Comfortably Numb: How Psychiatry Is Medicating a Nation [Hardcover]

Charles Barber (Author)

Book Description

Release date: February 5, 2008

Public perceptions of mental health issues have changed dramatically over the last fifteen years, and nowhere is this more apparent than in the rampant overmedication of ordinary Americans. In 2006, 227 million antidepressant prescriptions were dispensed in the United States, more than any other class of medication; in that same year, the United States accounted for 66 percent of the global antidepressant market. In Comfortably Numb, Charles Barber provides a much-needed context for this disturbing phenomenon.

Barber explores the ways in which pharmaceutical companies first create the need for a drug and then rush to fill it, and he reveals that the increasing pressure Americans are under to medicate themselves (direct-to-consumer advertising, fewer nondrug therapeutic options, the promise of the quick fix, the blurring of distinction between mental illness and everyday problems). Most importantly, he convincingly argues that without an industry to promote them, non-pharmaceutical approaches that could have the potential to help millions are tragically overlooked by a nation that sees drugs as an instant cure for all emotional difficulties.

Here is an unprecedented account of the impact of psychiatric medications on American culture and on Americans themselves.

Editorial Reviews

Review

“In Charles Barber's compelling new book, "Comfortably Numb: How Psychiatry Is Medicating a Nation," the author contends that we underwent a major shift in attitudes toward mental illness and medications…Barber brings a street-smart perspective to all this…[and he] offers something several of the other books don't: practical, therapeutic alternatives to antidepressants.”
—Salon.com
“A fine, informed writer on cultural history as well as neuroscience, psychotherapy, and economics, Barber convincingly argues against the overprescription of psychiatric drugs in the United States and sums up the history of U.S. psychiatry from the asylum to the community to glitzy but still elementary neuroscience. A blockbuster essential for all libraries.”
—Library Journal (starred review)
“A sharply critical look at the way antidepressants are marketed and prescribed in the United States . . . Barber articulately and persuasively counsels that it’s time to abandon the quick-fix, pop-a-pill approach.”
—Kirkus
“Comfortably Numb chronicles the extraordinary psychopharmaceuticalization of everyday life that has arisen in recent years and appears to be growing apace. Barber marks out the inconvenient truths on our path to emotional climate change but also offers alternatives to readers who wish to avoid pharmageddon.”
—David Healy, author of Let Them Eat Prozac
“In this passionate yet fair-minded book, Charles Barber explores the disturbing medicalization and medication of unhappiness in America today. The author understands that while medication has an important role to play in the treatment of severe mental illnesses such as schizophrenia, Big Pharma has seduced Americans into believing they need drugs for the normal sorrows of life. Almost 70 percent of antidepressants worldwide are sold in the U.S. The author asks the critical question of whether Americans are crazier than the rest of the world or whether we have simply developed a crazy dependency on legal drugs.”
—Susan Jacoby, author of The Age of American Unreason

About the Author

Charles Barber was educated at Harvard and Columbia and worked for ten years in New York City shelters for the homeless mentally ill. The title essay of his first book, Songs from the Black Chair, won a 2006 Pushcart Prize. His work has appeared in The New York Times and Scientific American Mind, among other publications, and on NPR. He is a lecturer in psychiatry at the Yale University School of Medicine and lives in Connecticut with his family.

See all Editorial Reviews

Product Details

• Hardcover: 304 pages
• Publisher: Pantheon; 1 edition (February 5, 2008)
• Language: English
• ISBN-10: 0375423990
• ISBN-13: 978-0375423994
• Product Dimensions: 6.3 x 1.2 x 9.5 inches
• Shipping Weight: 1.3 pounds
• Average Customer Review: 4.4 out of 5 stars  See all reviews (15 customer reviews)
• Amazon Best Sellers Rank: #929,945 in Books (See Top 100 in Books)
  • #91 in Books > Health, Fitness & Dieting > Psychology & Counseling > Psychopharmacology

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Most Helpful Customer Reviews

53 of 63 people found the following review helpful

3.0 out of 5 stars Poison pill among sugared reviews March 12, 2008

By Andrei Cervoneascii

Format:Hardcover

I am not trying to take away from the importance of the book's subject, quality of author's prose, or the general conclusions that Mr. Barber makes about American society members' happy embrace of the magic pill as an istant solution to almost any problem life throws at them. However, I disagree with the author's liberal use of a key statistic - that "66 percent of the global antidepressant market was accounted for by the United States" - a phrase singled out and repeated on the cover jacket, and reviews, and thus removed even further from clarifying context. Given Mr. Barber's apparent knowledge of the subject matter, I believe he should have made clear that the quoted percentage is based on dollar sales, not patients or even prescriptions. As US prices for prescription medication are much higher than in the rest of the world, and IMS Health data (used as a source for the quoted percentage) most likely covers a handful of other major markets, besides US, the cited percentage creates the desired (?) sensational effect. For some readers, familiar with the pharmaceutical industry, this instance of biasing inaccuracy may undermine credibility of author's use of other numbers and facts to support his conclusions. It is a worthy read, nonetheless, as long as the reader is prepared to think critically and make up own mind.

