If the public knew these things, there would be more focus on how to use these drugs judiciously and there would be more focus on alternative therapies that don’t rely on meds, or that minimize use.

The author spends some time visiting psychiatric facilities in Western Lapland. Here, patients are treated to something called “open-dialogue” therapy. The nurses, psychologists, social workers, and psychiatrists have, for the most part, completed a three-year, 900-hour course in family therapy. According to psychologist Tapio Salo, “Psychosis does not live in the head. It lives in the in-between of family members, and of people. It is in the relationship, and the one who is psychotic makes the bad connection visible. He or she ‘wears the symptoms’ and has the burden to carry them.”

Wow. And, even though this practitioner is referring specifically to psychosis, I felt when I read those words that they potentially have much wider application. What if all the folks who bought into the myth of “chemical imbalance in the brain” were to switch over to an understanding that mental illness resides in the spaces between people… between family members, certainly… and friends, but also members of one’s church, classmates, co-workers, between a government and a people, and between other species and ourselves? What if we all took that seriously and began to put the focus on treating those relationships as if our sanity depended on it?

But let’s go back to this “open dialogue” in Western Lapland. Everyone goes to the first meeting with family and patient with the awareness that they “know nothing.” Wow. Really? Yes, really. Those 900 hours have trained them all to be “specialists in saying that we are not specialists.”  In fact, the therapists consider themselves guests in the patient’s home. If the patient runs off, they just ask them to leave the door open so they can hear the conversation.

There is no mention of antipsychotics in the first few meetings. If the patient begins to sleep better and bath regularly, and in other ways reestablish societal connections, the therapists see that the “grip on life” is strengthening and meds will not be needed. Sometimes benzodiazepenes are given short-term for anxiety or sleep problems, but when the problem goes away, the meds are stopped.

Yes, this process takes time. Sometimes up to five years. Teachers and prospective employers are asked to join the dialogue. The focus is on restoring social connections.

 Results? Since 1992 not a single first-episode psychotic patient has ended up chronically hospitalized. The spending is less than any other district in Lapland. Eighty-four percent of the patients had returned to work or to school, and only 20% were on antipsychotics. Families have come to trust the system and call for help at the first sign of psychosis… and, consequently, very few go on to develop schizophrenia.  They have had a 90% drop in new cases of schizophrenia since the early 1980’s.

 
What about alternative therapies for depression? 70% of depressed patients respond to an exercise program. In fact, general practitioners in the UK are writing prescriptions for exercise. And the side effects are fantastic: more strength, better cardiovascular function, lower blood pressure, better sleep, better sex, improved cognitive functioning. Oh, and studies have shown it is not wise to combine exercise with drug therapy.

Then there is the Seneca Center in California, a last-stop for severely disturbed kids. When a child enters the residential program, the question is not “What’s wrong with the kid?” but “What happened to them?” The Seneca Center also does something else interesting. As they chart the life history of the kids, they also chart the medication history… looking for how behavior may have changed after medication. Not surprisingly, these histories regularly tell of psychiatric care that has worsened behavior.  If they can see that a drug did not help, they don't prescribe it.They frequently detox the kids and institute behavior modification techniques to help the kids control their own behavior.

According to the program director, “… feeling in charge of yourself and being responsible for yourself is [sic] the central issue of their lives.” It’s about power. And power in relationships. They provide “mentors” for the kids, and the kids learn that it’s safe to form attachments.

The Seneca Center highlights a major issue in mental health today: The need for social and medical support for detoxing from prescription medications.

Whitaker ends his book talking about an organization in Alaska called PsychRights that mounted a public information campaign in 2002 with judges, lawyers, psychiatrists, and the general public about the outcomes for antipsychotics. The founder of this organization, Jim Gottstein, filed a lawsuit against the state in a forced-drugging case, and won a stunning legal victory in 2006. The Alaska Supreme Court ruled, “Psychotropic medication can have profound and lasting negative effects on a patient’s mind and body. These drugs are known to casue a number of potentially devastating side effects.”

