Copyright -- 2005, American Society for Clinical Investigation
Tom Cruise is dangerous and irresponsible
Top Abstract
Yes, even the JCI can weigh in on celebrity gossip, but hopefully
without becoming a tabloid. Rather, we want to shine a light on the
reckless comments actor Tom Cruise has recently made that psychiatry is
a "quack" field and his belief that postpartum depression cannot be
treated pharmacologically. We can only hope that his influence as a
celebrity does not hold back those in need of psychiatric treatment.
Top Abstract References
Several interviews have aired in which Tom Cruise has publicized his
disdain for psychiatry and the mental health profession (1, 2). In one
interview, Cruise claimed to know the literature on the history of
psychiatry, chemical imbalances, and Ritalin (methylphenidate), the
attention-deficit hyperactivity disorder (ADHD) drug (1). In another,
he called actress Brooke Shields irresponsible for publishing a book on
her battle with and treatment of postpartum depression, since he
believes vitamins and exercise are all that is needed for treatment
(2).
Throughout these and other interviews, Cruise spewed a number of
irresponsible statements, attempting to pass them off as facts.
However, several of Cruise's statements are very easy to dispel as
false.
With regard to the number of children currently taking drugs to control
ADHD, Cruise is quoted as saying "[Psychiatrists] said, 'Oh, you
know, Ritalin is safe. It's safe. It's safe.' Ritalin is an
amphetamine" (2).
The National Institute on Drug Abuse (NIDA) begs to
differ. Ritalin (a stimulant, but not an amphetamine) has been shown to
amplify the release of dopamine and thereby improve attention and focus
in individuals who have weak dopamine signals, such as those with ADHD
(3).
NIDA goes on to note that ADHD patients do not become addicted to
Ritalin or similar medications when taken in the form and dosage
prescribed by doctors, and it has been reported that individuals with
ADHD who are treated with Ritalin are significantly less likely than
those who do not receive treatment to abuse drugs and alcohol when they
are older (4).
Later in the same interview, Cruise discusses how he "recently helped
a family have their daughter get off [ADHD] drugs . . . We stepped the
[7-year-old] child off the drugs, got her vitamins and food. She has
calmed down now and she has grown seven inches in about four months"
(2).
If true, this child should be examined for growth abnormalities,
as a normal growth spurt occurs during puberty (12-14 years old in
females) and is on average 3-5 inches. Hyperbole on the part of Mr.
Cruise, perhaps? One would hope the child was under the care of a
medical doctor.
Cruise believes the education of children is suffering due to extensive
Ritalin use. In connection to the drug, he said, "SAT scores have
gone right down the toilet" (2).
Not so, says the College Board, the
non-profit organization that designs, administers, and evaluates the
SAT (scholastic aptitude test) and PSAT (preliminary SAT) among other
tests and advanced placement courses. In a recent article about trends
in test scores, the College Board said, "Consistent with a
decade-long trend, SAT math scores have continued to rise.
In 2002, the
average SAT math score rose two points to 516." The report does note
that while "Verbal scores declined in 2002 [by 2 points] to an
average of 504 for the entire test-taking population . . . The average
verbal score for 2002 is just 4 points higher than that of 1992" (5).
I would dare say this report does not indicate that SAT scores are
going down the toilet.
My favorite part of this interview was when Cruise equated
psychiatrists to drug dealers. "You know what? I'm sure drug
dealers on the street, in some way, they are making money. That's
what I equate it to. Here is the thing: you have to understand, with
psychiatry, there is no science behind it. And to pretend that there is
a science behind it is criminal" (2). In Cruise's eyes, there are a
lot of us criminals, including the 38,000 members of the American
Psychiatric Association (APA), who have issued several statements
disagreeing with many of Cruise's exhortations about the mental
health field.
I suppose now would also be an appropriate time to
mention my particular conflict of interest - I am the daughter of a
psychiatrist/neurologist. That said, my father, and most responsible
physicians, are well-trained scientists who do not run around
willy-nilly dispensing controlled substances nor filling irresponsible
prescriptions to, in Cruise's words, "drug the piss" (2) out of
their patients.
Though it is hard to believe Cruise has ample time to help legions of
drug addicts, given his intense movie production and publicity
responsibilities, it is admirable that he tries. But he goes on to say,
"I have an easier time stepping people off heroin then I do these
psychotropic drugs" (2).
In his efforts to help drug abusers, Cruise
supports the Scientology-based 9-step drug withdrawal program Narconon
International (6). Step 3 of Narconon is called the "Purification
Rundown," in which drug residues and other toxic substances are
removed from the body through a regimen of exercise, sauna, and
nutritional supplements.
In 1989, Everett R. Rhoades, US assistant
surgeon general, was quoted as saying the concepts behind Narconon
could not be considered medically sound. Further, the Board of Mental
Health in Oklahoma concluded in 1991 that the high doses of vitamins
and minerals administered in the Purification Rundown could be
potentially dangerous and therefore declined to certify the program.
While it is commendable for any person with a drug addiction problem to
seek help, state-certified, proven rehabilitation programs should be
sought.
Let us move on to postpartum depression and chemical imbalances. Cruise
pulls no punches when asked about his thoughts on the existence of
chemical imbalances: he claims there is no scientific evidence to
verify they exist, based on his reading of the scientific literature
(1).
When asked about drugs like Paxil for the treatment of postpartum
depression, he spoke plainly: "Let me tell you something: it is not a
cure and it is actually lethal. These drugs are dangerous . . . There
is a hormonal thing that is going on that is . . . scientifically, you
can prove that. But when you talk about emotional chemical imbalances
in people, there is no science behind that" (2).
Again, I beg to
differ and so does 50 years' worth of literature (summarized in refs.
