ESSENTIAL READING: Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America

Treating a disturbed mind is orders of magnitude more subtle and complex than treating a diseased body. To begin with, there is the problem of deciding what is ‘sickness’ in a mind as opposed to the normal cognitive path of humanity in all its glory. We are, according to every philosophy, body of literature, and religion, meant to suffer in our mind along the path to maturity and greater insight. This suffering is the path to happiness, according to reports by people who have documented their path for others to follow.

Treating disease of the body is morally simple; the disease is bad and healing is good. A body taken down by injury or infection offers some emotional upside as the mind accepts the limits of human life on the way to death. Conclusion: mental suffering is different than physical suffering.

It wasn’t until recently that the medical establishment and the pharmacological industry brought its powers to bear on the human mind, and this is the subject of Robert Whitakers’ book Anatomy of an Epidemic. Whitaker was the science reporter for the Boston Globe, and over the years, he developed a reporting niche writing about mental health as a normal part of his duties. This work eventually led him to review the medical literature around drugs meant to treat mental disturbance, and in 2010, Anatomy of an Epidemic was published.

The book is a damning account of the consequences of drugging millions of Americans for what was defined as mental illness. At the very least, one may conclude that the drugs that target the mind have been ineffective in making people less mentally ill; diagnosis of mental illness is at an all-time high in the United States. Further, Whitaker documents how the Social Security Administration has made mental illness a career path. Millions of Americans are on permanent disability due to mental illness, and all of this has occurred AFTER the development of drugs meant to treat mental illness. Clearly, one is driving the other.

The essential ‘why’ of this epidemic is complex but can be attributed to two basic events.

First, there was the effort by the drug industry to give psychiatrists the same pharmacological tools that other doctors had, which was pills. Medical doctors had miracle pills, like antibiotics, which made them undisputed heroes in the press. It also made them and the pill manufactures very rich. Psychiatrists had only talk therapy of dubious merit, but that changed when drugs that targeted the mind were isolated and distributed beginning in the 1950s.

This development led to the second great event which was the ‘medicalizing’ of human behavior. Behavior noted and accepted for thousands of years was then defined as a medical condition. Behavior was attributed to a ‘broken’ or ‘chemically unbalanced’ brain for which there was now a pill. What started with ‘housewives’ who were given a pill to treat their depression spread to everyone else, and eventually to kids. Medical textbooks that had no definition for actively enthusiastic kids who didn’t want to sit and study until there was a drug to subdue them. At that point, a medical condition was defined (Attention Deficient Hyper-active Disorder) that justified the use of the drug. Normal kids, mostly boys, were drugged into submission to the delight of teachers and subsequently parents. The literature around these drugs indicates no long term benefit for the child.

The same story can be told about depression and the discontent of late adolescence when childhood is ending and adulthood begins. This period is marked by uncertainty and emotional volatility which forms a sort of signaling mechanism for the person to discover what they are interested in and good at. When it was defined as a medical condition driven by ‘chemical imbalance’ in the brain, the drugs began to flow and many normal young people, mostly women, were given drugs that, according to Whitaker, converted a temporary and useful phase of life into a long term diagnosis for which there was an income stream for all. The drug companies passed the drugs to the doctor who gave it to the patient and the Social Security Administration, insurance companies, and various health authorities paid for it.

The next step was to fill the medical diagnosis literature, called the The Diagnostic and Statistical Manual of Mental Disorders (or just ‘the DSM’), with descriptions of ‘disorders’ so doctors could use their coveted subscribing powers (something the talkers didn’t have) to ‘treat’ the now well defined ‘illness.’

The final step was to get the public to accept the idea which wasn’t hard when the media was filled with stories of miracle cures and regular old advertising:

The details are as alarming as they are upsetting. Have we really been taken in with ‘cures’ to our behavior that is a normal part of human growth and development? Have we drugged normal kids into submission to serve our abnormal educational system which values quiet and compliance over a child’s normal active and curious minds? Have we really developed a governmental agency dedicated to paying off the sad recipients of this kind of ‘help’? I think we have. Nearly everyone I know, myself included, has tried some mind drug to address our ‘chemical imbalance’ that was proscribed by a psychiatrist after one visit. Xanex, Prozac, and many other drugs are part of the normal lexicon of Americans because we’ve used these drugs. We think ADHD and other childhood ‘diseases’ are real, but they were only added to the medical definition of disorders AFTER the drugs were developed.

My own experience with Prozac is instructive. In my late twenties, I was still struggling to define where I wanted to go in life. It was upsetting. The thing I had been told would make me successful, college, had failed to really prepare me for the complexities of life, and I just didn’t know what to do. I went to a psychiatrist and he gave me, after 45 minutes of talk, a prescription for Prozac. I got the drug and in spite of being told that it would take 30 days to work, I felt the effects immediately. Suddenly I wasn’t as upset, but I wasn’t really emotionally anything else either. One day, I realized that I was unaware of how long I had been sitting on my bed starring ahead with no feelings, plans, emotions, or direction. Maybe 20 minutes or so had passed with no reaction from me. I decided then and there that whatever life had to offer, even if it was more pain, I would address it sober, because a bad ‘something’ was better than nothing.

BTW, that was a long time ago and I feel great most days. When I don’t, I need to listen to my emotions, which I do.

But it was a long time ago and since then, the explosion of mind altering drugs has continued apace. Here is but a tiny of sample of what is waiting for you, your friends, or your kids:

Celebrity endorsed
Who wouldn’t want this?
Buying things you don’t need is a disorder?
Again.. who is this drug for? Looks like its for Mom
This could be you! Just a pill away.
Shy, or sick?

Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America is a critical component of my library of books that help me understand the world and therefore, I view it as essential reading.