Gottstein has moved on to filing lawsuits on behalf of foster children and children living in poverty. He likens these suits to Brown vs. Board of Education, hoping they will have a similar effect to that watershed lawsuit that ended segregation—in this case changing national attitudes about the drugging of children.

There’s no neat way to sum up these ten blogs. Obviously, I consider it an important book. As an activist, I have seen a country and a generation of activists become progressively more numb and more complacent. I have seen friends change personalities, stop moving forward. I have experienced the suicides and attempted suicides of friends and colleagues—four in this last year. As global warming advances, as resources become more scarce and economies more fragile, as social services are increasingly cut, and as the environment becomes more and more toxic, there has never been so great a need for awareness, for clarity, and—yes—alarm. It is a time for radical honesty, for confrontation of the conflict-of-interest when drug companies have so many financial ties to Congress, to doctors, and to medical schools. It is time for honest studies, for “open dialogue” on a national level.

What I take away from the book, and take most seriously, is a new understanding that mental illness resides in the spaces between people. I want to take responsibility for my part in the healing of that space.

Click here to go back to Part 1.

This is the ninth part of my very long blog on Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs and the Astonishing Rise of Mental Illness in America by Robert Whitaker.

Today's blog is on childen… specifically the so-called rise of mental illness among children and young people. What appears to be on the rise is an ideology.

The first thing to understand is that  the prescribing of psychiatric drugs to children is fairly recent. Prior to 1980, very few young people were medicated for mental conditions.

As Whitaker’s book makes clear, it’s all about the story. In fact, no research has ever shown a chemical imbalance in the brain to be the cause of depression or schizophrenia. Research does show that long-term use of psychotropic drugs creates a chemical imbalance in the brain that can be permanent, leading to permanent dependence and disability. Okay.. but the story is this: "Wow!  Good thing you’re on meds, because look how ill you get when you try to get off them! That just PROVES what a terrible imbalance you had before you were diagnosed."  I suppose alcoholics and heroine addicts could try to spin their withdrawals the same way…

Anyway, same thing going on with the drugging of kids:  Spin. Story. Apparently millions and millions of kids who, in the benighted past, were considered bored, rambunctious, temporarily sad, introspective, or angry were (according to “the story”) actually suffering from mental illness that was biological in nature (the elusive “chemical imbalance of the brain” story puts in a pediatric appearance), and FORTUNATELY these kids are now being diagnosed and medicated, and the fact that their mental health is becoming worse and worse just shows what a great thing it is that they are now getting help!

Turns out, depression and mania have always been common among children.  At least, that's the story.

And, here, let me put in a word for my own reasoning capacities. I think there are many and excellent reasons for a decline in the mental health of children. For starts: nutrition. There’s a B-vitamin deficiency in the global food supply (result of depleted soil). Kids eat crap. We all know that. It’s pushed on them. And low-income families have little choice but to load up on high-carb, low-nutrient foods. If we treated our cars the way we treat our bodies, the engines would have seized up long ago. 

Then there is what some have begun to call Nature Deficiency Syndrome. It’s a pretty recent thing that a child can spend months, even years at a time in man-made environments without a day in nature. I think this has a severe impact on perspective, perceptions of reality, being right-sized, etc.  I think that being in nature has many effects on us that are still poorly understood.

And then there is the electronic media thing… staring at screens: TV, DVD’s, WII sports, Nintendo games, texting. We are learning reality from unreality. Not to mention that radiation thing.

