The psychiatric drug crisis

Many of the diagnoses given are pulled out of thin air and made to justify a patient's admission, or to appease a patient's desire to feel as if they have a treatable illness. I would ask psychiatrists I trained with to explain why a drug worked or why a disease developed. They would do nothing more than give me the same surface-level information we all know: SSRIs block serotonin reuptake, leading to more serotonin in the synaptic cleft that would then cause increased stimulation, and voila, you're not depressed. This is information anyone can attain with a google search. The majority of their knowledge dealt with pharmacological dynamics.

I sat in on a psychiatry conference one afternoon where the docs discussed the treatment of several patients. Never was a scientific article or concept uttered. It was all "well, let's try him on seroquel and olanzapine, let's also throw Paxil in there." It was evident that their treatment protocol was largely one of extremely unsupported trial-and-error based on very, very unique experiences, anecdotes, and preferences each psychiatrist had.

Now, I don't want to discredit the entire field. I do know friends and family who have benefited from psychiatric medications, although that could entirely be due to placebo effect. What needs to happen first is that we need to attain a much deeper understanding of how the brain works on the low and high levels, mechanically and abstractly. Mechanically so that we may develop effective meds, abstractly so that we may learn how to manipulate cognitive processes, like with what we see with CBT, which has worked wonders for many with depression -- no medication involved.

tl;dr: Psychiatry is a very, very loose and abstract field. You can't run any diagnostic tests on patients. It's mostly a field of educated guessing and confirmation bias. We need better mechanical and abstract understanding of the mind before we douse it in chemicals.

1. Producers and consumers are both equally informed 2. There are so many producers and so many consumers that no single producer or no single consumer is able to appreciably change the market price

Neither of those assumptions hold with the the drug market. Drug makers are massively more informed about the benefits and side effects of their drugs than I am. And there aren't that many drug manufacturers - and ongoing mergers keep shrinking the pool. In reality, the drug market is a barely regulated oligopoly, where a few large players manipulate the price signal to coordinate behavior so that they can move in relative unison to screw over the consumer. It's just like oil companies or airlines.

If the drugs had no effect, then why are people (ab)using drugs like Adderall to improve cognition, etc?

A big problem with trying to make a science out of the brain, is that it can be very unique to the person. For example, in people that are blind since birth, the pathways in the brain that are normally used for visual processing can get re-purposed over a lifetime to be used for other things.

I'd almost say that the brain is sort of like an evolutionary algorithm. Given similar parameters, the results largely resemble each other, but alter things enough and the results can be way off.

Placebo effect is certainly an effect. But the claim is not that the drugs don't have an effect (though it's true, some work no more effective than a placebo), but that we have no sound explanation for their effects.