      However, apparently you do not know what a p-value is and what it is not. A p-value of <0.05 means that you have a less than 5% chance of observing a difference between groups like one did under the assumption that there is no difference. Therefore the hypothesis that there is no difference is rejected. However, that does NOT mean that the alternative hypothesis (i.e. homeopathy works) is true. There are literally thousands of alternative hypotheses and that means that the prior probability of your hypothesis (i.e. homeopathy works) has to be taken into account. Since homeopathy violates several very well established principles in natural sciences (i.e. the law of thermodynamics and the laws of concentration response) it is save to assume that the probability of your hypothesis (homeopathy works) being true to be low or very low. This is called the prior probability. Under such circumstances a few p values below 0.05 do not change much of the prior probability of your hypothesis, i.e. despite citing an underpowered study with mixed results, the probability of homeopathy to work remains low to very low.

  • Rick

    Homeopathic and conventional treatment for acute respiratory and ear complaints

    http://bmccomplementalternmed.biomedcentral.com/articles/10.1186/1472-6882-7-7

    • Thomas Mohr

      Vz my comment on AOM

  • Rick

    Homeopathic and conventional treatment for acute respiratory and ear complaints

    http://bmccomplementalternmed.biomedcentral.com/articles/10.1186/1472-6882-7-7

  • Rick

    Homeopathy for treatment of irritable bowel syndrome

    http://www.ncbi.nlm.nih.gov/pubmed/24222383

    • Thomas Mohr

      Quote: “A pooled analysis of two small studies suggests a possible benefit for
      clinical homeopathy, using the remedy asafoetida, over placebo for
      people with constipation-predominant IBS. These results should be
      interpreted with caution due to the low quality of reporting in these
      trials, high or unknown risk of bias, short-term follow-up, and sparse
      data. One small study found no statistically difference between
      individualised homeopathy and usual care (defined as high doses of
      dicyclomine hydrochloride, faecal bulking agents and diet sheets
      advising a high fibre diet). No conclusions can be drawn from this study
      due to the low number of participants and the high risk of bias in this
      trial. In addition, it is likely that usual care has changed since this
      trial was conducted. Further high quality, adequately powered RCTs are
      required to assess the efficacy and safety of clinical and
      individualised homeopathy compared to placebo or usual care.” I.o.W. it is not what you claim. Did you actually *read* the metastudy ?

  • Rick

    Homeopathy for treatment of irritable bowel syndrome

    http://www.ncbi.nlm.nih.gov/pubmed/24222383

  • Rick

    Compare Homeopathy and Conventional therapy in Acute Otitis Media

    http://www.ncbi.nlm.nih.gov/pubmed/22226309

    • Thomas Mohr

      AOM is a self limiting disease where treatment has little impact on the natural course. Treatment aims at preventing rare but severe complications. I.o.W. this study says homeopathy does not alter the natural course either. The main aim, preventing complications, has not been tested and could not have been tested in that number of patients

  • Rick

    Compare Homeopathy and Conventional therapy in Acute Otitis Media

    http://www.ncbi.nlm.nih.gov/pubmed/22226309