And, seriously, WHAT are they watching for 5-8 hours a day? Porn and violence. There have been some hugely ignored studies documenting that children before the age of four register traumatic events they see on film as if these events were real. In other words, they actually develop PTSD from watching people get burned alive, blown up, eviscerated, raped, tortured, and murdered. I remember back in the 1950's, my brother developed a bunch of fear behaviors after seeing the movie "House on Haunted Hill." Which would be considered light-weight today.  Anyway, the research about pornography is equally conclusive and equally ignored: exposure to pornography desensitizes the viewer, impairing their capacity for intimacy, fostering an objectification of (usually) women. Oh, and it teaches rape.

Are children more restless, depressed, aggressive? I wouldn’t doubt it. Is it about chemical imbalance in the brain? Until there is one shred of research to support that theory, I’m going to go with “no.” Is it about how far we have removed ourselves from being an animal species among animal species?  Well, those folks who are actually creating environments to bring us back to that are getting good results.

But let’s get back to “the story.”  Children have been massively mentally ill all along… who knew? 

Let’s look at Attention Deficit Disorder (ADD).  At the turn of the century, a doctor did identify hospitalized children with “violent outbursts… destructiveness, and a lack of responsiveness to punishment.” This was found to be associated with known brain injuries (meningitis, brain tumors, etc.) It was a rare condition.

In 1956 Ritalin went on the market as an alternative to amphetamines for treatment of narcolepsy. It was found helpful for treating these hyperactive kids who were hospitalized for brain injuries. But things didn’t really change until 1980, when ADD made it into the DSM for the first time (Diagnostic Statistical Manual), which, in cynical terms, determines what insurance will and won’t pay for. In 1987, ADD became ADHD (Attention Deficit Hyperactivity Disorder). In 1991, ADHD became covered by an act of Congress, so that now children with the diagnosis were eligible for a range of special services.

What happened? Suddenly there were children in every classroom with this formerly rare, brain-disease side effect. Who was diagnosing? Mostly teachers, not doctors.  A study in 2009 showed that “only a minority of children with this disorder exhibit symptoms during a physician visit.” By 2007, one out of twenty-three children (4-17 years old) were being medicated for ADHD.  It’s called a brain disease, but, again, no research supports this finding. The neuroanatomy appears to be normal. The “chemical imbalance” thing is a drug-marketing claim, not science. Who needs facts when the story is so good?

Do the drugs “work?” Well, the children definitely become subdued, or, in clinical terms, there is a “reduction in movement and engagement with others.” In teacher language that would mean “stops fidgeting and talking to students during class.” In research language, other phrases have been used: “emotionally flat,” “reduced curiosity about the environment,” “socially withdrawn,” “little or no initiative,” “devoid of humor.”

What about the children?  Researchers have found a pervasive dislike for taking the pills among hyperactive kids. Seems that it’s not great for self-esteem. But what about academic performance? If the pills enhance the student’s ability to focus, then wouldn’t that enhance self-esteem?

Ritalin helps with focus on  routine, repetitive tasks, but it does not lend itself to creative problem solving or divergent thinking—both of which are necessary for critical thinking. Ritalin appears to be taking on a sinister tinge: The improvement is in classroom manageability, not academic performance.

And the long term?  Seems to be a growth suppressant (shorter, less weight). Symptoms worsen over time. Greater overall functional impairment.  Oh, gosh… Okay (deep breath): drowsiness, appetite loss, lethargy, facial and vocal tics, insomnia, headaches, abdominal pain, motor abnormalities, skin problems, liver disorders, sudden cardiac death, depression, apathy, anxiety, irritability, obsessive-compulsive disorder, mania, paranoia, hallucination…  reduced ability to experience pleasure. Yeah. Ritalin.

Moving on. By 2002, one in forty children were on anti-depressants. In 2004, the number of children killing themselves on these drugs was so alarming, the FDA started requiring the drug companies to include a warning label that describes the "increased risk of suicide and suicidal thoughts and behavior in children and adolescents given antidepressant medications." A warning. The drugs are still available, still prescribed, and young people are still killing themselves. Read my earlier blog on the failure of antidepressants… Or, if you have a strong stomach, go to the SSRI stories website.

