Something’s Rotten in Psychiatry

Julian Whitaker, MD

Every day in the United States, one in 10 people over age six takes an antidepressant. A similar percentage of 10-year-old boys pop Ritalin or another amphetamine-like stimulant. Nearly 250,000 people get a prescription for anxiety-easing, mind-numbing Xanax, Valium, or Ativan, for a total of 85 million prescriptions per year. Half a million children, some of them as young as age two, and untold numbers of adults take antipsychotic drugs, extremely powerful medications that are linked with increased risk of diabetes and significant weight gain.

One in 76 Americans is considered “mentally ill” enough to receive government disability checks. And a large survey found that 46 percent of respondents met the American Psychiatric Association diagnostic criteria for having or having had at least one mental disease, and most of them “qualified” for more than one.

Something is seriously wrong. Do you really believe that almost half of us are mentally ill? Sure, we worry and get anxious, grieve and feel sad. Our attention wanders and we sometimes misbehave. But is it illness? Of course not.

What it is, as detailed in three harshly critical books by Daniel Carlat, MD, Irving Kirsch, PhD, and Robert Whitaker, is an epidemic of pseudo-disease created by psychiatrists and abetted by the pharmaceutical industry. And it’s inflicting horrific damage on us and our children.

The Achilles Heel of Psychiatry

First, all these authors agree that there’s a huge problem in the manner and frequency in which mental illnesses are diagnosed, and it’s about as scientific as soothsaying.

Let’s say you have chest pain and you go to the emergency room. You’ll undergo a battery of tests to look for the origin of your pain, which could be a heart attack, severe indigestion, a muscle strain, or a lung infection. Chest pain is a symptom—a subjective indication of a problem—not a disorder or disease in and of itself.

Well, in psychiatry there are no lab tests or scans to determine the cause of symptoms. In fact, there is not a shred of evidence demonstrating any kind of underlying pathology in so-called mental illnesses. All they have to go on are symptoms, which panels of psychiatrists (“key opinion leaders”) have grouped together, voted on, and labeled as “mental disorders.”

The fourth and current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the bible of psychiatry, describes 365 diagnoses—up from 265 in the 1980 edition—and includes such absurdities as Mathematics Disorder and Caffeine-Induced Sleep Disorder. (So if you’re not good in math or too much coffee is keeping you awake, you’re mentally ill?) The fifth version, DMS-V, due out in 2013, will have considerably more, equally absurd “illnesses,” all of which can be managed with medications. And that, my friends, is the crux of the problem.

Big Pharma is Pulling the Strings

The unprecedented increase in psychiatric diagnoses has coincided with the introduction of a steady stream of psychoactive drugs. The first one out of the chute in 1987 was Prozac, an antidepressant that ushered in the unfounded theory that depression and other mental disorders were caused by chemical imbalances in the brain and could be ameliorated by drugs.

An ever-increasing number of mind-altering meds have since gained approval, and it’s been an enormous windfall for the pharmaceutical industry and its lackey psychiatrists, who’ve pushed through one bogus diagnosis after another. In the decade after Prozac’s debut, for example, diagnosis and treatment of depression increased by 300 percent. The frequency of juvenile bipolar disorder skyrocketed 40-fold from 1993 to 2004. And in terms of expenditures, antipsychotic drugs are now the top-selling class of medications in the United States!

When you think of psychiatry, you may envision a patient stretched out on a couch telling his troubles to the doctor. But this medical specialty is no longer about therapy; it’s about prescribing drugs. Even psychiatrists admit that this is not because psychotherapy is ineffective, but because 10-minute visits to come up with a diagnosis and write a prescription are far more profitable than one-hour talk therapy sessions.

More Harm Than Good

Rather than helping patients, all these diagnoses and drugs are only making them worse.  Psychoactive medications by design change normal brain function. They upset the balance of neurotransmitters, modify neural activity, and, with long-term use, actually alter the anatomy of the brain. This can cause a multitude of adverse effects—including additional “mental illnesses” and more drugs!

Once you get started on these meds, they’re hard to stop. Some of them are outright addictive, while others upset neurotransmitter balance so dramatically that when they are discontinued, even more side effects rear up and patients feel much worse than ever before.

I’m particularly concerned about our children. Kids in this country take far more psychoactive drugs than anywhere else in the world. What kind of a system labels two-year-olds with ADHD? What two-year-old doesn’t have a short attention span, excess energy, and some behavior problems? It’s a normal phase of childhood.

First, Do No Harm

This is obviously a very important and complex topic, and I am unable to do it justice in this short article. Therefore, I encourage you to read the three excellent books listed on this page. At the very least, take a look at Marcia Angell’s comprehensive two-part series of articles in the New York Review of Books, which inspired this story and turned me on to these notable books.

Dr. Angell is former editor-in-chief of the New England Journal of Medicine, one of the most prestigious and conservative medical journals in the world. She concluded her review with this admonition, which is directed at both physicians and patients:

“…We need to stop thinking of psychoactive drugs as the best, and often the only, treatment for mental illness or emotional distress. Both psychotherapy and exercise have been shown to be as effective as drugs for depression, and their effects are longer-lasting, but unfortunately, there is no industry to push these alternatives and Americans have come to believe that pills must be more potent. More research is needed to study alternatives to psychoactive drugs, and the results should be included in medical education.

“… In view of the risks and questionable long-term effectiveness of drugs, we need to do better. Above all, we should remember the time-honored medical dictum: first, do no harm (primum non nocere).”

Recommendations

• To learn more read, “The Epidemic of Mental Illness: Why?” and “The Illusion of Psychiatry” by Marcia Angell, MD, in the New York Review of Books, June 23 and July 14, 2011. (Visit nybooks.com to read these articles.)

References

• Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America by Robert Whitaker. Crown, New York, NY, 2010.
• Unhinged: The Trouble with Psychiatry—A Doctor’s Revelations About a Profession in Crisis by Daniel Carlat, MD. Free Press, New York, NY, 2010.
• The Emperor’s New Drugs: Exploding the Antidepressant Myth by Irving Kirsch. Basic Books, New York, NY, 2010.

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