Factors Influencing the Increased Prevalence of Mental Illness

Fernando Espi Forcen, M.D.
35
600

After reading Robert Whitaker’s “Anatomy of an Epidemic” and doing some reflection on his arguments I thought I could provide some ideas on factors that might have played a role on this “increased prevalence of mental illness.” I am writing this letter with the intention of enriching the open debate on this issue and provide a different perspective.

  • Decreased stigma: In general, it is believed that due to stigma of mental illness, still, as opposed to other medical specialties,  mentally distressed people do not seek help regarding their issues. Over the last few decades, much emphasis has been made to prevent this to happen. Probably after the expansion of psychoanalysis, psychiatry started to reach a wider population, the so-called “well-worried.”

 

  • Romanticization of mental illness: After Vincent Van Gogh, who is believed to have suffered from bipolar disorder, a link between “being mad and being a genius” was established. Today, artists create a “persona” that help them market their products. Experts in bipolar disorder believe that creativity is a sign of bipolarity and recently some researchers have proposed that many of the most influential writers, artists and politicians including Beethoven, Churchill, Hemingway and even Freud had bipolar disorder.

 

  • Pathologizing the normal: In general, psychiatrists err on the side that a patient coming to our office already have some kind of psychiatric disorder and our role is to figure out which one. Many of our patients come with transitory normal life emotional crises and may end up diagnosed with depressive disorders or other mental disorders. Encouraging health and providing support is an underutilized therapeutic weapon.

 

  • Assuming chronicity: Classically, mental illness has been thought to be chronic and irreversible. This belief is still rooted in most of the clinicians, even in the younger ones. However, there is more evidence, that some psychiatric disturbances are acute and reversible and even severe mental illness like schizophrenia may improve over the years.

 

  • The comorbidity crisis: For every symptom there is a psychiatric disorder and a psychiatric drug. Often, one patient receives polypharmacological treatment for the several different psychiatric disorders. In general we all would benefit from re-reading the classical authors in the field that spent so much time describing the psychopathology of the psychiatric illnesses. A new symptom does not mean a new psychiatric disorder and a new drug is not always the answer.

 

  • Widening the criteria for psychiatric disorders: Since selecting patients with the current DSM-IV criteria is not helping much to advance in the understanding of the pathophisiology of mental illness, for research purposes, some scientists propose a different way of recruiting people for their studies. More recently, it has been proposed that patients can be selected from a spectrum of psychiatric traits rather than choosing only those who meet full criteria. This will probably help understand better the etiology of psychiatric diseases. In the other hand, for patient care, widening the criteria would result in an obvious increase of prevalence of psychiatric disorders. This already happened with depression but is happening now with bipolar and autistic spectrum disorder. This could result in the pathologization of what used to be normal.

 

  • The pharmaceutical companies: They have certainly spent a good deal of money in the marketing of their products rather than in the research of new medicines. I am under the impression that part of their marketing is focused on pushing psychiatrists to diagnose patients with severe mental illness. A patient diagnosed with bipolar disorder in general receive more medicines than a patient diagnosed with depression. This is good for their revenue. Usually they come with studies indicating that bipolar disorder is today underdiagnosed and that if we miss the diagnosis our patients may commit suicide. Pharmaceutical representatives encourage physicians to prescribe antipsychotics in order to prevent that.

 

  • The drug-centered paradigm of care: In order to prescribe any medicine of any kind, a diagnosis is required. Despite targeting a wide population, in the psychoanalytic era, psychiatrists used to treat neurotic symptoms rather than mental illness. Less often psychiatric diagnoses were made as compared with the more recent psychopharmacological model.

 

  • The reimbursement of the medical visits: Insurance companies required also a psychiatric diagnosis for reimbursement. Despite being some years in these system I still not understand it well, but I am under the subjective impression that some milder forms of psychiatric disorders, such as dysthymic disorder or adjustment disorder give more problems for reimbursement purposes. This might influence in an increased number of severe mental illness diagnoses. To prevent this, the psychiatrist should be reimbursed by the time he or she spends with the patient rather than the complexity of the patient’s disease. A capitated system of reimbursement might help prevent this as well.

 

  • The media: The impact of the media in the incidence of psychiatric disorders have been widely studied. Several Hollywood actors and other musicians with substance dependence claim to have bipolar disorder. Today, in T.V., ADHD and bipolar disorder and common topics. As a result, may psychologically distressed individuals may identify with the symptoms and come to the psychiatric office reporting a history of the symptoms they have seen on TV, the paper or hear through friends. The cultural component in our field, cannot be forgotten. In the past, many patients were diagnosed with other conditions such as multiple personality disorder that were treated with psychoanalysis.

