Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America

In this astonishing and startling book, award-winning science and history writer Robert Whitaker investigates a medical mystery: Why has the number of disabled mentally ill in the United States tripled over the past two decades? Every day, 1,100 adults and children are added to the government disability rolls because they have become newly disabled by mental illness, with this epidemic spreading most rapidly among our nation’s children. What is going on?
Anatomy of an Epidemic challenges readers to think through that question themselves. First, Whitaker investigates what is known today about the biological causes of mental disorders. Do psychiatric medications fix “chemical imbalances” in the brain, or do they, in fact, create them? Researchers spent decades studying that question, and by the late 1980s, they had their answer. Readers will be startled—and dismayed—to discover what was reported in the scientific journals.
Then comes the scientific query at the heart of this book: During the past fifty years, when investigators looked at how psychiatric drugs affected long-term outcomes, what did they find? Did they discover that the drugs help people stay well? Function better? Enjoy good physical health? Or did they find that these medications, for some paradoxical reason, increase the likelihood that people will become chronically ill, less able to function well, more prone to physical illness?
This is the first book to look at the merits of psychiatric medications through the prism of long-term results. Are long-term recovery rates higher for medicated or unmedicated schizophrenia patients? Does taking an antidepressant decrease or increase the risk that a depressed person will become disabled by the disorder? Do bipolar patients fare better today than they did forty years ago, or much worse? When the National Institute of Mental Health (NIMH) studied the long-term outcomes of children with ADHD, did they determine that stimulants provide any benefit?
By the end of this review of the outcomes literature, readers are certain to have a haunting question of their own: Why have the results from these long-term studies—all of which point to the same startling conclusion—been kept from the public?
In this compelling history, Whitaker also tells the personal stories of children and adults swept up in this epidemic. Finally, he reports on innovative programs of psychiatric care in Europe and the United States that are producing good long-term outcomes. Our nation has been hit by an epidemic of disabling mental illness, and yet, as Anatomy of an Epidemic reveals, the medical blueprints for curbing that epidemic have already been drawn up.

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3 comments for “Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America

  1. Louise Gordon
    June 8, 2014 at 5:15 AM

    Evidence-Based Medicine or an Epidemic of Iatrogenic Disorders? Robert Whitaker’s Anatomy of an Epidemic reveals the damage that can and very often does result from long-term use of psychotropic drugs, and, along with it, the alarming rise in chronic mental illness in this country since such drugs as Thorazine were introduced in the 1950s. Because this drug could cause tardive dyskinesia and other permanent nervous system damage, the pharmaceutical industry got to work on new generations of drugs that are being used now.The rise in drug use corresponds with psychiatry staking a renewed claim to therapeutic expertise and market share, which had begun to erode due to competition from counselors, social workers and others (see the Selling of DSM by Kirk and Kutchins — [...]– and Making Us Crazy by the same authors). The prescription pad, and the power of academic psychiatry in collaboration with Big Pharma, allowed psychiatry to open up a very large market, one that today seems to encompass the entire population.Whitaker documents the alarming rise of disability and increasing number of people on SSI and SSDI due to mental illness over the last 50 years, including the increase since the 1980s, when serotonin reuptake inhibitors such as Prozac were introduced, and again, with the introduction of what are called atypical antipsychotics (e.g., Risperdal, Zyprexa), and reliance on drugs in the benzodiazepine family (Valium). But perhaps the most tragic of all cases with drugs used to treat what were once considered within the range of “normal” behavior (e.g., shyness) is the prescribing of amphetamine-like agents such as Ritalin or Adderall for so-called attention deficit disorder (ADHD) in children, and, even worse, powerful psychotropic drug cocktails to treat a newly introduced category of illness, childhood-onset bipolar disorder. In all of these cases, Whitaker documents how long-term use of such drugs can lead to severe debilitating effects and what may be irreversible brain damage. He also reveals that there is no scientific evidence, none whatsoever, for the psychiatric storyline that psychotropic drugs compensate for chemical imbalances in the brain.Impeccably researched and documented, Whitaker’s book is based on long-term outcome studies that have received almost no publicity from psychiatry and other guardians of the psychiatric establishment, including, of course, the pharmaceutical companies that keep churning out new generations of magic bullets. It’s a multibillion dollar industry with a lot to lose were the full truth about the drug risks disclosed and understood.While far from an anti-psychiatry or anti-drug polemic, Whitaker’s interviews with patients who are on psychiatric medications are nonetheless heartrending. Also revealing is his disclosure of the brutal treatment meted out to maverick doctors like Peter Breggin, David Healy and Loren Mosher, who all questioned the efficacy of pharmaceutical treatment of mental disorders, from schizophrenia to bipolar disorder and other maladies. Harvard Medical School-trained Breggin was in effect blacklisted. Mosher lost his position with the NIMH over his successful drug-free treatment of patients through the Soteria project he founded. And Healy promptly lost a job offer after publicizing his criticism of SSRIs and their possible relation to suicide.In a TLS April 2009 review of Healy’s book Mania, the reviewer says Healy “goes on to describe how Big Pharma has captured almost total control over the research process, to say nothing of buying up academic experts and turning them into marketing shills.” Whitaker essentially reports the same thing; especially telling is the chapter titled Tallying Up the Profits, including a subsection titled the Money Tree.On top of this, there is the DSM, or Diagnostic and Statistical Manual (the fifth edition soon to be released; see Ofer Zur’s critique at the Zur Institute site), with its ever-expanding list of disorders. No longer are only those thought to be suffering from schizophrenia or bipolar disorder entreated to take their medication, without which, they are told, they would be like a “diabetic without insulin.” Now everyone suffering from problems such as grief or the blues or any number of things — in the case of children, ADHD, “oppositional defiant disorder” or childhood-onset bipolar disorder — are also told they should take drugs, as if they needed the psychological equivalent of insulin. The tragedy in the case of children is that often, after taking stimulant drugs, they begin to experience psychotic symptoms. Then, more drugs are used to treat the additional symptoms, a fact that accounts for more and more young people ending up on disability rolls.I hope everyone who sees a primary care doctor or counselor or any kind of therapist will read this book and think twice or a dozen times before attempting to solve any type of emotional problem or bedeviling…