In 1960, researchers were unable to find any cases of manic-depressive syndrome in children. By the late 1960’s, Ritalin began to be prescribed. Some children taking Ritalin began to exhibit manic behavior.  No surprise there. Any parent with a kid on Ritalin can tell you about the daily “crash.” The drug produces arousal followed by dysphoric symptoms. Daily. But this is the very cycle that doctors describe as bipolar!  Every child on a stimulant is a bit bipolar, and the risk of moving on to a full diagnosis is ever-present. Voila! Pediatric bipolar disorder was “discovered.”

As antidepressants began to be prescribed, the numbers rose even higher.  And here was the story: The antidepressants were not causing bipolar.. no, no, no!  They were simply unmasking the bipolar illness that was already there! In fact, by 1995, studies showed that one quarter of children and adolescents diagnosed and medicated for depression would convert to bipolar within two-to-four years.

To sum up: 400,000 children have arrived at bipolar via the ADHD doorway, with at least another half-million on the way through the antidepressant doorway. This is an iatrogenic epidemic, people. Iatrogenic. Look it up. And how bad off are these kids?  In 1987, there were about 16,000 psychiatrically disabled youth on SSI.  Twenty years later? 560,000.

And what about really young kids? About ten years ago, doctors began to prescribe psychotropic drugs to toddlers. In those ten years, the number of children under the age of six who are on SSI has tripled.

Whitaker goes on to interview some of the children who are on these medications. The stories are heartbreaking and also infuriating. What is most upsetting is that the doctors who are attempting to explore other treatment modalities in lieu of medication are finding they can’t get funding, and their work is not being published. 

The next blog will probably be the last… talking about these alternative methods for dealing with mental illness.

Click here to go back to Part 1.
Click here to go on to Part 10.

It was not my intention to write so many blogs on Anatomy of an Epidemic, but I have lost so many friends, acquaintances, and colleagues to this iatrogenic “epidemic,” I find that every time I want to skip a chapter, there is a nagging compulsion that haunts me until I include the material.

This was the case with Whitaker's chapter on bipolar. I had covered anti-psychotics, neuroleptics, antidepressants… and I just wanted to move on to conclusions. But my  conscience would not let me.

So, here we go: Robert Whitaker on bipolar...

He opens the chapter with a report on the 2008 American Psychiatric Association annual meeting, which he attended. Because of new disclosure guidelines, Whitaker was able to access information about some of the speakers. One example: Joseph Biederman of Massachusetts General who led the way in popularizing juvenile bipolar disorder received research grants from eight drug companies, was a “consultant” to nine of them, and served as a “speaker” to eight. The enmeshment between medical professionals and pharmaceutical companies has apparently become so routine and so widely accepted, no one thinks to ask if this connection might constitute conflict of interest. In fact, failure to have these connections is likely to call into question one's medical credentials. But that's another chapter.

The fact is this:  outcomes for bipolar have dramatically worsened since the “discovery” (read “accidental blundering onto questionably useful, but decidedly marketable side effects while developing drugs for other purposes”) of psychiatric drugs.  To what does “worsened” refer?  Increased chronicity, functional decline (as in "becoming disabled"), cognitive impairment, and physical illness… all of which, the author notes, can be EXPECTED to show up with patients taking the usual bipolar cocktail that often includes an antidepressant, a mood stabilizer, a bezodiazepine, an antipsychotic, and maybe a stimulant.

In the past, bipolar disorder was considered extremely rare. In 1955, the rate appears to have been about one in every 13,000. Outcomes were very positive. Whitaker cites a number of studies illustrating that about 50% hospitalized for mania did not have a recurrence. Seems that 70-80% used to end up “socially recovered”…  that is,  married, working, home-owning.  Okay, somewhat heterosexist and capitalist criteria, but at least they were not institutionalized, not on disability payments, not lying on the couch or in bed.