 

  •  Social help: As compared to other European countries. In the U.S.A. the easier way for poor people to get help is through disability. Mental rather than physical illness is an easier way to get financial support.

 

In general most psychiatrists I have met would rather have more time to spend with their patients and do the psychotherapy part rather than refer our patients to other mental health providers. In general, the system is always looking for a way to save more money, even if this means to decrease the quality of care. I am under the impression that more people, especially the younger clinicians are not happy with the drug-centered paradigm of care and the “15 minute med-check” medical visits. I am under the subjective impression that over the last 2-3 years, the pendulum is shifting to a more well balanced biopsychosocial model of patient care, wishful thinking? Hope not!

Fernando Espi Forcen, M.D., is a child psychiatry fellow at the University of Chicago.

35 COMMENTS

    • psychiatry conception of defining people in troubled time has spread all over across the human thinking in such dilema that its very important we raise the following issues sincerely, and claiming that everyone in the world needs to be accurately informed of facts not assumptive if so one must sell or prescribe psychatry medications packaged in like cigaret cases saying logo, “it will kill you ” but free available in health service” it never happens why? whats wrong i did that to cigaret companies starting from palmall in late eighties onward am in it until i see no smoking anywhere: but choices to choose anything is open to individual after having introduce all informations truthfully, without gimmicks
      I’ve got direct experience working in hospitals renowned throughout Europe. I’ve worked in various wards over the last 25 years where people have been categorised in many ways starting from various disorders, personality imbalance and numerous psychosis definitions. Apart from that, as and when those admitted were no longer known as people but as patients, I did not treat them or recognise them as patients, but treated them fully as people, it was easier for me to meet them and speak to them, and was able to get them to open up and try new experiences, and spoke to them openly about what the hospital and doctors would regard as issues. The first thing was that people felt value as people and respected that they weren’t being treated differently. I did not define any one as ill, unless they were treated by medication and with such gained symptoms from other illnesses such as diabetes and various other ‘side-effects’. My experience where I had a conversation between the patient and a consultant who denied the fact that the medication is what was causing the illness, and was blaming the ‘psychological issues’ This takes place all over the world and the pharmaceutical companies sell their products with giimmicks such as, ‘this product will take the edge off, will help you relax, will help you be you more’, ‘no longer be down, ‘ on the other hand i used to attend lots of national international conferences numerous workshops and academic classroom studies and their workshops for psychiatric medical students and research , doctors journal clubs , every where on raising this above awareness and questions it was unanimously discussed as ‘everything that is being conceived in psychiatry are suumptive including alzheimer and any issues based on what has MRI said is very unstable and unscientific , however the department of neurology has been coming up with new statements of these issues to try a futile effort to open new floodgate or citadel of new era for more opportunity for pharmaceuticals to take out new medications, pharmaceuticALS have gone too far too mesmerise general people and hospital professionals by saying changing compounds created new generation medications which have less ‘side effects’ now that expression is untrue and unscientific illegal as far as change of compounds does not create new medications at all, Plus why side effects, its the effects whatever way one puts it or gimmicks it, medications have only debilitating and dangerous harmful impacts on everyone having medications to damage ones health emotions psychology and day to day life normal thinking ability , much of the physical biological impacts are irreversible (sad enough) as long as the psychiatric medications continue on any person’s health its continuing to damage a persons health and emotions, that itself a “fairground “exhibition for psychiatrists and experts pharmaceuticals to base on that to launch new more medications on person and continue to transfer person from place to place to the either full amazement surprise confusion or taken for grated way, however even the ‘LEGAL SYSTEM’ are playing a much more unethical unaccademical virulent and most unsympathetic role by completely supporting the hospitals and psychiatry for their such deadly cruel proforma including forcing many or all treatments inclusive shock treatments to induce a huge large massive spark of epileptic fit in a person’s brain(just to create a regular complete mess in the system just like antibiotic kills all enzymes) and hoping that a person regardless of loss of memory would be civil and “normal” ‘calmer’ and what not , over my 25 years of challenges and experiencing on direct evidences of my arguments there have been progressively much more careless care system exist, only on the basis that since medications administered on assumptive and symptomatic issues a person get listed and warranted for furtherence of so called devastating treatments and harmful(unsafe at any dose all medications in psychiatry:Dr BOB JOHNSON, madness in medications DR Peter Breggin, blocking of dopamine never possible(use of antipsychotics or antidepressants for increase of seratonin (not possible):Dr Robert Whitaker.

