Robert Whitaker, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America (Crown Publishers 2010)
When I told my ENT surgeon I was reading a book about science and the use of psychiatric drugs, he said, ‘One of those books about evil psychiatrists, is it?’ I was only about a third of the way in at the time, and replied, ‘No, I think the villain of the piece is the drug companies defending their huge profits.’ ‘Ah,’ he said, shocking me just a little, ‘psychiatry is about a hundred years behind the rest of medicine in terms of being evidence based.’
In fact, this book mounts a convincing case that psychiatry is not a hundred years behind at all, but is in a whole different paddock. Basically Robert Whitaker has done a meticulous survey of the scientific literature about ‘mental illness’ (my quote marks) and the effects of psychiatric drugs, and holds up to the light the startling difference between the received wisdom on one hand and what the science shows – or fails to show – on the other. In fact, it seems, the evidence indicates that drugs used to deal with anxiety, depression and schizophrenia are not only ineffective, but do more harm than good and in the long run are causing widespread devastation. Towards the end of the book he lists no fewer than sixteen major studies conducted since 1990, all contradicting the mainstream version the efficacy of psychiatric drugs, and says he can find no mention of any of them in any US newspaper. In such matters, of course, newspapers depend on press releases from professional organisations and government agencies, and it seems that the US psychiatric profession has thrown its lot in with the big pharmacological companies. Likewise the relevant government body, the National Institute of Mental Health, and the major patient advocacy group (which, like opinion leaders among psychiatrists, receives staggering level of funding from big business). The websites of neither the NIMH nor the advocacy group make any mention of the uncomfortable science.
Whitaker writes well. He appears to be meticulous in his reporting of the science. I’ve taken a while to blog about it because I didn’t want to write in a state of rage. But let me say now, calmly, that anyone who has ever been prescribed psychiatric drugs, anyone who routinely or occasionally prescribes them, and especially anyone who is being advised to give them to their children, should read this book. Whether the drugs are for depression, anxiety or schizophrenia, this holds true. The fact that someone is wearing a white coat and has a lot of money and big words at their disposal doesn’t make them a scientist. The fact that people’s lives are made miserable by ‘mental illness’ doesn’t mean that prescribing drugs for them is an act of compassion rather than a way to suppress the symptoms that disturb the rest of us at significant cost to the sufferer. The fact that psychiatric drugs are opposed by Scientologists and people who want to blame the mother doesn’t mean they’re good for you.
The most striking thing about the book for me was something I read after I’d finished it. I was concerned that Whitaker’s argument coincided pretty closely with my own understanding of things before I read it (see final paragraph below). So I went looking for responses and rebuttals. As it turns out, Whitaker has a web site where he provides links to just such writing: the slippery logic and shaky data of the rebuttals delivered by leading psychiatrists provides emphatic confirmation that he is on the money.
There are alternatives. The book and Whitaker’s web site include examples of projects that have produced very promising results before attack from the psychiatric profession and withdrawal of funds closed them down, and a couple of examples where the projects managed to gain funds not controlled by the forces of darkness (oh dear, I obviously haven’t calmed down quite enough! but really, the Alaska Mental Health Trust Authority, with 200 million dollars in its pocket, was able to successfully challenge the iron-clad assumption of the courts that anyone who objected to being given psychiatric drugs was ipso facto incompetent, where elsewhere no one has had the resources to challenge the expert witnesses for the status quo). There’s a region in Finland where schizophrenia has virtually been wiped out by an approach that involves (I’m simplifying) open dialogue with someone with signs 0f psychosis and caution in prescribing drugs. In Australia, the Personal Helpers Mentors Program, while not antagonistic to psychiatry, has a non-medical approach which goes a long way to helping people to function well and to manage their symptoms.
Some friends of mine are on the way to opening the Pajaro Valley Sunrise Center in California, a residential facility for people wanting to come off psychiatric drugs. Because, of course, you can’t just stop taking drugs that change the functioning of your brain without bringing on terrible reactions (which, according to Whitaker, is used as an argument for keeping people on them for life). I was mildly supportive before reading this book. Now I’m in danger, as my brother in law says, of becoming a proselytiser.