So, what’s the scenario today?  One in forty people are diagnosed as bipolar. WHAT? From one in 13,000 to  one in 40? And, no, that huge a difference can’t be explained just by saying that medicine has expanded the boundaries of the diagnosis. It has definitely done that, but there is obviously something more significant going on.

Okay… dirty little secret: Studies show that one-to-two thirds of patients hospitalized for bipolar episodes have abused (used?) illicit drugs… specifically stimulants, cocaine, marijuana, and hallucinogens. These weren’t all that popular and available until the 1960’s. So that's part of the epidemic.

But there’s something else…  The American Psychiatric Association in 1993 admitted that “all antidepressant treatments, including ECT [electroconvulsive, or "shock" therapy], may provoke manic episodes.”  In fact, 20-40% of patients diagnosed with depression convert to bipolar.  One study notes that 60% of bipolar patients turned that way after exposure to antidepressants. 

Even more sadly, withdrawing the antidepressant that produced the mania will not alter the condition. In other words, antidepressant-induced bipolar disorder is neither temporary or reversible.

And, yes, doctors (and keep in mind the tremendous amount of money that many receive from drug companies for endorsing their products) expanded the diagnosis. You no longer need to be hospitalized in order to get a bipolar diagnosis. You no longer need to have four days of “elevated, expansive or irritable moods.” You just need two. So now, 5% of the population is bipolar. But even that’s not good enough.  In 2003, the former head of the National Institute for Mental Health (NIMH) said that many folks can suffer from “subthreshold” symptoms of depression and mania. The new name is “bipolarity spectrum disorder.” 6.4% of American adults are apparently affected, and some optimistically declare that it’s more likely that  25% are somewhere on the bipolar spectrum! Talk about expanding markets!

Page after page after page of studies in Whitaker's book illustrate how the antidepressants destroy the symptom-free interludes, which, of course, destroys functionality. Frankly, it makes for depressing reading: “induction of mania,” “induction of rapid cycling,” “increase in number of episodes,” “chronic depression,” “cognitive impairment.” Finally, in 2008, the NIMH released their findings on bipolar treatment: “the major predictor of worse outcomes was antidepressant use, which about 60% of patients received.”

Let me just cut to the chase: In 1955 there were about 12,700 patients hospitalized for bipolar. Today, there are about SIX MILLION adults with the illness, and 83% are “severely impaired.”

And if you have loved ones, as I do, who have been diagnosed and who are on the usual drug cocktails for bipolar, then you can skip the narratives at the end of the chapter. I’m sure the stories will be familiar. Whitaker puts a human face on this tragedy, interviewing patients whose lives illustrate the stages of cognitive impairment and loss of functionality. The descriptions from those who have gotten away from the drugs and managed to survive are telling. One patient notes, “Honestly, it felt like I was waking up for the first time in five years… I had gotten back to being myself again. I felt like the drugs took away everything that was me.”

As terrifying and/or debilitating as episodes of mania or depression can be, it might be helpful for doctors to keep in mind the fact that longterm outcomes for both schizophrenia and manic-depressives are consistently better for patients who are not treated with psychiatric drugs.

Click here to go back to Part I.
Click here to go on to Part 9.

 “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”…

This quotation by a patient opens the tenth chapter of Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astounding Rise of Mental Illness in America.  This is the seventh part of a blog about the book.