      The symptoms that are shown by people, which consultants claim are showing signs of an illness or health problem, are only apparent after the person starts taking the medication. Whereas normal behavior is defined as quietness, stillness, inactivity i.e. not energetic.

      The only positive fact is that we have discovered a person can have issues that are unresolved from growing up of any nature, any kind with varying degrees of significance. Those things if remain unresolved, the person will carry on with those issues that will come out in emotions of fear, trauma, anxiety and anguish, and can cause other behaviors to surface. societies view of this above truth is of psychiatry conception , pharmaceutical- assurance of selling meds (huge media publications ) , then any confrontation as human being to these conceptions about the person concerned becomes “an issue of problem” its such an irony that how a person with above dilema trauma soon looses all independence freedom of thoughts and conceptions nor mal thinking ability under such huge umbrella of psychiatry conception of “problems”

      Only way out is to talk to people with dignity respect and seeing a person as any other person and just talk not intending to be therapist nor counsellor, a role of counsellor becomes a source of suggestions and advises eventually whereby one losses independence again and possibly a new stigma;’getting help’ from counsellor, must have to have problems etc etc
      no one is ill in any form or proportions until one is subjected to psychatric medications, law needs to be seen to help a person being victimised this way than just follow the trends and do service to code of conduct not reading between the lines: first do no harm!!!!!!!
      0044 7715911201 0044 7956577095 [email protected] [email protected] [email protected] facebook [email protected]

  1. Fernando,

    Nowhere did you list prescibers.
    So, your long list ended up short.

    You are in child psychiatry?
    I would encourage any parent to grab his/her kid by the hand, and RUN from any child psychiatrist who prescribes drugs!

    I hope you don’t prescribe mind-altering, brain-damaging, body-injurying, spirit-numbing drugs to children.

    If so, consider adding yourself (and other similar child psychiatrists) to the reasons why we are seeing an epidemic take place in front of our eyes.

    Duane Sherry, M.S.

    discoverandrecover.wordpress.com

      • i love to talk to people
        I’ve got direct experience working in hospitals renowned throughout Europe. I’ve worked in various wards over the last 25 years where people have been categorised in many ways starting from various disorders, personality imbalance and numerous psychosis definitions. Apart from that, as and when those admitted were no longer known as people but as patients, I did not treat them or recognise them as patients, but treated them fully as people, it was easier for me to meet them and speak to them, and was able to get them to open up and try new experiences, and spoke to them openly about what the hospital and doctors would regard as issues. The first thing was that people felt value as people and respected that they weren’t being treated differently. I did not define any one as ill, unless they were treated by medication and with such gained symptoms from other illnesses such as diabetes and various other ‘side-effects’. My experience where I had a conversation between the patient and a consultant who denied the fact that the medication is what was causing the illness, and was blaming the ‘psychological issues’ This takes place all over the world and the pharmaceutical companies sell their products with giimmicks such as, ‘this product will take the edge off, will help you relax, will help you be you more’, ‘no longer be down, ‘ on the other hand i used to attend lots of national international conferences numerous workshops and academic classroom studies and their workshops for psychiatric medical students and research , doctors journal clubs , every where on raising this above awareness and questions it was unanimously discussed as ‘everything that is being conceived in psychiatry are suumptive including alzheimer and any issues based on what has MRI said is very unstable and unscientific , however the department of neurology has been coming up with new statements of these issues to try a futile effort to open new floodgate or citadel of new era for more opportunity for pharmaceuticals to take out new medications, pharmaceuticALS have gone too far too mesmerise general people and hospital professionals by saying changing compounds created new generation medications which have less ‘side effects’ now that expression is untrue and unscientific illegal as far as change of compounds does not create new medications at all, Plus why side effects, its the effects whatever way one puts it or gimmicks it, medications have only debilitating and dangerous harmful impacts on everyone having medications to damage ones health emotions psychology and day to day life normal thinking ability , much of the physical biological impacts are irreversible (sad enough) as long as the psychiatric medications continue on any person’s health its continuing to damage a persons health and emotions, that itself a “fairground “exhibition for psychiatrists and experts pharmaceuticals to base on that to launch new more medications on person and continue to transfer person from place to place to the either full amazement surprise confusion or taken for grated way, however even the ‘LEGAL SYSTEM’ are playing a much more unethical unaccademical virulent and most unsympathetic role by completely supporting the hospitals and psychiatry for their such deadly cruel proforma including forcing many or all treatments inclusive shock treatments to induce a huge large massive spark of epileptic fit in a person’s brain(just to create a regular complete mess in the system just like antibiotic kills all enzymes) and hoping that a person regardless of loss of memory would be civil and “normal” ‘calmer’ and what not , over my 25 years of challenges and experiencing on direct evidences of my arguments there have been progressively much more careless care system exist, only on the basis that since medications administered on assumptive and symptomatic issues a person get listed and warranted for furtherence of so called devastating treatments and harmful(unsafe at any dose all medications in psychiatry:Dr BOB JOHNSON, madness in medications DR Peter Breggin, blocking of dopamine never possible(use of antipsychotics or antidepressants for increase of seratonin (not possible):Dr Robert Whitaker.

