Are the very drugs we are taking to combat mental illness actually making us sick?
This is one of the questions raised in Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America by Robert Whitaker.
And, after reading the book, I think, maybe, they are.
Several weeks ago a friend shared Cheeseslave’s article “School Shootings Linked to Pharmaceutical Drugs” and its very inflammatory—and I do so love inflammatory—picture of a revolver, bullets, and prescription drugs, and the caption “guns don’t kill students, antidepressants do.” The article looked at 55 cases of school violence over the past 25 years and found that in all of them the aggressor was on some sort of psychotropic drug. Pretty scary stuff, huh?
So I poked around a bit more and discovered that up to eight million children take at least one psychotropic drug and learned that six percent of children on Prozac become psychotic, which can lead to violence. More scary stuff.
And it struck me as inherently and viscerally wrong. What is going on that eight million children need some sort of drug to get through life?
When I shared these alarming bits of information, and my concern, with my friends, what might have turned into a helpful discussion about other ideas for treating mental illness before reaching for the pill bottle, instead turned into a barrage of exclamation points and capital letters by a few people who claimed that the mentally ill NEED drugs, that not taking drugs can lead to DEATH, that articles like this one are IRRESPONSIBLE (I think the implication was that we—me and the friend who posted it in the first place—were equally irresponsible… sigh…), and that if your child needed insulin for diabetes you wouldn’t think twice before giving it to him, so why would you even hesitate before giving him medication for mental illness?
Well, I know almost nothing about childhood diabetes, except to say that if any doctor, for any reason, prescribed any medication to my child, I can assure you that I would think at least twice.
And as for mental illness, I didn’t know much about that either… except that it is epidemic in our country. I have friends who are on “happy pills” and I know quite a few children who are on drug cocktails to control everything from ADHD to bipolar disorder. When he was in kindergarten, the Boy asked me if he could take pills to help him sit still and pay attention in school like his friend did.
I decided to follow Cheeseslave’s advice and read Anatomy of an Epidemic for myself.
And, knowing what I know now, I can safely say that I would think nine, or ten, or maybe even twenty times before putting either of my beloved children on any sort of psychotropic drug. I can also safely say that I would exhaust every single possible non-pharmacological option before even considering psychotropic drugs for either myself or my children.
Anatomy of an Epidemic is well-written and does not require a medical degree or multiple trips to Google to understand it… and it presents some very disturbing facts. I am going to second the recommendation that you read the book for yourself, because it’s just not possible for me properly explain the scope of what’s going on in this post.
I hadn’t even made it all the way through the book’s Forward when I read the oft-quoted phrase “insulin for diabetes.” Whitaker said that,
I believed that psychiatric researchers were discovering the biological causes of mental illness and that this knowledge had led to the development of a new generation of psychiatric drugs that helped “balance” the brain chemistry. These medications were like “insulin for diabetes.” I believed that to be true because that was what I had been told by psychiatrists…
Unfortunately, the TRUTH is that no one knows what the biological cause of mental illness is, that the drugs being prescribed don’t balance anything, and that these drugs are not like insulin for diabetes.
We have been told that the mentally ill are suffering from“chemical imbalances” and that the drugs they take “fix” them. The disturbing thing is that psychiatrists don’t actually know this–they only wish they knew this. In 1984, Nancy Andreasen published a book entitled, The Broken Brain wherein she stated that the major psychiatric illnesses are diseases—medical diseases—just like cancer, heart disease, and diabetes. This is the message people heard. She also said that researchers hadn’t actually found that people diagnosed with mental illnesses had broken brains, but she was sure that the proof would come.
Only it hasn’t.
To this day, Whitaker notes,
The biological underpinnings of schizophrenia, depression, and bipolar disorder remain unknown.
The brain is almost infinitely complex—there are 100 billion neurons and 150 trillion synapses among the various pathways. However, the theory of chemical imbalance boils it down to a simple, easy-to-grasp explanation. In depressed patients, it is explained, too little serotonin is produced; in schizophrenic patients, either too much dopamine is produced, or there is an unusually high density of dopamine receptors. However, years and years of scientific study simply cannot make these theories turn out to be true. These people may be suffering from mental illness—but as far as scientists can tell, their brains are working just fine.
Nevertheless, whenever researchers identify how a new drug works—either by lowering or raising the levels of a brain neurotransmitter—we are told that the people taking those drugs suffer from the opposite problem. These drugs take a brain that has nothing wrong with it and change—sometimes permanently—the way it works. These drugs
“do not normalize brain chemistry, but disturb it… to a degree that could be considered ‘pathological.’”
This is not what insulin does for diabetes.
When drugs like insulin and antibiotics were developed, researchers first identified the cause of the disease, then they developed a treatment to counteract it. The first psychiatric drugs, on the other hand, were discovered by accident—while trying to come up with a drug to do something else, researchers found that these drugs had side effects that calmed mental patients. Now, without ever discovering what, specifically, was wrong with the patients, we have a whole host of drugs that treat the symptoms—they are antipsychotics, anti-anxiety medications, antidepressants. They do nothing to treat the disease itself. In fact, they actually impede normal brain function.
This might be one thing if they actually made people better… but as Whitaker explains in Anatomy of an Epidemic, they don’t.
He illustrates study after study and shows proof upon proof that demonstrate that the introduction of medications into the treatment of the mentally ill—whether they are depressed, schizophrenic, bipolar, or suffering from ADHD—actually make the patient worse, and dramatically increase the likelihood that they will never get better.
