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Robert Whitaker Anatomy Of An Epidemic
August 18th, 2010
Science writer Robert Whitaker’s new book about psychiatric drugs is so depressing, readers may want to reach for a Prozac. They’d be better off ordering a dry martini....
Anatomy of an Epidemic (Crown, 404 pages, $26) begins with a startling statistic: The number of Americans on disability payments for mental illness tripled between 1987 and 2007. If new psychiatric drugs are so effective at treating mental illness, Whitaker asks, why are so many more Americans getting sick and so few getting well?
To answer this, Whitaker traces studies on mental illness and the long-term efficacy of psychiatric drugs. Chief among his findings, although it’s not a new one, is that the chemical imbalance theory of mental illness—the notion that a shortage or surplus of this or that brain chemical makes you crazy—is a myth.
Not only do the mentally ill exhibit no marked difference in brain chemistry from that of normal people, researchers have known as much for decades. Psychiatric drugs “work” by disrupting normal brain chemistry, not restoring it. Study after study reveals how these drugs may offer short-term relief from a disorder, but long-term use puts patients at risk of chronic mental illness, permanent physical and cognitive impairment, lifelong addiction and even death.
In other words, drugs are fueling the epidemic, not stemming it. One drug leads to another to treat the side effects of the first, and pretty soon the patient is taking a cocktail of brain-altering medications. In 2008, sales of psychotropic drugs reached $40 billion annually. One in eight Americans takes a drug prescribed for a psychiatric disorder.
Whitaker uncovers not so much a conspiracy to propagate the “truth” about the biological basis for mental illness and the efficacy of psychiatric drugs but a convergence of mutually reinforcing interests.
The American Psychiatric Association seeks validation as a genuine medical profession superior to counselors and psychologists because it wields the authority to prescribe drugs. The pharmaceutical industry needs federal approval and prescribing physicians to market expensive products of dubious worth. The National Institute of Mental Health thrives on perpetual crisis and new drugs to study to boost its research budget. The National Alliance on Mental Illness wants reassurance that its members suffer from recognized diseases successfully treatable with medication.
Abetting this public delusion are the news media, whose reporting is only as good as their sources, usually press releases from NIMH and “independent experts” who are often paid consultants for the drug companies. Another unwitting ally is the Church of Scientology, whose notorious antagonism toward psychiatry enables proponents of drug therapy to dismiss any criticism as the ravings of kooks like Tom Cruise who, everyone knows, takes his marching orders from Emperor Klaktu of Rigel VII.
Whitaker’s book could mark the point in history when Americans started looking back on much of modern psychiatry with the same derision we now regard 19th-century physicians who practiced bloodletting. His dispassionate survey of the human devastation of psychiatric drug therapy makes Anatomy of an Epidemic a harrowing must-read. Just don’t forget to ask for two olives.
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Robert Whitaker is the author of four books: Mad in America
, The Mapmaker's Wife
, On the Laps of Gods
and Anatomy of an Epidemic
. His newspaper and magazine articles on the mentally ill and the pharmaceutical industry have garnered several national awards, including a George Polk Award for medical writing and a National Association of Science Writers Award for best magazine article.
A series he cowrote for the Boston Globe on the abuse of mental patients in research settings was named a finalist for the Pulitzer Prize in 1998.
http://bipolarblast.wordpress.com/2010/ ... -epidemic/
A note from Robert Whitaker
Here’s how the book is set up. During the past 20 years, the number of people on government disability due to “mental illness” has soared, rising from around 1.25 million people in 1987 to more than four million today. The number of children on the SSI rolls due to severe mental illness has increased more than 35-fold since 1987. Those numbers tell of an “epidemic,” and the book then asks this heretical question: Could our drug-based paradigm of care be fueling that epidemic?
To answer that question, I fleshed out what the scientific literature has to say about the long-term effects of psychiatric medications. I think an observation made by one of the many people I interviewed for the book aptly sums up the tale told in the scientific literature. She said:
“With psychiatric medications, you solve one problem for a period of time, but the next thing you know, you end up with two problems. The treatment turns a period of crisis into a chronic mental illness.”
After this tale of science is told (and the book basically relates a history of science that has unfolded since the 1950s), I look at why our society doesn’t know about the many studies that have documented the poor long-term outcomes. These study results never get reported in the newspapers, and the book explores the financial reasons why that is so.
Finally, in the last part of the book, I report on programs that use psychiatric medications in a limited, cautious manner (or not at all), and are producing good results. For instance, I traveled to western Lapland in northern Finland to report on open-dialogue therapy. There, only about one-third of first-episode psychotic patients are ever exposed to antipsychotic medications, and at the end of five years, only about 20% of first-episode patients are still on antipsychotics. Western Lapland adopted this “selective use” of antipsychotics in 1992, and their outcomes are now the best in the western world. At the end of five years, roughly 80% of those patients are asymptomatic and either working or back in school. Only a small percentage of their first-episode patients end up chronically ill and on government disability.
So that’s the book. It investigates a medical puzzle, and along the way it tells the personal stories of a number of people caught up in our societal “epidemic” of mental illness. My hope—and I suppose this is a rather grandiose, naive hope—is that if this history of science could become widely known, then perhaps our society could have a rational discussion about what could be done to stem this epidemic.
The book, I should add, also explores what is happening over the long-term to children who are put on psychiatric medications. Once again, science tells a very clear story, and, as you might imagine, it is one that—when you think of the millions of children so affected—makes you want to weep.
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I read Anatomy Of An Epidemic and recently saw a presentation by Robert Whitacker alongside a psychiatrist. His ideas are challenging and are very well researched. No easy answer, but the book should be read by every mental health professional out there.
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The C-Span video library has author Robert Whitaker's presentation from August 2010 at http://www.c-spanvideo.org/program/Epidem
The 1998 Pulitzer Prize Finalist and author of Mad in America discussed the rise in diagnosis of mental illness in the U.S. and the proliferation of drugs to medicate various conditions. Mr. Whitaker contended that drugs do little to balance imbalanced brain chemistry. The event was held by Community Access, Inc. at the National Arts Club in New York City.