14 of 15 people found the following review helpful

5.0 out of 5 stars Thought Provoking, Useful and Informative June 18, 2009

By Roger E. Breisch

Format:Paperback

This book helped me a great deal. So that you can "consider the source" when reading my thoughts, I am not a healthcare professional, but I have spent over 1000 hours on a suicide hotline, and am active in Operation Snowball--an anti-drug, anti-alcohol program for teens. It is in those volunteer capacities that I relish this work.

I think the author, Charlie Barber, along with a great many others I have read in recent years, points to some very basic issues we have to face in the coming years. John Cacioppo, author of "loneliness," (another book I loved) feels we face an epidemic of loneliness. And while drugs can be effective as we battle the onslaught, I am concerned that we too often run for the bottle of pills.

I loved the way Charlie details the issues in the first half of the book, and then leaves the reader with practical and useful strategies for moving forward. I don't pretend to have the training or experience to employ the therapies he describes, but knowing about them sensitizes me to alternative avenues for the callers I face and teens who struggle to make sense of the oft-tragic lives they have been handed.

I apologize if what I am about to say seems hopelessly naive, but it is the world I navigate. Often the most effective "medication" for the people in my life is a word of hope, a non-judgmental ear or simply a hug.

18 of 22 people found the following review helpful

4.0 out of 5 stars Missing the Logical Conclusion? April 28, 2008

By Justiceseeker

Format:Hardcover

There is much in this beautifully written book to commend it, especially the cautionary message of how risky and ill informed the rampant overmedication of emotional ills is in America -- and why it might be occurring. The discussion of alternative psychotherapies is inspiring and informed. Critics, including Peter Kramer, author of Listening to Prozac, who claim Charles Barber is exaggerating the true scope of the increase by using the dollar value of prescriptions that includes price increases as opposed to simple pill numbers seem to be missing the forest for the trees. Just ask your acquaintances. There is hardly a family in America that hasn't been touched by psychopharmacology. Almost every other person is on or has been on antidepressants or even stronger medications. There really is something wrong with this picture, as Barber astutely argues, given our lack of knowledge about how these drugs work, what their long term effects are, and the conflicts of interest that permeate drug research.

Given all this marvelous insight it's a disappointment that Barber doesn't take his analysis to its logical conclusion and realize treatments for serious mental illnesses are as flawed as those for minor ones. Barber gets very tangled up trying to distinguish between "true" mental illness and what he thinks are lesser disturbances. This is because he understands how ill informed treatment paradigms are for what he calls "little d" depression but somehow thinks all these same medications are just fine for "big D" Depression because he has observed them "work". Barber gets a lot of credit for speaking from firsthand experience with seriously disturbed individuals but in those whom he has seen return to functioning it is not clear he has attributed the cause to the right place. Every mental disturbance, whether it's serious or not, cannot be segregated from the story that precedes it. To do so is to be dismissive and arrogant; it marginalizes that person's suffering. Whatever one's genetic predisposition or ability to tolerate stress is, ultimately every mental illness is situational in one way or another. The only road to true healing is by dealing with that situation. This turns out to be even more important for serious mental illness -- mania and psychosis -- than it is for psychosocial ills. Medication alone can never "cure" mania and psychosis and may only exacerbate it over time.

Barber recently appeared on Fresh Air (NPR) and admitted to the astonishment of many, given his views, that he takes Prozac. Perhaps this is why he gets tangled up and doesn't really have an entirely consistent point of view on these medications. Maybe he hasn't been able to withdraw. He must believe he has a "true" mental illness yet he indicated in the interview that the way he took control of his OCD [Obsessive Compulsive Disorder] was through behavioral and lifestyle steps (i.e. the situation), not medication. Mental illness is on a continuum from minor to major; it is presumptuous to assume that there is some magic point on this continuum where suddenly it's all right to use possibly toxic and addictive medications even if they do provide a benefit due to their stimulant or sedative effect. While there are surely situations in which a psychotropic medication may be life saving over the short term, using them long term and dismissing the importance of situational issues is probably always dangerous, not just sometimes, as Barber implies.