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Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America Hardcover
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Robert Whitaker
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Print length416 pages
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LanguageEnglish
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PublisherCrown
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Publication dateApril 13, 2010
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Dimensions6.48 x 1.48 x 9.54 inches
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ISBN-100307452417
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ISBN-13978-0307452412
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Editorial Reviews
From Booklist
Review
“Anatomy of an Epidemic offers some answers, charting controversial ground with mystery-novel pacing.”—TIME.com
“Lucid, pointed and important, Anatomy of an Epidemic should be required reading for anyone considering extended use of psychiatric medicine. Whitaker is at the height of his powers.”—Greg Critser, author of Generation Rx
“Why are so many more people disabled by mental illness than ever before? Why are those so diagnosed dying 10-25 years earlier than others? In Anatomy of an Epidemic investigative reporter Robert Whitaker cuts through flawed science, greed and outright lies to reveal that the drugs hailed as the cure for mental disorders instead worsen them over the long term. But Whitaker’s investigation also offers hope for the future: solid science backs nature’s way of healing our mental ills through time and human relationships. Whitaker tenderly interviews children and adults who bear witness to the ravages of mental illness, and testify to their newly found “aliveness” when freed from the prison of mind-numbing drugs.”—Daniel Dorman, M.D., Clinical Assistant Professor of Psychiatry, UCLA School of Medicine and author of Dante’s Cure: A Journey Out of Madness
“This is the most alarming book I’ve read in years. The approach is neither polemical nor ideologically slanted. Relying on medical evidence and historical documentation, Whitaker builds his case like a prosecuting attorney.”—Carl Elliott, M.D., Ph.D., Professor, Center for Bioethics, University of Minnesota and author of Better than Well: American Medicine Meets the American Dream
“Anatomy of an Epidemic investigates a profoundly troubling question: do psychiatric medications increase the likelihood that people taking them, far from being helped, are more likely to become chronically ill? In making a compelling case that our current psychotropic drugs are causing as much—if not more—harm than good, Robert Whitaker reviews the scientific literature thoroughly, demonstrating how much of the evidence is on his side. There is nothing unorthodox here—this case is solid and evidence-backed. If psychiatry wants to retain its credibility with the public, it will now have to engage with the scientific argument at the core of this cogently and elegantly written book.”—David Healy, M.D., Professor of Psychiatry, Cardiff University and author of The Antidepressant Era and Let Them Eat Prozac
“Anatomy of an Epidemic is a splendidly informed, wonderfully readable corrective to the conventional wisdom about the biological bases—and biological cures—for mental illness. This is itself a wise and necessary book—essential reading for all those who have experienced, or care for those who have experienced, mental illness—which means all of us! Robert Whitaker is a reliable, sensible, and persuasive, guide to the paradoxes and complexities of what we know about mental illness, and what we might be able to do to lessen the suffering it brings.”—Jay Neugeboren, author of Imagining Robert and Transforming Madness
“Every so often a book comes along that exposes a vast deceit. Robert Whitaker has written that sort of book. Drawing on a prodigious quantity of psychiatric literature as well as heart-rending stories of individual patients, he exposes a deeply disturbing fraud perpetrated by the drug industry and much of modern psychiatry—at horrendous human and financial cost to patients, their families, and society as a whole. Scrupulously reported and written in compelling but unemotional style, this book shreds the myth woven around today’s psychiatric drugs.” —Nils Bruzelius, former science editor for the Boston Globe and the Washington Post
“A devastating critique. . . . One day, we will look back at the way we think about and treat mental illness and wonder if we were all mad. Anatomy of an Epidemic should be required reading for both patients and physicians.” —Shannon Brownlee, senior research fellow, New America Foundation and author of Overtreated
About the Author
Excerpt. © Reprinted by permission. All rights reserved.
