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.
Whitaker's tale will be familiar to readers of WW contributor Philip Dawdy, a longtime survivor of bipolar disorder who questions the efficacy of drugs prescribed to treat the disease (see "Bitter Pill," WW, April 2, 2008).
Other books have probed wild claims made for psychiatric drugs, but Whitaker's is perhaps the first to attack the problem of mental illness holistically in a volume accessible to the average reader.
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.
Roger Whitaker appears at Powell's City of Books, 1005 W Burnside St., 228-4651. 7:30 pm Thursday, Aug. 19. Free.