The author offers an interesting exercise in logic: What if there was a virus that makes people sleep 12-14 hours a day, move slowly, and appear emotionally disengaged? What if this virus made blood sugar levels and cholesterol levels soar? What if patients with the virus were developing diabetes… especially children and young adults? And some were even dying from pancreatitis?  And then government studies were discovering that the virus was having these effects because it was blocking an astounding multitude of critical neurotransmitter sites in the brain:  dopaminergic, sertononinergic, muscarinic, adrenergic, and histaminergic?  And imagine that this virus was shrinking the cerebral cortex causing cognitive impairment…   Scary virus, no?  And then the author delivers the punchline: He has just described the effects of Eli Lilly’s best-selling antipsychotic drug Zyprexa.  And, yes, millions (including children) are taking it. And, yes, BILLIONS have been paid out and continue to be paid out in settlements by Lilly …

But Zyprexa continues to be sold. Why? Hold that question…

Whitaker’s research for the book takes the reader down some of the back alleys, where we find the researchers who consistently find, over and over, that there were no such things as "chemical imbalances" in the brain causing mental health conditions… who are finding in study after study that these psychiatric drugs are causing permanent brain damage and drug dependencies. What happened to them? They were fired, demoted, censored, discredited, had their funding withdrawn, their positions revoked.  This was not the story that people wanted to hear. And this is still going on. (Good thing Scientologists don't believe in psychiatric drugs... Now anyone who questions the practice can be equated with Scientologists and believing in aliens!)

What’s going on?  Let’s follow some of the money…

Eli Lilly’s value increased nearly tenfold between 1987 and 2000.  The head of the psychiatric department at Emory received $960,000 from one drug company just to promote Paxil and Wellbutrin. In 2006, drug companies gave physicians in Minnesota $2.1 million dollars.  The totally accidental and random discovery of drugs that affect the brain and the very focused and intentional marketing of them has ushered in what amounts to a psychotropic Gold Rush.

And who pays the bill? In 2008, the US spent $170 billion on mental health services, which was twice as much as in 2001.  By 2015, the cost is estimated to be almost twice as high. About 60% of this is paid by the US government via Medicare and Medicaid. We’re all paying the bill.

But money is not the primary cost. The highest price is the cost to our mental health. Whitaker makes an argument that is difficult to refute that the current mental health epidemic in this country is an iatrogenic one.

The eighth blog on this issue will be focused on solutions. Stay tuned!

Click here to go back to Part 1.
Click here to go on to Part 8.

This is the sixth part of a blog about Robert Whitaker’s book, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs and the Astonishing Rise of Mental Illness in America.

Okay… So this blog is about depression. And, of course, those “magic bullets,” the anti-depressants.

Some background: Community surveys from the 1930’s and 1940’s found fewer than one in a thousand people suffered an episode of clinical depression each year. And most of those who did, did not require hospitalization. In 1955, the disability rate from depression was one in 4,345 people. Oh, and it was a disease of the middle-aged and the elderly. Hold that thought.

Study after study from these years showed that folks with depression had great prospects for recovery via spontaneous remission… about half, in fact.   And folks recovering from depressive episodes had the same “capacity and prospects” in their work life as before the onset of the illness.  In other words, they were not being disabled by depression.

Yep… the anti-depressants were joining the neuroleptics and the benzodiazepines as psychiatric drugs proving to cause more serious conditions than those they purported to cure. And pretty much for the same reason: The drugs were introducing a chemical imbalance to the brain, and the brain was making drastic adjustments to compensate. These adjustments, over time, would become permanent, which is why withdrawal of the drugs had such disastrous consequences. The brain had now become permanently imbalanced.

But the investment in these "magic bullets" was enormous. In response to the evidence of harm, the medical establishment began to circle their theory wagons. They found a way to explain away the earlier, pre-1960 history of depression: Apparently, the reason so many depressed patients seemed to recover so easily in the past was because the doctors back then had inferior systems for describing and classifying mental illness. Depression, they insisted, is, and always has been, a chronic condition requiring medication... and any statistics that would contradict this must be invalid.  Why, all you had to do was look at how many patients relapsed when they went off their meds, to see how necessary the drugs are! 

So let me recap: Prior to the discovery of anti-depressants, depression was reported as relatively rare, and with good prospects of complete recovery. Children and young people hardly ever suffered from it. Today, one in ten people are diagnosed with depression as a chronic condition, and these folks can expect recurrences throughout their lives. In fact, two-thirds of patients treated with anti-depressants can expect recurrent bouts.  In one study, only 6% could expect remission.

