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.
unlike dr. angell, i have 30 years of actually taking care of patients as an internist and general practioner.
the harriet hall piece is balanced, thoughtful and useful. dr. angell’s long track record of u.s. healthcare, pharmaceutical industry and now, psychiatric-drug bashing is another example of a perfectly smart, talented person straying from their area of expertise into foolish commentary.
of course the drugs have down-side risk. there are no children involved in the decision making—the journey from the pre-drug/talk-therapy days and now have been an exhilarating, wonder-ride, understandably flawed in these, the early decades of a revolution in making the best of some TOUGH situations.
DEA agents went to Columbia and murdered Pablo Escobar – the alleged head of a large cocaine cartel, and a man known for his generosity to the poor.
The largest, most powerful drugs cartel in the U.S. is the American pharmaceutical industry. DEA should arrest its leaders, white-coated dealers,and mules who deliver their poison to retail operators. This
criminal enterprise, responsible for the untimely deaths of children and adults alike, enables the fraudulent theft of taxpayer money under SSDI and other welfare programs for the greedy and lazy, “bribes” doctors and research scientists to produce biased test results, and has even invented
an entire new “branch” of phony medical professionals(psychoparmacologists) to pedal its poisons to naive patients, would, in a just world,
be prosecuted under the RICO statutes, and the entire “industry” should be outlawed.
@dr.tom
“The Hall piece is balanced thoughtful and useful”.. But actually it seems to corroborate, if slightly water down most of Angell’spoints. As for her objection to Angell’s wish to remove the MD’s discretion re off-label usage, the loosening of diagnostic categories in DSM-5 obviates that. Personally I found that a quick diagnosis of adult ADHD without psychotherapy and with easy access to Adderall, gave me more energy and focus which I expended on unrealistic goals and stubborn positions, with catastrophic results.
Psychiatrists are drug dealers for anxiety and sleeping pills. Anyone who uses them for any other purpose is not doing it right.