        The symptoms that are shown by people, which consultants claim are showing signs of an illness or health problem, are only apparent after the person starts taking the medication. Whereas normal behavior is defined as quietness, stillness, inactivity i.e. not energetic.

        The only positive fact is that we have discovered a person can have issues that are unresolved from growing up of any nature, any kind with varying degrees of significance. Those things if remain unresolved, the person will carry on with those issues that will come out in emotions of fear, trauma, anxiety and anguish, and can cause other behaviors to surface. societies view of this above truth is of psychiatry conception , pharmaceutical- assurance of selling meds (huge media publications ) , then any confrontation as human being to these conceptions about the person concerned becomes “an issue of problem” its such an irony that how a person with above dilema trauma soon looses all independence freedom of thoughts and conceptions nor mal thinking ability under such huge umbrella of psychiatry conception of “problems”

        Only way out is to talk to people with dignity respect and seeing a person as any other person and just talk not intending to be therapist nor counsellor, a role of counsellor becomes a source of suggestions and advises eventually whereby one losses independence again and possibly a new stigma;’getting help’ from counsellor, must have to have problems etc etc
        no one is ill in any form or proportions until one is subjected to psychatric medications, law needs to be seen to help a person being victimised this way than just follow the trends and do service to code of conduct not reading between the lines: first do no harm!!!!!!!
        0044 7715911201 0044 7956577095 [email protected] [email protected] [email protected] facebook [email protected]

  2. But nowhere in your list is the fact that psychiatric drugs themselves impair normal brain function and can cause mental illness. I experienced this first hand as a child. Even if the drugs I were given did actually help with whatever reason I was given them, after awhile I would begin having more and more severe problems caused by the drugs. I went from not paying attention to my teacher in the first grade to spending half my childhood in mental hospitals suffering from rage, mood swings, panic attacks, severe OCD, and all sorts of weird things that probably don’t even have names such as becoming extremely annoyed and agitated by certain textures and smells (developed on Mellaril and still persists to this day) that had never bothered me before such as paper and denim. This is an extreme nails-on-chalkboard sort of effect that it has on me.

    I cant help but to wonder if your list is really just your brain trying to deny the reality of this fact. A lot of people seem to be desperate to find alternate explanations for what Whitaker has discovered. Why? Why cant you just accept that the drugs are neurotoxic and stop using them?

    • Excellent question, Jeff. Why is it that so many psychiatrists and other “professionals” in the system, refuse to state the obvious that all the rest of us already know? Why do they spend so much time beating around the bush, rather than coming out and admitting that these things are not medicines but toxic drugs which cause terrible damage to so many people?d

  3. Decreased stigma: fact is that “stigma” hasn’t decreased, but increased since numerous efforts have been made to tell the public that emotional distress is caused by biological brain diseases. People can relate to a person’s life story. They can’t relate to imbalanced neurotransmitters. Also, enquiries have shown that if people avoid to seek out professional “help”, they do so not because they fear the “stigma”, but because they don’t expect the “help” offered to be of any help to them. So, if more people seek out “help” today than ever before, it’s not due to decreased “stigma”.

    Assuming chronicity: you write that “(c)lassically, mental illness” has been thought to be chronic and irreversible.” What do you mean by “classically”? Fact is that classically, “mental illness” has been thought to be the opposite of chronic and irreversible. Bockoven and Solomon, quoted in Anatomy of an Epidemic (p. 100): “the majority of mental illnesses, especially the most severe, are largely self-limiting in nature if the patient is not subjected to a demeaning experience or loss of rights and liberties.” Just one of many statements back from the time before the massive drugging of emotional distress took off that clearly shows that classically, “mental illness” was not seen by professionals as chronic and irreversible before this massive drugging turned it chronic and irreversible. So, your reasoning here is backwards. “Mental illness” was not assumed to be chronic and irreversible until drug “treatment” actually turned it chronic and irreversible.

