April 11, 2011

Mark Foster, DO
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Dear Bob–

I want to share an email I received from a physician friend, who practices in a hospital-based specialty. He is highly intelligent, naturally skeptical, and thus interested in seeing for himself if there was any merit to your findings in Anatomy of an Epidemic. This email conveys his impressions of your book. He asked to remain anonymous, because after seeing what happened to me, he wants to avoid any potential repercussions for these new views.

Here it is:

Well, I have just spent another evening delving into psychiatric studies. This Whitaker fellow really does cast a spell. Time after time his analysis proves to be spot-on, while the physicians defending the drugs are misinterpreting evidence. I keep expecting to find the opposite, that he has made mistakes in his analysis, or missed influential studies, but the more I delve into it, the more I agree with him.

I read his Answering the Critics blog where he discusses a psychiatrists grand rounds and the problems with it. One thing I was struck by when reading the NEJM article that the psychiatrist cites, http://www.nejm.org/doi/full/10.1056/NEJMsa043266, is that indeed the percentage of people treated for psych disorders goes up over 10 years, but more troubling to me was:

“However, the fact that in roughly half the respondents who received treatment, the mental disorder did not meet the criteria of the DSM for any disorder assessed in the NCS and NCS-R has led to controversy with regard to the relationship between severity and the need for treatment.25,26”

Whitaker does not really address this issue in his book, since the book is about the drugs, but I think we both see the dramatic increase in diagnosis of a mental disorder for almost any old symptom. Didn’t sleep last night? You have insomnia. Felt bad last week? You have depression. The DSM is not a great handbook, but MOST of the people taking these drugs don’t even meet its criteria!

Part of what got me out of primary care and into the hospital is that I think the over-diagnosis syndrome of psychiatry also exists in other areas of medicine. People rely on the medical model to form a world-view and give their life meaning. So they come to the doctor who reinforces that world-view because, hey, that’s what we do. So all kinds of things get diagnosed and treated that are really baloney. In the hospital we have some falsety and malingering, but the standards for real pathology are so much higher. Due to payors now reviewing everything, we have to prove that people are actually sick. And I like that.

On a related note, I just returned from Dr. Peter Breggin’s Empathic Therapy conference in Syracuse, New York. It was a great conference, and wonderful to be surrounded by hundreds of people–psychiatrists, neurologists, family doctors, psychologists, social workers, recovered consumers, family advocates–from all over the country who see the falseness and harm of the biopsychiatric model. For once, I felt like I wasn’t stranded on an island by myself.

I remain optimistic that slowly but surely we can change the ingrained paradigm with convincing evidence, reasoned debate, and with proposing an alternative, much more humane and compassionate view of mental stress and the human condition, both for providers and consumers.

Mark