Marcia Angell, an internist and pathologist who is a senior lecturer at Harvard Medical School, has recently written two lengthy book reviews for The New York Review of Books — The Epidemic of Mental Illness: Why? and The Illusions of Psychiatry – that has re-ignited a debate among medical professionals regarding the effectiveness of modern psychiatry.
Dr. Angell reviews three books that challenge the effectiveness of psychiatric medications and the hypothesis that disordered neurotransmitters cause psychiatric ailments. Irving Kirsch’s The Emperor’s New Drugs: Exploding the Antidepressant Myth analyzes research on antidepressant medications and concludes that the vast majority of their impact stems from the placebo effect.
Roger Whitaker’s Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America is even more disturbing in that Whitaker contends that the huge increase in diagnosis of serious psychiatric illness is actually caused by the detrimental effects of the medications. According to Whitaker, the problem isn’t that medications don’t help, it’s that they make the problem worse. Yowza!
Finally, in Dr. Angell’s second article, she takes on the entire profession of psychiatry in discussing Daniel Carlet’s Unhinged: The Trouble with Psychiatry — A Doctor’s Revelations About a Profession in Crisis and the American Psychiatric Association’s controversial "Diagnostic and Statistical Manual of Mental Disorders" a/k/a "DSM."
As Harriet Hall points out, Dr. Angell’s criticisms – particularly in regard to DSM – borders on psychiatry-bashing, which is of dubious merit. Sure, psychiatry is less science-based than other medical fields, but it has undeniably saved lives and improved the quality of life of many tortured souls. Are we simply to dispense with that progress?
Nevertheless, Dr. Angell reviews – as well as the books that are their subjects – provide a more nuanced view of human interaction that takes into consideration both the importance of both the "brain" and the "mind" without forcing a choice based on competing pseudo-truths.
These are discussions that need to be nurtured, both for the benefit of developing better protocols for patients afflicted with such disorders and for a society that still struggles on how best to deal with the social impact of such disorders.