    You may have a point when you say, basically, that “mental illness” never before in history was marketed as it is today, through the media, drug ads, awareness and “anti stigma” campaigns, etc. etc.. But this does not account for the growing number of people who actually are, physically, neurologically, disabled, supposedly by “mental illness”. People who “fake” “mental illness”, for whichever of the reasons you mention, will hardly end up physically, neurologically disabled, unless it is the “treatment” they receive for their supposed “mental illness” disabling them. Fact is, the vast majority of those who do receive psychiatric “treatment”, whether they actually can be said to have a “mental illness”, or not, end up physically, neurologically disabled.

    I’ve seen many people with a label of “severe mental illness” on drugs, and I’ve seen many with the same labels off them. The difference, the disabling effects of the drugs, is glaringly visible. I don’t know how anybody can be blind to it.

    • Your point about chronicity is a critical one. I hope the doctor is reading these comments. Its only been in the last 25 years or so that the narrative of chronicity and irreversability has emerged. Robert outlines this well. That’s a HUGE change from the way these “illnesses” were viewed for many many years.

      Once you realize that it’s a marketing message made real by the toxic drugs you will be motivated to look at how we did things prior to reductionistic conceptualizations.

      Also, a question Dr. your comment, “In general most psychiatrists I have met would rather have more time to spend with their patients and do the psychotherapy…”

      Has not been my experience in talking with psychiatrists. I’m told they receive virtually zero training in talk therapy during their training. Can you confirm?

      Thanks for your contribution here.

      • David, good point on your part, the one about psychotherapy. Virtually zero training in talk therapy is also what I have heard. Additionally, time and again, I hear psychiatrists bash talk therapy, loud and clearly. With the exception of CBT, which most of them admit can be effective in teaching people “insight” and “treatment adherence”, especially those who do not respond satisfactory to psycho-education alone, and still show some signs of independent thinking. It’s actually quite hip and trendy among at least Danish psychiatrists to go and get some training in CBT for the mentioned reason. Additionally to their training in psychiatry. Nope, not even the basics of CBT are included. However, I for one wonder whether CBT applied for this purpose deserves the name “therapy”, or whether another description maybe would be more appropriate.

      • I agree with you David. I’ve worked in and around doctors of all kinds for twenty years now. Out of all the psychiatrists that I’ve worked around or known, only one of them actually sits down with people and listens to their story and lets that person be the driver of their own care and car. All the rest of them just push pills down people.

    • I’ve got direct experience working in hospitals renowned throughout Europe. I’ve worked in various wards over the last 25 years where people have been categorised in many ways starting from various disorders, personality imbalance and numerous psychosis definitions. Apart from that, as and when those admitted were no longer known as people but as patients, I did not treat them or recognise them as patients, but treated them fully as people, it was easier for me to meet them and speak to them, and was able to get them to open up and try new experiences, and spoke to them openly about what the hospital and doctors would regard as issues. The first thing was that people felt value as people and respected that they weren’t being treated differently. I did not define any one as ill, unless they were treated by medication and with such gained symptoms from other illnesses such as diabetes and various other ‘side-effects’. My experience where I had a conversation between the patient and a consultant who denied the fact that the medication is what was causing the illness, and was blaming the ‘psychological issues’ This takes place all over the world and the pharmaceutical companies sell their products with giimmicks such as, ‘this product will take the edge off, will help you relax, will help you be you more’, ‘no longer be down, ‘ on the other hand i used to attend lots of national international conferences numerous workshops and academic classroom studies and their workshops for psychiatric medical students and research , doctors journal clubs , every where on raising this above awareness and questions it was unanimously discussed as ‘everything that is being conceived in psychiatry are suumptive including alzheimer and any issues based on what has MRI said is very unstable and unscientific , however the department of neurology has been coming up with new statements of these issues to try a futile effort to open new floodgate or citadel of new era for more opportunity for pharmaceuticals to take out new medications, pharmaceuticALS have gone too far too mesmerise general people and hospital professionals by saying changing compounds created new generation medications which have less ‘side effects’ now that expression is untrue and unscientific illegal as far as change of compounds does not create new medications at all, Plus why side effects, its the effects whatever way one puts it or gimmicks it, medications have only debilitating and dangerous harmful impacts on everyone having medications to damage ones health emotions psychology and day to day life normal thinking ability , much of the physical biological impacts are irreversible (sad enough) as long as the psychiatric medications continue on any person’s health its continuing to damage a persons health and emotions, that itself a “fairground “exhibition for psychiatrists and experts pharmaceuticals to base on that to launch new more medications on person and continue to transfer person from place to place to the either full amazement surprise confusion or taken for grated way, however even the ‘LEGAL SYSTEM’ are playing a much more unethical unaccademical virulent and most unsympathetic role by completely supporting the hospitals and psychiatry for their such deadly cruel proforma including forcing many or all treatments inclusive shock treatments to induce a huge large massive spark of epileptic fit in a person’s brain(just to create a regular complete mess in the system just like antibiotic kills all enzymes) and hoping that a person regardless of loss of memory would be civil and “normal” ‘calmer’ and what not , over my 25 years of challenges and experiencing on direct evidences of my arguments there have been progressively much more careless care system exist, only on the basis that since medications administered on assumptive and symptomatic issues a person get listed and warranted for furtherence of so called devastating treatments and harmful(unsafe at any dose all medications in psychiatry:Dr BOB JOHNSON, madness in medications DR Peter Breggin, blocking of dopamine never possible(use of antipsychotics or antidepressants for increase of seratonin (not possible):Dr Robert Whitaker.