In a 1995 study by the NIMH, patients who had been medicated for depression were likely to have become disabled. And children and young people? Today depression is the leading cause of disability for folks between the ages of 15 and 44.

And then, of course, there are the side effects: The SSRI’s can cause sexual dysfunction, suppression of REM sleep (which will cause psychiatric problems), fatigue, emotional blunting, and apathy. And…  impaired memory, impaired problem-solving ability, loss of creativity, learning disabilities.  All this for a short-term effect often little better than that of a placebo, likely to result in chronic depression, with possible disability.  Such a deal.

And here I am departing from a review of Whitaker’s book to take a sidetrip to a website called SSRI Stories.  This is not for the faint-of-heart: Here's their self-description: "This website is a collection of 4,300+ news stories with the full media article available, mainly criminal in nature, that have appeared in the media (newspapers, TV, scientific journals)  or that were part of FDA testimony in either 1991, 2004 or 2006, in which antidepressants are mentioned."

And the stories are doozies. For the reader's convenience, the website has categorized them by atrocity. Here's the list:

Soldier Cases
School Shootings / Incidents
Most Recent (Last 30 Days)
Workplace Violence
Celebrity Cases
Highly Publicized Cases
Won SSRI Criminal Cases
Women Teacher Molestations
Postpartum Cases
Murder-Suicides
Murders / Murder Attempts
Suicides / Suicide Attempts
Road Rage Cases

If you click on any of these, you can read the details about these cases, with links to corresponding journal or newspaper articles. Is the association with anti-depressants a coincidence? I mean, only people with depression and mental illness are prescribed the drugs, so is it fair to blame these crimes on pharmaceuticals?  Check out the narratives from family members, insisting that, prior to the use of medications, the person did not have suicidal ideation, mood swings, erratic behavior. Check out how many times drug companies have paid out claims on these cases... and you know that these settlements are not cheap.

Finally, the FDA has had to admit that the SSRI's are causing children and young people to take their lives, and labels now have to carry warnings about  increased risk of suicide among young adults aged 18 to 24. Clearly, the folks who run the SSRI Stories website see this as just the tip of the iceberg, and, at least to me, they make a compelling case.

So, since the anti-depressants have such poor efficacy and such gargantuan risks, why are so many people still taking them? In the US, by 2005, one in ten people were on anti-depressants. By 2008, there were 164 million prescriptions written for anti-depressants.

What the hell is going on? Stay tuned!

Click here to go back to Part 1.
Click here to go on to Part 7.

This is the fifth part of a series of blogs in response to Robert Whitaker’s book Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America.

Whitaker reviews the scientific research to demonstrate that the psychiatric drugs were discovered by accident, and were not intentionally developed to treat mental diseases. The theory of a chemically imbalanced brain was put forward after these drugs began to be prescribed and, according to Whitaker, this theory has not been supported by studies. As he noted, researchers did not find chemical imbalances in the brains of mental patients, but these imbalances did turn up after use of psychiatric drugs.

This is the fourth part of my blog on Robert Whitaker’s Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Riase of Mental Illness in America.

The previous blog explored the accidental nature of the discoveries of these so-called magic bullets, and this blog will examine how the tail of those discoveries came to wag the dog of scientific theory.

Whitaker notes how psychiatry was viewed very differently from other branches of medicine. Traditionally, the patient would lie on a couch as the psychiatrist led them back through the labyrinthine convolutions of their childhood or provided interpretations for their dreams. This was a far cry from the medical practitioner who diagnosed specific illnesses and prescribed scientifically formulated medicines to correct the condition. With the discovery of “magic bullet” antibiotics, the prestige of doctors rose considerably, and psychiatrists were eager to see their practice achieve the same degree of validation and popularity. If only there was some way to frame these accidentally-discovered drugs as disease-fighting agents!  

