Has anyone noticed that Robert Whitaker’s latest book has undergone a name change?
Old title: Anatomy of an Epidemic: Psychiatric Drugs, Magic Bullets, and the Astonishing Rise of Mental Illness in America
New title: Anatomy of an Epidemic: Psychiatric Drugs, Magic Bullets and the Astonishing Rise of
Does the name change reflect the observation that there is an astonishing rise of mental illness in other countries, as Robert Whitaker perhaps has learned over the course of his international speaking engagements?
So, if we still don’t know what is meant by “short term” use of antipsychotics, is there a doctor in the house or out in cyberspace who can shed some light on this? If I don’t get an answer, shall I assume that nobody is looking seriously at this issue?
The question is quite deliberate on my part. Since most of us don’t get a dress rehearsal for a schizophrenia diagnosis (60% of new “cases” apparently do not have family history), we will find ourselves on medications because we haven’t got a clue that there are other ways of dealing with trauma.
I have heard that the most recent research says (patients have been saying this for years) that medications, if used at all, should be short term. If this is so, then people ought to know what short term is so they, and their doctors, can agree on an end date while bolstering their recovery with alternative therapies. Many doctors will claim that the patient has to be “stable” in order to go off them, while many patients claim that they shouldn’t be on meds in the first place and don’t function well on them. Doctors (pharma) have been getting a free pass up until now because the specifics, if there are any, are cloaked in mystery. I am not referring to how to go about withdrawal (there’s lots of information here), I mean how short is short?
Thanks to Robert Whitaker’s book, Anatomy of an Epidemic, we now know that the “medication is to schizophrenia just like insulin is to diabetes” argument was an falsehood (or misconception, depending on how you look at it) that was not clarified by the pharmaceutical companies until the author put the question directly to a pharmaceutical company executive.
If we are starting to hear that drugs, if used at all, should be short term, what is meant by short term?
In his latest book, Anatomy of an Epidemic, Robert Whitaker looks at the Open Dialogue program in Western Lapland (Finland) and can’t quite put his finger on why these group meetings generally in the person’s home are so effective. (The number of new cases annually in this region show an astonishing 90% drop from the 1980s.)
Without knowing this program either, but having spent two years in another program in Europe which thought it was cutting edge, I will offer some thoughts. First of all, the initial Open Dialogue meeting takes place usually in the person’s home within twenty-four hours of reported psychotic behavior. If the psychotic person jumps up and leaves the room, he is encouraged to listen in to the conversation even if not physically present in the room. (The open door policy.) Medication is not usually discussed in the first few meetings and often is not recommended at all.
Whitaker claims that the Open Dialogue concept of psychosis doesn’t fit into either the biological or psychological category. It is familiar to me because it is very much like the Family Constellation Therapy that Bert Hellinger and others espouse. “Psychosis does not live in the head. It lives in the in-between of family members, and the in-between of people,” Salo explained. “It is in the relationship and the one who is psychotic makes the bad situation visible. He or she ‘wears the symptoms’ and has the burden to carry them.”
As a parent, would this concept of the origin of psychosis make me feel better or worse about the situation compared to the group meetings that I went to with the family in the psychiatrist’s offices? There, psychosis was considered something foreign to everybody, family and patient included. It was something that just “happened,” like becoming diabetic or discovering that your house was burgled. Medications were part of the deal, and were insisted on. I’ll put my money on better outcomes in Lapland.
The program we were involved with made me feel anxious. I am sure that the families are anxious in Lapland, too, but it seems like the situation is diffused rather quickly within the privacy of the home. We suffered through the horror of thinking that my son’s brain was inexplicably damaged, we were led to believe that the doctors held the key and that there was nothing that we could have done to prevent this or to get over this. (There’s no cure, right?) We were also encouraged to attend meetings with other parents who, naturally, were worried about their children – and it showed. It was a climate of fear. Then the side effects of the drugs quickly became apparent – leading to more fear and a sense of doom.