      The symptoms that are shown by people, which consultants claim are showing signs of an illness or health problem, are only apparent after the person starts taking the medication. Whereas normal behavior is defined as quietness, stillness, inactivity i.e. not energetic.

      The only positive fact is that we have discovered a person can have issues that are unresolved from growing up of any nature, any kind with varying degrees of significance. Those things if remain unresolved, the person will carry on with those issues that will come out in emotions of fear, trauma, anxiety and anguish, and can cause other behaviors to surface. societies view of this above truth is of psychiatry conception , pharmaceutical- assurance of selling meds (huge media publications ) , then any confrontation as human being to these conceptions about the person concerned becomes “an issue of problem” its such an irony that how a person with above dilema trauma soon looses all independence freedom of thoughts and conceptions nor mal thinking ability under such huge umbrella of psychiatry conception of “problems”

      Only way out is to talk to people with dignity respect and seeing a person as any other person and just talk not intending to be therapist nor counsellor, a role of counsellor becomes a source of suggestions and advises eventually whereby one losses independence again and possibly a new stigma;’getting help’ from counsellor, must have to have problems etc etc
      no one is ill in any form or proportions until one is subjected to psychatric medications, law needs to be seen to help a person being victimised this way than just follow the trends and do service to code of conduct not reading between the lines: first do no harm!!!!!!!
      0044 7715911201 0044 7956577095 [email protected] [email protected] [email protected] facebook [email protected]

  4. This is a fascinating case study of a psychiatrist who appears to only have ever read Whitaker. (I love Whitaker), but I’m just pointing out, this is fascinating, it shows how the psychiatrist’s faith in his “profession” has been ever so slightly chipped away at, but he still believes in the bulk of psychiatric dogma. Fascinating.

    I read the whole thing, and at the end, there was a sting in the tail… “child psychiatrist”… wow, that is always like a straight shot of whiskey to read that…

    Kids!

    Suffer the little children.

    The contention that one should go back to the classical psychiatrists who defined unwanted thoughts and behaviors as medical problems in the first place, is outrageous.

    I’m giving this guy a partial/mostly a pass, because he’s clearly a newbie to thinking critically about psychiatry.

    I will say this though,

    Your medical education is about as useful as a screen door on a submarine when it comes to helping people/children get through their life.

  5. Vincent Van Gogh was not bipolar. He was alcoholic. He suffered from wet brain. How many “creative” people in the past acted crazy because they drank too much? I told my GP I had a problem with mood-altering substances, that I tended to self-medicate my unhealed rape trauma, and he said, “Oh, my wife is an alcoholic and I prescribe her these drugs. They are absolutely NOT addictive.” It took me 5 years to discontinue the neurotoxins compared to a few days to detox from alcohol. Psychiatric behavior-control chemicals are simply legal, forced addiction.

  6. Oh, and I did not become disabled and chronic and unable to support myself until AFTER I was labeled and poisoned. The GP who identified me as a source of profit for Big Med also pressured me to drug my child. What kind of arrogance and alienation must a person have to give neurotoxins to developing children and not see the damage to their bodies and souls? I saw the damage and I took her off the drugs after a few weeks. She has permanent endocrine damage. Teach kids how to manage their stress. Change the schools and parenting, not children’s bodies. Don’t maim the foot to fit a broken shoe.