A Modern Plague
“That is the essence of science: ask an impertinent question, and you are on the way to a pertinent answer.” —Jacob Bronowski (1973)
This is the story of a medical puzzle. The puzzle is of a most curious sort, and yet one that we as a society desperately need to solve, for it tells of a hidden epidemic that is diminishing the lives of millions of Americans, including a rapidly increasing number of children. The epidemic has grown in size and scope over the past five decades, and now disables 850 adults and 250 children every day. And those startling numbers only hint at the true scope of this modern plague, for they are only a count of those who have become so ill that their families or caregivers are newly eligible to receive a disability check from the federal government.
Now, here is the puzzle.
As a society, we have come to understand that psychiatry has made great progress in treating mental illness over the past fifty years. Scientists are uncovering the biological causes of mental disorders, and pharmaceutical companies have developed a number of effective medications for these conditions. This story has been told in newspapers,
magazines, and books, and evidence of our societal belief in it can be found in our spending habits. In 2007, we spent $25 billion on anti-depressants and antipsychotics, and to put that figure in perspective, that was more than the gross domestic product of Cameroon, a nation of 18 million people.
In 1999, U.S. surgeon general David Satcher neatly summed up this story of scientific progress in a 458- page report titled Mental Health. The modern era of psychiatry, he explained, could be said to have begun in 1954. Prior to that time, psychiatry lacked treatments that could “prevent patients from becoming chronically ill.” But then Thorazine was introduced. This was the first drug that was a specific antidote to a mental disorder—it was an antipsychotic medication—and it kicked off a psychopharmacological revolution. Soon antidepressants and antianxiety agents were discovered, and as a result, today we enjoy “a variety of treatments of well documented efficacy for the array of clearly defined mental and behavioral disorders that occur across the life span,” Satcher wrote. The introduction of Prozac and other “ second- generation” psychiatric drugs, the surgeon general added, was “stoked by advances in both neurosciences and molecular biology” and represented yet another leap forward in the treatment of mental disorders.
Medical students training to be psychiatrists read about this history in their textbooks, and the public reads about it in popular accounts of the field. Thorazine, wrote University of Toronto professor Edward Shorter, in his 1997 book, A History of Psychiatry, “initiated a revolution in psychiatry, comparable to the introduction of penicillin in general medicine.” That was the start of the “psychopharmacology era,” and today we can rest assured that science has proved that the drugs in psychiatry’s medicine cabinet are beneficial. “We have very effective and safe treatments for a broad array of psychiatric disorders,” Richard Friedman, director of the psychopharmacology clinic at Weill Cornell Medical College, informed readers of the New York Times on June 19, 2007. Three days later, the Boston Globe, in an editorial titled “When Kids Need Meds,” echoed this sentiment: “The development of powerful drugs has revolutionized the treatment of mental illness.”
Psychiatrists working in countries around the world also understand this to be true. At the 161st annual meeting of the American Psychiatric Association, which was held in May 2008 in Washington, D.C., nearly half of the twenty thousand psychiatrists who attended were foreigners. The hallways were filled with chatter about schizophrenia, bipolar illness, depression, panic disorder, attention deficit/hyperactivity disorder, and a host of other conditions described in the APA’s Diagnostic and Statistical Manual of Mental Disorders,and over the course of five days, most of the lectures, workshops, and symposiums told of advances in the field. “We have come a long way in understanding psychiatric disorders, and our knowledge continues to expand,” APA president Carolyn Robinowitz told the audience in her opening- day address. “Our work saves and improves so many lives.”
But here is the conundrum. Given this great advance in care, we should expect that the number of disabled mentally ill in the United States, on a per- capita basis, would have declined over the past fifty years. We should also expect that the number of disabled mentally ill, on a per- capita basis, would have declined since the arrival in 1988 of Prozac and the other second- generation psychiatric drugs. We should see a two- step drop in disability rates. Instead, as the
psychopharmacology revolution has unfolded, the number of disabled mentally ill in the United States has skyrocketed. Moreover, this increase in the number of disabled mentally ill has accelerated further since the introduction of Prozac and the other secondgeneration psychiatric drugs. Most disturbing of all, this modernday plague has now spread to the nation’s children.