  2. kamasl
    June 8, 2014 at 5:22 AM

    Only The Pharma-Industry? 0

  3. W.H.
    June 8, 2014 at 5:50 AM

    Whitaker presents a lopsided view of mental illness and the drugs used to treat it Whitaker and many of Amazon’s reviewers have a lot to say about psychiatric drugs, most of them virulently negative. As someone who actually is mentally ill and takes some of these drugs, I see things very differently and I want to share my story and my point of view.I have schizoaffective disorder (a combination of schizophrenia and bipolar disorder). I developed this disease in my early 20s. I was beset by mania, depression, and psychosis. The mania and depression were bad but easier to manage than my psychosis. I heard loud, terrifying voices which threatened to kill me and worse. They sounded just as real as any voice I had ever heard in my life. They tortured me morning, noon, and night without interruption. I was completely disabled by them.I was a bright young woman with a good education but I could barely leave my house, let alone work. I could not even have a meaningful conversation with anyone because the voices were too loud. My parents became my caretakers and my friends disappeared completely. Despite my family’s support, I felt utterly alone in the world.This went on for years as I tried different antipsychotics. They worked to a degree but the voices simply would not go away. I certainly did not get better or “heal” on my own–despite my family’s love and support. No words can describe how hellish and worthless my life felt. I thought about killing myself but my parents helped me hold on to what seemed like a very slim hope that the voices would be stilled one day.Geodon, the last antipsychotic I had settled on, began to give me symptoms of dyskinesia and my doctor made me stop taking it right away. The symptoms went away and I began to take a new drug: Seroquel.Within weeks of starting on Seroquel, the voices dropped off and virtually disappeared. They are very few and far between now and they no longer seem real. It took me a while to adjust to the absence of the voices. I did so rather slowly and with cautious optimism–what if this freedom didn’t last?It lasted. Several years have passed and the Seroquel is still working. It can be very sedating, which is why I take it bedtime. It really wasn’t such a bad side effect–my body eventually adjusted and in the meantime I just learned to love my morning coffee. All drugs have possible side effects: Seroquel’s most dangerous one is that it can cause high blood sugar which can lead to diabetes.I have a battery of blood tests done every year to be cautious. Anyone on medication (psychiatric or otherwise) should. I am in fine shape physically and mentally. I don’t have cognitive problems and I am certainly not subdued or “drugged into a stupor.”I am happier and more productive than I have ever been before in my life.The pharmaceutical industry, which Whitaker and so many reviewers here look askance at, restored my sanity and saved my life. It didn’t work on the first try or even the second, but my doctor and I persevered and did not give up. I am no longer afraid to leave my house and I have a good job. I have a great relationship with my family and I can talk to anyone at anytime without being interrupted by voices. I have friends and a social life again.This may not sound exceptional to a normal person, but it means the world to me. None of it would be possible without the drugs I take. I take them every day–happily and with more gratitude than Whitaker or his acolytes will or could ever understand.I realize that my experience is not everyone’s. Like “normal” people, the mentally ill are quite different from each other and we respond differently to different drugs and therapies. Whitaker would have you believe that psychiatric drugs are useless and even detrimental to people like me, though, and that is simply not the truth–not my truth, anyway.I should mention that I work in NYC. The streets are full of unmedicated schizophrenics. Some of them beg for money but others are too out of it to do even that–they are completely absorbed in their fights with their voices. Some are loud and menacing, others just sit in silence looking terrified.It breaks my heart to see them because I could have wound up like them. I would have had it not been for my parents, my doctor, and my drugs.I’d like to bring Whitaker along with me one morning so he could see them, too. Would he really tell me that they’re better off than I am? Happier? Healthier?I give them food and money (I want to make them feel better even if it’s only temporarily) but most people hurry away from them without even trying to hide their fear and disgust.I would never, ever want to trade places with any of them. Neither would Whitaker or anyone else.(You may have noticed that I wrote the same review for Whitaker’s “Mad In America.” This is because I have the exact same problem with both…

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