Big NIMH

One of the saddest lessons of history is this: If we’ve been bamboozled long enough, we tend to reject any evidence of the bamboozle. We’re no longer interested in finding out the truth. The bamboozle has captured us. It is simply too painful to acknowledge — even to ourselves — that we’ve been so credulous. – Carl Sagan

I swiped this quote from Beyond Meds because Robert Whitaker’s new book Anatomy of an Epidemic*, currently on my reading table, points to the “Big Bamboozle” in the pharmaceutical industry when it comes to the treatment of the mentally ill. As it was with Ida Tarbell and Standard Oil, Upton Sinclair and the meat packing industry, let’s hope that the Whitaker book will put an end to the encroachment of the big pharma/academia/American Medical Association alliance on your brain.

The meticulously documented book explains that it was the Medicare and Medicaid legislation enacted in 1965 that allowed the discharge of chronic schizophrenia patients from unsubsidized state mental hospitals into subsidized nursing homes, not the invention of Thorazine in 1955, as it is so often attributed. Patients treated with neuropleptics in a 1956 studied cited had a lower discharge rate for first psychotic episodes than those who had been treated with a neuroleptic. The general opinion of researchers back then was that patients treated with neuroleptics had lower discharge rates than patients for whom no neuroleptics were administered.

Unfortunately our societal belief that it was this medication that emptied the asylums, which is so central to the “psychopharmacology revolution” narrative, is belied by the hospital census data.

Numerous studies in the 1980s cited in the Whitaker book came to the conclusion that there was no evidence that the dopamine function of the brain is disturbed in schizophrenia. Still the public continued to be told that people diagnosed with schizophrenia had overactive dopamine systems, with the drugs likened to “insulin for diabetes,” and thus former NIMH director Steve Hyman, in his 2002 book, Molecular Neuropharmacology, was moved to once again remind readers of the truth. “There is no compelling evidence that a lesion in the dopamine system is a primary cause of schizophrenia,” he wrote.

The pharma bamboozle is particularly poignant because of the millions of lives wasted and lost. Parents have been told, by a medical profession that they trust, that their child has a brain disease, just like diabetes, and that in order to “protect the brain,” they must continue to take these medications, just like a diabetic must do with insulin. That guilt is overwhelming because it is personal and had we been less credulous, the outcome may have been different.

Having heard Dr. Thomas Insel, Director of the National Institute for Mental Health (NIMH), I have no great confidence that that organization, despite it being a supposed watchdog of public mental health, will suddenly “see the light”. He stated very clearly in that seminar that research has demonstrated again and again that current and past drugs are ineffective in treating mental disorders, but they were shining their flashlights looking for the key in the wrong areas! They just haven’t found the right drug targeted to the particular problem! There’s a term for that in business that eludes me. . . when you trash the old product in order to stimulate sales of the new one. Don’t worry, in the NIMH’s world, there are always exciting new drug possibilities. So, the Big Bamboozle will continue as long as the public is gullible. It will take a different pharmaceutical tactic, that’s all. The insulin for diabetics idea has been exposed, so we’re not buying that one, but what will it be? It’ll be clever, that’s for sure.

Here is where Dr. Insel’s flashlight is looking:
We must address mental illnesses, from autism to schizophrenia, as developmental brain disorders with genetic and environmental factors leading to altered circuits and altered behavior. Today’s state-of-the-art biology, neuroscience, imaging, and genomics are yielding new approaches to understanding mental illnesses, supplementing our psychological explanations. Understanding the causes and nature of malfunctioning brain circuits in mental disorders may make earlier diagnosis possible. Interventions could then be tailored to address the underlying causes directly and quickly, changing the trajectory of these illnesses, as we have done in ischemic heart disease and some forms of cancer. For serious mental illness, this is a new vision for prevention, based on understanding individual risk and developing innovative treatments to preempt disability.
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Anatomy of an Epidemic: Magic Bullets, Psychatric Drugs, and the Atonishing Rise of Mental Illness in America, author Robert Whitaker