Before the advent of psychiatric medications, a person who was suffering from depression could expect to work through it, be discharged from treatment, and enjoy the reasonable likelihood that they would never suffer a relapse.
Even schizophrenia patients who did not take antipsychotic medications could expect a 40 percent chance that they would recover completely. Now schizophrenia patients who are discharged with medications—even if they take them reliably—find themselves returning to psychiatric emergency rooms in such numbers for the hospitals workers to have dubbed it “the revolving door syndrome.” On antipsychotic medications they have a five precent chance of making a full recovery.
Today a patient suffering from depression can expect to be given medication, which may initially deliver some relief, but which might also trigger a manic episode and lead to a diagnosis of bipolar disorder, even though the patient had never had a manic episode before taking medication. The patient will be prescribed new drugs and end up taking a cocktail of medications to stabilize and restabilize their moods. And they can expect to have to be on some sort of medication for life.
This can happen to adults and, even more disturbingly, it happens to children. In fact, it seems that psychotropic drugs can even create an entire category of disease where there never had been one before. Once it was thought that it was impossible to give a diagnoses of bipolar disorder to children, yet we not have some 400,000 children with that diagnosis—and most of the newly diagnosed bipolar children have been on Ritalin or some other medication prior to their diagnosis of bipolar disorder. Outcome studies have found that the long-term prognosis of these children is grim. They are
typically put on drug cocktails that include an atypical antipsychotic and a mood stabilizer. This means they now have multiple neurotransmitter pathways in their brains that are getting mucked up, and naturally, this treatment does not lead them back to emotional and physical health.
These drugs may cause metabolic dysfunction, hormonal abnormalities, diabetes, obesity, emotional blunting and tardive dyskinesia (involuntary, repetitive body movements); eventually they will cause cognitive decline. A child who stays on drug cocktails throughout his life can expect to die early.
The long-term outcome for anyone who stays on psychotropic drugs is poor. Some of these drugs are literally addicting. Many other people become so dependent on the drugs because of the idea that the drugs are helping them, or by the way the drugs have altered their brains, that it becomes very difficult to stop using them. All of the drugs have side effects—some of which are horrific—ranging from insomnia and dizziness to seizures and akathisia (severe inner agitation—which is associated with violence and suicide); other side effects include apathy, loss of motivation, memory loss, and excessive menstrual bleeding (often leading to an hysterectomy), cardiovascular problems, diabetes, and impaired high-order cognitive thinking. Most of the drugs available to us today had to go through multiple, carefully manipulated, biased trials to make it appear to the FDA that the drugs were safe and effective. Many have not been fully tested for long-term effect.
So why are our doctors still prescribing these drugs?
I would like to think it’s because they don’t know any better.
Our doctors don’t know what they think they know about mental illness either because they were taught, not by professionals with a deep interest in the well-being of their patients, but by a psychiatric industry who was losing patients to psychologists and therapists and who turned to the pharmaceutical industry for help. The drug industry “endows” continuing education programs for doctors (complete with fabulous free food and alcohol) which sing the praises of the drugs. They give money to the American Psychiatric Association (APA) and they recruit doctors to become paid spokespersons to the media and to write the APA’s textbooks. In fact, one of the APA’s bestselling textbooks was co-authored by Charles Nemeroff, who has earned at least $2.8 million as a speaker and consultant for drug firms. Under these circumstances, I would not consider his to be an unbiased opinion regarding the benefit of psychiatric drugs.
Drug company representatives visit individual doctors–bearing gifts and information detailing what other doctors in the area are prescribing, often with recommendations coming, not from true colleges, but from doctors on the payroll of the drug companies. Anyone who go against the “script” (pun intended) is blacklisted. They don’t teach at medical schools and they assuredly don’t teach continuing education programs. They may even lose patients once word gets out that they have subscribed to the completely crazy theory that the drugs aren’t actually helping people.
The drug industry also courted patient advocacy groups and educational organizations, eagerly funding their programs. The National Alliance for the Mentally Ill (NAMI) which began as a parents’ group eager to embrace the idea that mental illness was a biological illness accepted $11.72 million dollars from 1996 to 1999, which funded educational programs. Now NAMI considers medications to be the “first-line treatment for most individuals.” And the idea that medications for mental illness are like “insulin for diabetes” is still going strong.
On the cover of the book, a blurb from Time states: “Chart[s] controversial ground with mystery-novel pacing.” And, just like any good mystery novel, it leads us to the “bad guy” and provides us with a surprising twist—in this case, that the “bad guy” has an unwitting accomplice… and we are the unwitting accomplice.
Really scary stuff.
I had no idea. I believed the chemical imbalance theory too. I thought that drugs, while not ideal and probably overused, was not really harmful.
It seems I was wrong.
But what can be done?
At the end of the book, Whitaker points to programs that have successfully pulled kids off their medications and taught them how to cope with their symptoms. He examines a Finnish program that uses therapy to work through schizophrenia. He suggests exercise.
Personally, I am curious about the role that the kind and quality of food we eat plays.
But the fact is something has to be done because approximately twenty percent of Americans suffer from mental disorders and are turning to pharmacological solutions as their first and only attempt at solving the problem. We have reached a point where every day 850 adults and 250 children are disabled by mental illness–meaning their families or caregivers are newly eligible to receive a disability check from the federal government. In 2007 this country spent $25 billion on antidepressant and antipsychotic medications and, as far as I can tell, the only people being served by that are the drug companies.
Something else has to be done.
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