  7. Mental illness is when ones emotions rule ones rational mind.
    You aren’t in love are you?

    Only an adult can be expected to control themselves. If they don’t, the out of control person can be named-judged “mentally ill” by those in authority.

    A child by definition is not an adult. A child can not be expected to control themselves, if they could , they would then be an adult, and be able to sign legally binding contracts.

    “Child psychiatry — like all of psychiatric slavery — cannot be reformed. It must be abolished.”Thomas Szasz

  8. Okay, the author is a doctor and thus taking his chances as a target, but his article is about the factors that may contribute to the statistics on “mental illness” getting pumped up.

    The article does not address the excessive prescription of psychiatric drugs and does not defend it, it merely implies why it might be so.

    • Yes, but the author states that he read the book, and offers a “different perspective” on why disability rates have sky-rocketed.

      Whitaker’s work points to psychiatric drugs as the reason. The author seems to think otherwise.

      This of course comes from a child psychiatrist, a field of medicine that prescribes “off label” daily – to millions of kids around this country – causing the epidemic we are witnessing, and anxious to have a debate… although the author seems nowhere to be found at the moment, in spite of the comments made thus far.

      Maybe he should respond, Alto.
      It seems to me that if he needs to defend his views, he would be in a much better place to do so than you… Call me crazy.

      Duane

  9. I listened to psychiatrists for twelve years. I’m not so interested in how they explain why people use their services. What does interest me very much are those who promote the inherent value and dignity of people who are labeled as “mentally ill”.

    Thank you Altostrata, Duane, JefferyC, MarianB.Goldstein, David Ross, Mad in Vermont, and markps2 for your comments. They are thoughtful and eloquent. I want to be better able to defend my position on why it cannot be considered health care to “medicate” a person’s moods.

    I want to understand why I ever thought I could, and why I endeavored so very long in such a losing proposition. I don’t think that I will ever have a sufficient explanation! I am very interested in ways that others might be spared a fate of believing (and then living) a diagnosis of inherent inferiority.

    Regardless of the hows and whys, I cannot think of a more important issue than trying to protect minors from becoming society-approved/sponsored drug addicts. I applaud those who have the courage to speak up to MDs on behalf of children.

  10. Hi Dr. Forcen.

    In most of Whitaker’s book, his main point isn’t about increased “prevalence” of mental illness at all. It’s much more about the evidence that there is increased CHRONICITY of mental illness. So if you want to explore factors influencing “prevalence”, I worry that might be just side-stepping the more important point.

    As others have already pointed out, “Anatomy of an Epidemic” look at evidence suggesting that most people used to get over depression & schizophrenia much more quickly, and that increased chronicity is largely a more recent phenomenon, one that coincides with, and seems to follow from, the increasingly chronic administration of medications.

    I”ve seen a couple of other reviews of “Anatomy of an Epidemic” that argue over what constitutes an “epidemic”, then refuting the notion of increased prevalence as a way of refuting the “epidemic”. But except for the explosion of childhood bipolar, Whitaker doesn’t focus that much on prevalence. I can’t speak for him, but is it imprecise or poetic of him to use the word “Epidemic” in the book title to describe a vast increase in the CHRONICITY of these disorders (when maybe a stricter definition of “epidemic” refers instead to prevalence)? I don’t know.

    But let’s not get distracted here about the actual content of his book, most of which discusses not prevalence, but a serious problem of increased CHRONICITY, and medications as the being most likely cause of that increased chronicity.

  11. Yes, Philroy is correct here. I really wasn’t focused on prevalence of mental disorders at all, and in that sense, the title is imprecise. I was looking at the soaring number of people on disability due to mental illness (that’s the epidemic), and then looking at why that is so. And that leads to two questions:

    a) how do medications shape the long-term course of major mental disorders (science shows that they increase the chronicity of disorders)

    b) Is it possible that use of psychiatric drugs is creating an epidemic of bipolar illness (i.e. transforming depressive episodes into chronic states, etc.) The answer again, which we can see from a review of the science, is yes, that is clearly the case.

    So Philroy is right: that’s the real crux of the book, and not prevalance numbers.