I’m blogging my response to Robert Whitaker’s book Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs and the Rise of Mental Illness in America. In Part One, I explored the historical disconnect between popular support for a medical treatment and the fact that this treatment may be ineffective or even dangerous, with no supporting research. Part Two reviewed the statistics for the epidemic.

Today’s subjet is “magic bullets.”  Medicine does have some. Antibiotics and insulin are examples. Researchers identified a medical condition, like bacterial infection or insulin deficiency, and then they developed a medicine that would fix it… Antibiotics to kill the bacteria, and insulin to provide insulin.

This is the second part of a series of blogs about the book Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs and the Astonishing Rise of Mental Illness in America by Robert Whitaker.

The book is by a man who founded a publishing company to report on the business aspects of clinical testing of new drugs… an “industry-friendly” enterprise. Baffled by studies suggesting the inefficacy of medications for patients with schizophrenia, he began an investigative journey that resulted in this book.

“Epidemic” is  a strong word. How does Whitaker support it? 

He starts by looking at the data for 1955, when the disabled mentally ill were primarily cared for in state and county mental hospitals. Today, these folks would typically be receiving SSI (Supplemental Security Income) or SSDI (Social Security Disability Insurance) payment, with many of them living in residential shelters or other subsidized living arrangements. 

Did you know that bloodletting was the most common medical practice from the first century AD until the nineteenth century—nearly two thousand years!—even though, in the majority of cases, the practice was harmful and even fatal to patients?

Wow.

Wouldn’t you think that in two millennia, people might have noticed that folks losing pints of blood got worse instead of better?

Actually, I’m sure they did. They would definitely notice when the patient died. So why the extraordinary longevity of such an obviously pernicious therapy?

The answer is simple: human nature. We are emotional, not rational creatures. And we are creatures of habit; our traditions die hard. And we are social animals; shunning by the herd will bring most of us back into line. 

Why am I telling you this? Because it might make it easier to swallow the fact that millions of people today are receiving a medically prescribed treatment that is making the majority of them much sicker, shortening their lives, and sometimes killing them… and there is absolutely no research to support the theory upon which these treatments are based.

In this case, the practice is only a few decades old instead of millennia, but the principle behind it is the same: human nature.

This blog is my response to reading Anatomy of an Epidemic by Robert Whitaker. The subtitle is “Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America."

The first thing that impressed me about this book was the story of the author’s involvement with the subject. He was not a counter-culture type guy. In fact, he had co-founded a publishing company to report on the business aspects of the clinical testing of new drugs. In his own words, “we wrote about this enterprise in an industry-friendly way.” Clearly Anatomy of an Epidemic is not “industry-friendly.” What changed?

Whitaker stumbled across a story about the abuse of patients in a research setting. He did a series of articles on the subject for the Boston Globe. In one of the stories, he reported on a study which had involved withdrawing schizophrenic patients from anti-psychotic medications. Since the medication for this disorder is likened to “insulin for diabetics,” the author questioned the ethics of a study that would deprive the patient of a medication supposedly known to be essential for their health.

In the course of researching this article, Whitaker ran across two findings that nagged at his conscience:

1)    In 1994, Harvard researchers announced that outcomes for schizophrenia patients has worsened since 1974 and were no better than they had been a century earlier… as in 1894.

2)    Two separate studies by the World Health Organization which found that schizophrenia outcomes were much better in poor countries like India and Nigeria, where only 16% of the patients were maintained on anti-psychotic medications.

The point of all this is that the author of the book was a solid believer in the conventional wisdom of modern psychiatry. He believed that psychiatric researchers had discovered biological causes for mental illness and that their findings had led to the development of a new generation of psychiatric drugs to “balance” brain chemistry. He was to discover that none of these assumptions were true.

Anatomy of an Epidemic is the story of his awakening.

Click here for Part 2.