The “problem” had been escalated by dragging it under a bigger spotlight instead of containing it and working through it where it arose – in the home. A massive case of over-reaction to a problem of living.
In Robert Whitaker’s Anatomy of an Epidemic there is no mention of alternative mental health remedies. This, I suppose, is understandable given that the book is about how pharma and her willing handmaidens have contributed to the epidemic of mental illness. However, from a consumer point of view it would be instructive to know if the people whose stories are told in the book ever seriously tried some form of psychotherapy or took vitamin supplements to help them get off the drugs.
It is clear even if you haven’t read this book that psychiatry has been hijacked by drug prescription and that psychiatrists (American ones, anyway) are handsomely remunerated for prescribing not listening. Psychiatrists have convinced themselves that the drugs are needed to help them do their job better, but their patients aren’t at all convinced. If they were, why is drug compliance such a problem? Why are people so fed up with their psychiatrists not listening to them?
Drug based psychiatry seems to be one area where the customer is always wrong. If manufacturers noticed that people were failing to use their products in they way they were intended, would they blame the customer? Of course not! Many psychiatrists, however, have this patronizing view that their clients are mentally ill and incapable of making rational choices when it comes to how they feel about what they are swallowing.
There is another way and people shouldn’t lose hope.
Taking vitamins, undergoing certain psychotherapies, practicing yoga and changing your belief system is not a quick fix, but it does work over time. As a relative, I can vouch that this also works for me. We all can benefit from the experience. Vitamin support should be a first line of defence if you are trying to get off your meds. Some people may not need this, but many do. Not everybody is going to have a hard time withdrawing from the drugs, but they will be the exception, not the rule. The drugs change your biochemistry. Your biochemistry is not changed because you are depressed or schizophrenic. For every study that claims it is, there is a study that refutes this. So why buy into the former claim? It makes you worse off in the long term, as Anatomy of an Epidemic so rightly points out.
I must confess that reading Robert Whitaker’s book Anatomy of an Epidemic is getting me down. He has nailed the human carnage that usually begins with the psychiatrist saying to the patient, “you have an incurable disease and you are going to need meds for the rest of your life just like a diabetic needs insulin.” We have all heard this Orwellian phrase and it is absolutely untrue but that is what we have all been told. So begins the slippery slope that we have all been on. And when I say “we” I include people like me in this because I am collateral damage. I suffer too from being told my son is incurable and needs the drugs.
Someone on another blog, a psychiatrist no less, accused Robert Whitaker of sensationalizing the negativity, especially when it comes to the drugs. I don’t see it and the fact that a psychiatrist doesn’t see this is troubling, especially if he’s taken the time to read the book. Whitaker’s book is factual, he interviews psychiatrists, researchers and patients alike, and what they report is what I know to be true. People used to have mental illnesses and got over them or suffered from them episodically. Whitaker links the rise of the number of people collecting disability for mental illnesses to the long term use of drugs – they are being treated as if they have an immediate, life-threatening, chronic illness.
Teenagers, a group in which depression was almost unheard of a few decades ago, are particularly vulnerable. Antidepressants can kick start a lifetime merry-go-round of drug use. The number of young people in the book who went in for depression, were treated with an antidepressant, went manic and told they were bipolar is not surprising. I have learned enough on my own to know this happens. We are not anecdotal evidence. We are real and numerous.
Who ever heard of bipolar disorder a few years ago? I hadn’t until about fifteen years ago when a friend went fairly loopy. Now, bipolar disorder is the flavor du jour – seems like everybody has it and may include those who would prefer not to say they might be schizophrenic. You are never not bipolar these days, probably due to the drugs that you need to take like a diabetic must take insulin. I had heard of manic-depression, but only knew of one person over the course of my life who was diagnosed with it. Every so often she would flip out and have to be hospitalized and take her lithium. Otherwise she carried on as the life of the party – and died at a fairly ripe old age.
Nobody today is going to die at a ripe old age if they permit their doctor to turn their personal coping skills into a biological disease. Judging from the swollen ranks of those collecting long term disability they won’t even be working.