Book Review – Anatomy of an Epidemic
n his book, Anatomy of an Epidemic (2012), Robert Whitiker paints a terrifying picture of the psychiatric health and treatment of patients today. As a society, we have been led to believe that scientists are uncovering the biological causes of mental disorders. We also believe that pharmaceutical companies have developed effective medications for these conditions. Anatomy of an Epidemic forces us to consider that neither of these beliefs are the truth.
A summary of some of the main points made in Anatomy of an Epidemic follows. Some of the information is very contrary to what we have been led to believe by psychiatrists and drug companies. My belief is that it is important to weigh the pros and cons before taking medications to treat mental illness. It is also important to work with a naturopath and therapist to find natural ways to help you improve your health without relying only on drugs that can sometimes cause additional problems. If you are presently taking psychiatric medications, a team approach is needed to determine your optimal treatment plan.
Anatomy of an Epidemic uses a large number of studies to back up the claims it makes. I have provided links at the bottom of this article for those who are interested in looking at the studies.
We would expect, based on the vast array of psychiatric drugs being prescribed these days that the number of mentally disabled people would be decreasing. Instead, as the new and supposedly more effective psychiatric drugs have been introduced, the number of disabled mentally ill in North America has skyrocketed and even spread to children. Prozac, called “the wonder drug”, was approved in 1987. At that time the rate of disability for mental illness in America was 1 in 184. The number rose to 1 in 76 people only twenty years later.
Psychiatric drugs do work and in selected cases, help people lead normal lives but unfortunately, with the use of these drugs, the number of people disabled by mental illness has risen dramatically.
The Causes of Mental Disorders
In 1965, the chemical imbalance theory of mood disorders was published in the American Journal of Psychiatry. It stated that some, if not all depressions are associated with a deficiency of neurotransmitters (chemicals) in the brain. Later, it was decided that the most important deficiency was serotonin. Many researchers have done studies to determine serotonin levels and there has been NO convincing evidence that any psychiatric disorder, including depression results from a deficiency of serotonin. The theory of serotonin deficiency lived on fueled by pharmaceutical company advertisements about Prozac, a drug that was shown to increase serotonin levels in the brain. They had the drug and wanted to appear to have a magic bullet to treat depression.
The evidence does not support any of the biochemical theories of mental illness. We need to realize that the precise causes of mental disorders are NOT KNOWN!!
Drugs Create A Chemical Abnormality
Psychiatric drugs create disturbances in the chemicals (neurotransmitters) of the brain. As a result, the brain makes changes to try to normalize the level of neurotransmitters. After some time, the brain can no longer compensate. The chronic use of psychiatric drugs creates large and lasting changes in the way the brain functions. Psychiatric drugs do not correct a deficiency of chemicals in the brain. Psychiatric drugs CREATE a chemical abnormality in the brain.
Anti-anxiety drugs show a good effect for the first week of treatment. After that, their advantage over taking a placebo (sugar pill) drug disappears. Withdrawal symptoms after long term use often result in an increase of anxiety over the starting level as well as insomnia, seizures, tremors, depression, etc. The risk of side effects varies according to how long a person has been on the drug and the speed of getting off the anti-anxiety pills. Long term use of these medications also results in a four time increase in symptoms of depression, and can lead to panic attacks and agoraphobia. Anti-anxiety drugs act like a trap. They get rid of anxiety for a short time but they cause changes in the neurotransmitter system. The brain undergoes adaptations that lead to difficulty in stopping the medication. Doctors often prescribe these drugs long term when they are only helpful for the very short term.
Antidepressants modify the function of chemicals in the brain which causes antidepressants to eventually stop working and can also lead to chronic depression. Two thirds of patients treated with antidepressants can expect recurring bouts of depression. Fifty years ago, depression was described by the National Institute of Mental Health as “mostly self-limiting with most cases resulting in spontaneous remissions”, a rare disorder with good outcomes. Today, depression affects 1 in 10 people and has a gloomy long term outlook. A study of 740 depressed people found that the 484 who were not medicated, had the best outcomes. They had better general health and less chance of recurrent depression. Following the introduction of SSRIs (drugs like Prozac), the number of people disabled by depression increased dramatically. Independent studies have shown that over the short term, taking SSRIS help to decrease symptoms of depression but not better than placebos. If medication is stopped, there is a high risk of relapse. People who remain on the drugs are likely to suffer recurrent episodes and this increases the risk of being disabled.
In 1997, a speech by the doctor who wrote the bible of manic-depressive illness stated that “we have a lot more rapid cycling, more mixed states and lithium treatment failure”. Bipolar outcomes had become much worse in the 10 years since the introduction of Prozac. Antidepressants used for depression can cause depression to switch to mania. This can turn patients into rapid cyclers (switching from depressed to mania quickly) which is a very serious illness that did not exist before psychiatric drugs. Today, bipolar illness affects 1/40 adults. Twenty to 40% of patients treated for depression eventually become bipolar. Bipolar outcomes have dramatically worsened with drugs. In the past, bipolar patients spent a large part of their life in symptom free intervals; antidepressants have dramatically shortened those intervals and patients have become more chronically ill.
The Problem Continues Today
Today psychiatry continues to expand its definition of what a psychiatric illness is. This means that an increasing number of adults and children are included in what they consider the treatment group. For example, in 1998, Paxil was approved for social anxiety disorder (also known as shyness) which 13% of the population suffers with. Kids with behavioral issues are labeled as ADHD and bipolar. Those treated with medications are at increased risk of becoming chronically ill and many will end up with new and more severe symptoms and cognitively impaired.
Anxiety used to be a mild disorder. Today 8% of young adults on welfare have anxiety as the primary diagnosis. Outcomes for depression used to be good. Today, major depression is the leading cause of disability in the US for 15-44 year olds. Bipolar disorder use to be very rare and people who suffered with it did well. Now, only a third of those diagnosed as bipolar can go back to work, many with long term medication end up extremely disabled.
The important question that needs to be answered is how and when psychiatric medications should be used. Drugs may alleviate symptoms over the short term and some people may stabilize well over the long term. The best outcome would require psychiatry to acknowledge that the biological causes of mental disorders are unknown. They need to admit that drugs do not fix chemical imbalances but instead they disturb the normal functioning of chemicals in the brain. Psychiatry could then determine how to use medications wisely and everyone in society would understand the need for alternative therapies that do not rely only on medications.
In the past, many people recovered from psychiatric illness. But, if you immediately put all patients showing mental health symptoms onto medications, you run the risk of creating a chronic problem. A better approach might be to watch and wait using alternative treatments before prescribing psychiatric drugs to patients. When drugs are necessary, they should be used at very low doses for a short time. Psychiatrists need to listen to their patients about how the drugs are affecting them.
A drug-free example of a treatment is using talk therapy which can be as useful as antidepressants for patients. Another treatment, exercise, produces substantial improvement and 70% of depressed patients improve in 6 weeks. Good diet and nutrition is also very important to improving mental health. (All of these treatments and many more can be found through the Spark Institute)
List of Studies
If you have questions or concerns about the information presented here, please feel free to contact us. The Spark Institute provides a holistic approach to mental illness and we have many effective, safe treatments to help you recover without the use of psychiatric drugs.