7, 8). While indeed other theories have been proffered to explain
depression, the idea that chemical or genetic imbalances may underlie
depression has been widely accepted. I wonder how an actor with
Cruise's educational background (no course of study noted past a high
school degree) came to understand the medical literature and whether he
would be conversant in the intricacies of the monoamine hypothesis or
serotonin and noradrenaline signaling.
Brooke Shields said it best in her July 1, 2005, New York Times Op-Ed
column: "Comments like those made by Tom Cruise are a disservice to
mothers everywhere. To suggest that I was wrong to take drugs to deal
with my depression, and that instead I should have taken vitamins and
exercised shows an utter lack of understanding about postpartum
depression and childbirth in general" (9).
Rather than Shields being
the irresponsible one, I have found most women agree that it is
Cruise's message that Paxil is lethal and that postpartum depression
does not exist that is irresponsible.
In addition to his unusual thoughts on postpartum mothers, Cruise is
assumed to share his religion's philosophy about care for newborn
infants, another course of action not condoned by medical care
professionals.
Scientologists believe in the "Silent Birth" method,
in which newborns are neither poked and prodded in medical tests nor
even spoken to in the first 7 days of life. According to their
theology, because babies go through so much pain during the birth
process, newborn babies should not be subjected to any further pain or
sensory experiences that could return later in life to haunt them. An
Omaha-based couple even attempted to introduce a bill in the Nebraska
legislature in 2003 exempting Scientologists from medical screening of
newborns. I can find no medical literature on the benefits of silence
in the first week of newborn life.
In terms of the Scientology view of medicine and mental health, I can
only assume that Cruise follows the religion's principles. According
to a primer on Scientology, followers generally shun conventional
medicine as they believe illnesses are largely psychosomatic. Illness
is a sign of weakness and failure, and followers are encouraged to
treat their ailments with auditing (talking through issues while
attached to a biofeedback device called an "E-meter" that is
similar to a lie detector).
Since all illness are psychosomatic in the
eyes of a Scientologist, members believe that everything from
indigestion to AIDS can be cured through auditing and vitamins.
L. Ron Hubbard, the founder of Scientology and the author of their main text,
Dianetics: the modern science of mental health (10), has been quoted as
saying, "Leukemia is evidently psychosomatic in origin and at least
eight cases of leukemia had been treated successfully by Dianetics
after medicine had traditionally given up" (11). Further, he has
claimed that "Arthritis vanishes, myopia gets better, heart illness
decreases, asthma disappears, stomachs function properly and the whole
catalogue of illnesses goes away and stays away [with Scientology]"
(10).
My personal favorite quote: "Scientology is the only specific
(cure) for radiation (atomic bomb) burns" (12). It is unclear whether
Scientologists continue to believe that auditing is superior to medical
therapy, though it is clear that they do not condone the use of
pharmacotherapy for mental illness.
But again, back to Tom Cruise. He continued in his Access Hollywood
interview to make note of how popular his methods have been. "You
just have no idea what it's like being me and all the people that
want help. All the people that call that I talk to at 2 a.m. that ask
for advice."
He continued: "People know that they can call me. They
are respectful, actually. They don't waste my time. They say,
'Look, I need help at this. What should I do?' And I help them. I
have nothing to gain. I just want to see people do well. . . . I get so
many letters from people thanking me. Thanking me for their children
and for themselves" (2).
Perhaps we should call Cruise and let him
know what we think? Despite his eagerness to speak with people on the
phone, I found it nearly impossible to find a phone number where I
could reach him to get help with this editorial. But, should you decide
to contact Cruise by mail, he can be reached care of Creative Artists
Agency (9830 Wilshire Boulevard, Beverly Hills, California 90212, USA)
or care of Church of Scientology International (6331 Hollywood
Boulevard, Suite 1200, Los Angeles, California 90028, USA).
Top Abstract References
References1.CNN.com. 2005. Cruise, Lauer argue on 'Today'.
http://www.cnn.com/2005/SHOWBIZ/TV/06/24/people.cruise.ap/.
2=2EAccess Hollywood. 2005. Tom Cruise: man on a mission.
http://www.accesshollywood.com/news/4537415/detail.html
3=2ENational Institute on Drug Abuse. 2005. NIDA InfoFacts:
methylphenidate (Ritalin).
http://www.nida.nih.gov/Infofacts/Ritalin.html
4=2EMannuzza S, Klein RG, Moulton JL III. Does stimulant treatment place
children at risk for adult substance abuse? A controlled, prospective
follow-up study. J. Child Adolesc. Psychopharmacol. 2003;13:273-282.
[PubMed] [Full Text]
5=2ECollege Board. 2002. 10-year trend in SAT scores indicates increased
emphasis on math is yielding results; reading and writing are causes
for concern.
http://www.collegeboard.com/press/article/0,,11752,00.html
6=2ENarconon International Drug Prevention & Rehabilitation.
http://www.narconon.org/.
7=2ENestler EJ, et al. Neurobiology of depression. Neuron.
2002;34:13-25. [PubMed] [Full Text]
8=2ECastr=E9n E. Is mood chemistry? Nat. Rev. Neurosci. 2005;6:241-246.
[PubMed] [Full Text]
9=2EShields, B. 2005. War of words [op-ed]. New York Times. July 1.
10.Hubbard, L.R. 1987. Dianetics: the modern science of mental health.
Bridge Publications. Los Angeles, California, USA. 72.
11.Hubbard, L.R. 1953. Journal of Scientology. Issue 15-G.
12.Hubbard, L.R., Denk, G., Spink, F.R., and Farley, R. 1957. All about
radiation. Bridge Publications. Los Angeles, California, USA. 109.
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