Saturday, October 22, 2011

Anatomy of an Epidemic

Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in AmericaAnatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America by Robert Whitaker

My rating: 4 of 5 stars

Anatomy of an Epidemic gives facts and figures on the astonishing rise in social security disability cases due to mental illness. Whitaker makes a comparison between the advent of Prozac in 1987 and the subsequent 37-fold increase in disability cases. What I found interesting is that his observations, backed by data, paralleled my anecdotal observations in my psychotherapy practice. In fact, prior to reading this book I had planned on writing a book about the limits of psychotherapy, and had actually published an article on it. When I first started practicing, clients would be on one, maybe two medications, if any. By the time I finished, 25 years later, clients were routinely sent for medication, prescribed at least two meds, constantly switched when the initial honeymoon period of those meds wore off, and often ended up on 4-6 meds. One of my clients died from overmedication and I had attempted to get her off the meds to no avail. Further, the attitude that a patient needed to stay on meds for life became increasingly entrenched and promoted. Drug companies bought lunch for the clinical staff and gave inservices on new ways to use existing drugs. When the patent for Prozac was over, it was renamed Serafim and aggressively promoted as a treatment for PMMD, pre-menstrual dysphoric disorder, the old-fashioned PMS. What the drug companies did not tell you, but Whitaker shows and I saw, was that once on drugs it was really hard to get off. The brain got used to relying on the artificial manipulation of neurotransmitters and seemed to lose the ability to do its own work.

Whitaker gives fascinating details of an American Psychiatric Association conference that he attended, in which the presentations questioned the efficacy of medications. More and more reports are coming out about the adverse effects of anti-depressants and other psychotropic medications. He raises an important question: Why, when we have so many new and supposedly wonderful drugs, are there more people permanently disabled by mental illness than ever?

This is not to say there is not a place for medication, but that it is being over-prescribed and given to people who should be using behavioral, emotional, and spiritual interventions. I personally know a number of "normal" people who are on anti-depressants and/or anti-anxiety agents who don't really need to be, in my clinical opinion.

Anatomy of an epidemic is an important book that anyone considering taking psychotropic medication, or is already on those medications, should read.

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