  12. Decreased stigma ScienceDaily (2010-09-16) — “A new study finds no change in prejudice and discrimination toward people with serious mental illness or substance abuse problems despite a greater embrace by the public of neurobiological explanations for these illnesses. The study raises vexing questions about the effectiveness of campaigns designed to improve health literacy.” The “Anti-Stigma” Campaign Increased Discrimination I find the author’s claim that it was “Probably after the expansion of psychoanalysis, psychiatry started to reach a wider population, the so-called ‘well-worried” ludicrous. The pharma-funded anti-stigma campaign urged early screening and diagnosis and pharmacological treatment that led to pathologizing the normal reactions to traumatic subjective experiences, inter-persononal conflicts, environmental and sociological deficits; such as poverty. As a mother whose son was diagnosed as a preschooler after being victimized by violent crime; I can attest that once a psychiatric diagnosis was given, all undesirable behavior was viewed as if it were a symptom of psychiatric illness–by psychiatrists, and the social service system.

    As for chronicity and comorbidity, psychiatry fueled both of these; first, by claiming in the absence of empirical data that psychiatric diagnoses are the result of brain diseases which can be treated but never cured. This fraud became the foundation of the public mental health system. Those unfortunate enough to have no other option but to rely upon the public mental health system were treated with teratogenic drugs, and told they had diseases which required treatment compliance. The treatment often caused the comorbid conditions due to the teratogenic effects of this ‘treatment.’ Psychiatrists then attributed iatrogenic diseases, cognitive and neurological impairments to the psychiatric diagnosis/‘disease’ being treated or diagnosed a comorbid psychiatric diagnosis which required drugs to treat, but could not be cured.

    I am sick of doctors abdicating responsibility and blaming the pharmaceutical companies, the drug-centered paradigm of care and the reimbursement system when none of these factors would have the influence or devastating impact they have, without the cooperation of psychiatrists themselves! Let’s be real: psychiatrists were active participants in the development and the adoption of the biomedical paradigm of care, and it’s drug-centered treatment approach, not passive, unwitting victims… It’s time for psychiatry to be responsible and hold unethical practitioners accountable and stop blaming everyone else.

    The same goes for blaming the media; ultimately they, like patients and the general public, have been misinformed by psychiatrists, but like psychiatrists they failed to adhere to the ethics of their chosen profession. Doctor you are blaming those who have been misinformed by the psychiatric profession; including poor people who seek subsistence through the social service system, for relying on the biased, and false information they relied upon. Many believed what they were told, because it was told to them by a doctor! Are you aware that there is no way in hell a person can be declared disabled by a psychiatric diagnosis without a psychiatrist attesting to the diagnosis? Your perspective blames victims for being victimized…

    • The anti stigma campaign INCREASED stigma, as the public has been led to believe that ALL of these problems are caused by people not being on there med’s. They blame us, as if we just took our medications, just like a diabetic takes insulin then we would have no problems. Problem is 99% of people readmitted were fully complaint at the time of admittance?? How can a person being complaint with medication relapse on drugs that cure a person??!! The fact is the stigma is created by the lies told about the drugs and nothing more. The lies allow them to blame us for not taking med’s and so there is no compassion, there can’t be, as they believe there is a cure and we just refuse to accept it.

  13. Hi,
    You list “Pharmaceutical companies” as one item on your list, which implies pharmaceutical company profit motive. Yet almost every other item on your list is a result of direct or indirect social engineering on the part of pharmaceutical companies. For instance the destygmatizing campaigns (along with screening campaigns) are sponsored by pharmaceutical companies.

    I would include appealing to the profit motive of doctors, insurance companies, and medical journals under the same category.

    The only item that jumped out at me as not arising out of pharmaceutical efforts is romanticizing by association with creativity.

  14. Another quote from University of chicago Medical Center web site; Comer Children’s Hosp: Child/Adolescent Psychiatry:

    “Very often, our clinicians are
    involved in leading-edge advances.
    For instance, they were among the
    first to test many of the now
    standard medicines for attention
    deficit hyperactivity disorder (ADHD)
    — and they continue to test new
    drugs for this disorder.
    • Cognitive disorders associated
    with epilepsy and immune
    dysfunction disorders (lupus)
    • Depression
    • Disruptive behavior disorders
    treatment approaches, including:
    • New medications that can reduce
    or minimize symptoms associated
    with all types of problems — from
    depression and anxiety to autism
    and psychosis ”

    Just another leading academic medical center engaged in “experimenting” for profit on little kids and teenagers— Fernando Espi Forcen, M.D., is a child psychiatry fellow at the University of Chicago. Gone are the days when academic medicine was a respect worthy safe guard for science based, ethical medical care!