The disability numbers, in turn, lead to a much larger question. Why are so many Americans today, while they may not be disabled by mental illness, nevertheless plagued by chronic mental problems—by recurrent depression, by bipolar symptoms, and by crippling anxiety? If we have treatments that effectively address these disorders, why has mental illness become an ever- greater health problem in the United States?
Product details
- Publisher : Crown; 1st edition (April 13, 2010)
- Language : English
- Hardcover : 416 pages
- ISBN-10 : 0307452417
- ISBN-13 : 978-0307452412
- Item Weight : 1.48 pounds
- Dimensions : 6.48 x 1.48 x 9.54 inches
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Best Sellers Rank:
#826,096 in Books (See Top 100 in Books)
- #200 in Medical Psychopharmacology
- #227 in Popular Psychology Psychopharmacology
- #283 in Popular Psychology Mental Illness Books
- Customer Reviews:
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Customer reviews
Top reviews from the United States
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Whitaker is not anti-medication, many of his supporters still use medications. Whitaker is not anti-psychiatry. He is anti-bullshit. Many psychiatrists support him, and are referenced in this book. But only the ones who have actually taken the time to learn the academic research in their own field. Don't believe the critics who cite 2-3 studies and think they have discredited this book without looking into details. This book cites like 400 studies, works with all the best patient advocates in the industry, and is the best science has to offer to explain both problems and solutions.
If you want to know the real deal, this is the book to read. Most critiques of this book are very shallow, and have already been readily and easily disproven.
I read Robert Whitaker's book almost two years ago, and his conclusions alarmed me. I also had to honestly wonder, do I really feel better on all these medications than I would without them? I had been told by well-respected psychiatrists at two major research universities that the only way to prevent recurring depressive episodes was to be on medication for life. I had believed them, and taken the medications. I felt reasonably okay a lot of the time, though somewhat dulled and flattened by the meds. But I still had debilitating depressive episodes, sometimes lasting for months, in spite of the medications. As I looked around at my many, many friends and family members on psychiatric medications, it seemed to me that most of them were still pretty substantially depressed a lot of the time.
For years I had found the notion of "chemical imbalance" reassuring. The solution to my mental distress–medication–was no different than if I had diabetes and needed insulin, apparently! Taking psych meds with this perspective makes you feel that you are doing your best to take care of yourself, which is reassuring when you're still feeling awful. You're doing what you can do. "Better living through chemistry!" I used to wryly joke, as I'd down my cocktail of three or more medications every night. I regularly saw my psychiatrist, who would tweak the meds here and there to give me better relief.
How sad that the "chemical imbalance" theory just doesn't hold up to actual research! I understand how doctors came to use that analogy to reassure patients who were alarmed at the prospect of being on mind-altering drugs for long periods of time. But there are no chemicals being balanced here. The drug effects are powerful, but they are not restoring what is missing and replicating a healthy brain. That truth, well researched in this book, needs to be told.
After reading "Anatomy of an Epidemic" two years ago, I was convinced that I at least needed to try life without medications. My husband is a physician, and he found the research in the book compelling as well. I did a very slow, careful taper off of my psych drugs, over a period of months (this part is absolutely crucial). The side effects of withdrawing were physically painful at times, but I got through them. I've been off psychiatric medication for over a year and a half, and I feel really good.
Do I still get depressed? Yes, sometimes I do. But certainly not more depressed than I did on the medications. I really appreciate having the full range of my emotional reactions restored to me. It's dreary having the ecstatic side of life chopped off, along with the abject misery. Drugs do that. And psychiatric medications have frightening long-term consequences, some of which are only coming to light now that people have been on them for decades. If medications are truly needed, in most cases they should be temporary, not long-term.
