Review: Book by Robert Whitaker; New York, Crown Publishers, 2010, 416 pp.
Robert Whitaker, a former Boston Globe reporter, was curious about why there has been such a large increase of disabling mental illness in the United States. His book, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America (Crown Publishers, 2010), begins with these data points: in 1987, the U.S. mental illness disability rate was 1 in every 184 Americans, but by 2007 the mental illness disability rate had more than doubled to 1 in every 76 Americans.
During this same time period, there has also been a huge increase in psychiatric drug use. Prior to 1988 when Prozac hit the market, the annual U.S. gross for antidepressant and antipsychotic drugs was less than $1 billion, but today those two classes of psychiatric drugs alone gross more than $25 billion a year in the United States. The question for Whitaker was: is it just a coincidence that disabling mental illness and psychiatric drug use have been rapidly increasing at the same time?
Whitaker does not discount cultural factors that may have something to do with this dramatic increase in mental illness disability. However, he discovered that the most scientifically identifiable factor for the increase of severe psychiatric problems is the increase in psychiatric drug use. He identified a frightening trend: long-term psychiatric drug use has caused children and adults with minor emotional problems to have severe and chronic disorders that result in mental illness disabilities.
How Psychiatric Drugs Create Chronic Illness
Whitaker examined the scientific literature over the last 50 years with respect to 2 related questions. First, do psychiatric medications alter the long-term course of mental disorders for better or for worse? Specifically, do they increase the likelihood that a person will be able to function well over the long-term or do they increase the likelihood that a person will end up on disability? Second, how often do patients with a mild disorder have a bad reaction to an initial psychiatric drug that can lead to long-term disability? For example, how frequently does a person with a mild bout of depression become manic in reaction to an antidepressant and is then diagnosed with bipolar disorder?
He discovered that while psychiatric medications can, for some people, be effective over the short term, these drugs, in long-term use, increase the likelihood that a person will become chronically ill, increasing the possibility that a mild psychological problem will worsen into a debilitating illness. This is especially clear and tragic in the case of children.
Not too long ago, "juvenile bipolar disorder" was very rarely diagnosed, yet today it is increasingly common. Whitaker points out, "When you research the rise of juvenile bipolar illness in this country, you see that it appears in lockstep with the prescribing of stimulants for ADHD and antidepressants for depression.... Once psychiatrists started putting 'hyperactive' children on Ritalin, they started to see prepubertal children with manic symptoms." Increasing numbers of children have also been prescribed antidepressants, such as Prozac, and a significant percentage of these young people have become manic in reaction to their antidepressants.
These frightening manic reactions result in heavy-duty antipsychotic drugs as well as "drug cocktails" made up of multiple psychiatric drugs. Whitaker discovered that a high percentage of these medicated kids end up as "rapid cyclers," which means they have severe bipolar symptoms that put them on a path to be chronically ill throughout their lives. Also, antipsychotics such as Zyprexa cause a host of physical problems, including diabetes. Whitaker concludes, "When you add up all this information, you end up documenting a story of how the lives of hundreds of thousands of children in the United States have been destroyed in this way."