Life is hard, stress is real, and problems need to be dealt with. There is no magic bullet. I have found daily aerobic exercise to be a far more reliable way of mitigating depression than my former medications, and research in this book shows this to be true for a majority of people as well. Mindfulness meditation has also helped, and kind people who listen to me.
I don't blame my doctors for my years of overmedication. They were doing the best they knew how for me, given the way that training is passed down doctor-to-doctor through medical education. The "medical model" of psychiatry saved that branch of medicine from dying out, given our insurance-based healthcare system, and Robert Whitaker does a great job of exposing the collusion between the pharmaceutical companies and the American Psychiatric Association, with its frightening consequences. I found the section of the book describing the way research evidence was "rewritten" for medical school textbooks truly alarming.
There's a lot at stake here for the psychiatric profession; it's not surprising that so many psychiatrists turn from this research with alarm and denial. I admire Robert Whitaker for bringing this problem to light, and for doggedly pursuing it both in the US and internationally. I recommend his website "Mad in America" for recent news and discussion.
I was getting progressively worse on the prescribed "medications", and for a while had suspected that it was the "medications" that were making me worse, and that their so called "side effects" (which for me were their primary effects) had actually been the cause of a significant part of my struggle. My "mental illness" started after being prescribed an SSRI for a totally normal, human response to a very difficult set of life circumstances.
Of course, my doctors wouldn't hear about this and said I had an illness that would require medication for life and what amounted to a future of overwhelming disability that maybe, just maybe, they could manage if only I'd take sufficient and ever-increasing doses of "medication".
The research in this book gave me the courage to get off the medications (very slowly and carefully after further research on how to do this successfully) despite my doctors' objections.
As a result I am now medication (and doctor) free, and functioning again and have been for over five years. I still struggle at times in response to what life throws up...who doesn't?....but there's no way I am "mentally ill" in any sense of the term.
The book is well-written and supported by very thorough research. It should be compulsory reading for ALL doctors in training, and all law makers - way too many people are locked up and drugged with appallingly dangerous and destructive "medications" in the name of the psychiatric/pharmaceutical industry.
Top reviews from other countries
What is so powerful is that the tone of the book is dispassionate; the author does not lecture, but simply lets the actual published research data tell the story; and the story is a shocking one. He provides overwhelming evidence that antidepressants and antipsychotic drugs, although they may help in the short term, do serious and sometimes irreversible harm in the long term. For example, long-term use of antipsychotic drugs causes shrinkage and atrophy of the frontal lobes in man, leading to severe cognitive impairment. This is not seen in unmedicated patients or patients who have only taken the drugs for a short time. This evidence of severe long-term damage is actively hidden from the general public by the pharmaceutical companies, who have made billions of pounds profit from these drugs and wish these profits to continue. Of all the disturbing facts discussed in the book, perhaps the most concerning is the rise in psychoactive medication of children.
In Europe psychiatrists are becoming aware of the long-term damage done by psychoactive drugs, and it is encouraging that in the uk, Finland and other countries forms of non-drug therapy are being successfully applied. However in the USA the grip of the psychiatric establishment and the profit motive is so strong that non-drug therapies have been suppressed or dismissed as ineffective. I wish that a copy of this book could be given to every medical student contemplating a psychiatric speciality; it seems that only by educating the new young doctors will the prescribing of these dangerous drugs be curtailed.
Reviewed in the United Kingdom on December 5, 2020
The underlying, implied appeal is - "first do no harm."
Don't think that, because the book is about the USA, it is not relevant to the UK and Europe - the book shows that this myth is promoted all over the 'developed' world, and the explosion of mental illness is happening everywhere that the medical view of mental health predominates.
It's very well written - even though it is about technical research the book is clear without dumbing down or missing out the salient facts.
A must for anyone interested in humanity, decency and accurate information on mental health...
It explores what this might mean for anyone taking the drugs and details how they may be the cause of the explosion of psychiatric cases in the USA. Sadly the UK is following along.
Mandatory reading of anyone who prescribes or takes these drugs.
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