Why I Refuse to Read Anatomy of an Epidemic
Many people here have read Robert Whitaker’s Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America (New York: Crown Publishers). And some of these people will likely claim that the book changed their lives or, at the very least, their view of psychiatry and psychiatric medication.
Well. Ho there. You would think with such a ground-breaking book I would be all over it.
I refuse to read Anatomy of an Epidemic. And yes, some people will fault me for this. But I have a good reason. I refuse to read Anatomy of an Epidemic as I have no desire to be outraged at a misunderstanding of science for 416 pages.
The Poster Child: Robert Whitaker
Robert Whitaker is the poster-child for antipsychiatry, which is his prerogative. If he enjoys talking to throngs of antipsychiatrists then I say, better him than me.
And part of his criticism of psychiatry is well-deserved. I would say that being concerned with the use, and possibly overuse, of some medications and the prescribing of heavy psychotropic medications to children is quite warranted. I take no issue with the fact that debate and concern is appropriate here.
What I do take concern with is his contention that psychiatric medication actually worsens treatment outcomes and causes disability. This is the reason why antipsychiatrits love him and it’s the reason I probably couldn’t stand to be in the same room as him.
Antipsychotics and Mental Illness
Whitaker’s chief whipping boy is antipsychotics and schizophrenia. He cites studies that he says back up his claim that not taking antipsychotics increases the chances of getting well and that antipsychotics induce the symptoms of schizophrenia.
Well that is complete falderal.
You see, Robert Whitaker, it seems, can’t read a study.
Studies are very tricky business and if you don’t actually read and entire study, look at the data and really read what the researchers are saying – you might miss something. In fact, you might miss something that changes the entire meaning of the study. Rarely do the researchers themselves miss it, but for some reason, when reading the study, people draw conclusions contrary to the researchers – like Whitaker does.
How do I know this? Well, rather than reviewing his book I reviewed some of the studies he cites and the claims he says are backed up by those studies and I found them to be fallacious at best. Sure, he cites studies, he just contraindicates what the study actually proves. And nothing ticks me off more than this because people believe him just because there is a linked study – no one ever bothers to check that the study says whatever Whitaker says it does.
Whitaker Contrarians - Doctors
Except, of course, the people who do – the doctors. You know, the people who went to medical school for over a decade. You know, the people actually qualified to understand what all the fancy numbers mean. You know, those people.
And I, for one, rely a lot on what doctors make of medical data and they are the ones most able to refute Whitaker’s claims.
Enter E. Fuller Torrey, MD. He wrote a most excellent piece on how Robert Whitaker got it wrong. And chiefly, how his assertions of medication-induced schizophrenia and treatment outcome improvement without medication is wrong. Fuller uses the very studies that Whitaker cites to prove the very opposite of what Whitaker is saying. Because quite honestly, Whitaker either doesn’t understand how to read a study or his misrepresents the data on purpose.
Well, you know, wrong.
The problem with the study Whitaker cites is that it contains a moving target – namely the definition of schizophrenia over time. The way schizophrenia was diagnosed in the 1950s isn’t how it was diagnosed in the 1970s or the 1990s. The diagnostic criteria differed substantially as we learned more about the disease at there was progression of the Diagnostic and Statistical Manual of Mental Disorders. Earlier on, diagnostic criteria for schizophrenia were very broad and so more people who were less sick were diagnosed with schizophrenia whereas now, the criteria are much stricter and people in the category of schizophrenia are much sicker. Fuller states:
When a broad definition of schizophrenia was in vogue, outcomes were better but when a narrow definition was in vogue, outcomes were worse, as would be expected.
In fact, in that very study it showed that treatment outcomes improved in the 1960s and 1970s specifically coinciding with the usage of antipsychotics. At no time in the study do the authors suggest that treatment outcomes have worsened over time. That was just Whitaker’s unsupported claim.
And Fuller goes on to explain more about how Robert Whitaker got the science wrong – and he does – over and over. He gets it wrong, wrong, wrong, wrong. One really starts to wonder how he can call himself a journalist at all.
OK, I’m Getting Worked Up
And see, this is why I can’t stand to read the book because I would have to dissect all of his claims and find out where he was wrong simply because I would feel compelled to do so. I’m that kind of girl. I don’t like falsehoods hanging around for people to pick up and inadvertently digest.
In short, if you like Whitaker’s work, that’s fine, but you might want to read some doctor’s reviews of his work before you start believing everything he wrote because by-and-large, for many of the claims, the science isn’t there. It just isn’t.
Please read Anatomy of a Non-Epidemic - a Review by Dr. Torrey for all the details. More critique here.
Tracy, N. (2012, June 5). Why I Refuse to Read Anatomy of an Epidemic, HealthyPlace. Retrieved on 2019, July 19 from https://www.healthyplace.com/blogs/breakingbipolar/2012/06/why-i-refuse-to-read-anatomy-of-an-epidemic
Author: Natasha Tracy
See, that's the thing about the kind giant conspiracy you embrace. It's impossible to keep all the conspirators in line. Yes, Oswald killed Kennedy. No, the aliens did not crash at Rosswell, and my doctors do not meet in secret conclaves to devise new ways to harm me.
What you do accomplish is the rather sick goal of encouraging very sick people from getting help. Like many others, I survived the period from onset to diagnosis and treatment; barely. With the help of extremely well educated doctors, I do more than survive. I live. Why would you dedicate your life to hurting those who doctors have helped? Honestly, what do you gain from it?
Dear BP, where are the bio-markers which prove those tests are accurate? They aren't anywhere. They don't exist. You see the problem?
Now, that is fascinating. A rabid anti-mental health zealot, who knows perfectly well mental illness does not exist, tries to win an argument that indeed mental illness doesn't exist, claims that it does, as long as it's amphetamine induced, thinking she can slide that little inconsistency past someone far smarter than she can imagine and get away with it. Listen girls, I'm mentally ill. You better be nice to me or I'm tellin!
I have yet to meet someone who experienced a full blown manic episode who hadn't been on psych meds prior to the episode. I'm talking about the type of mania that requires hospitalization. Mania is terrifying to experience and can easily ruin or end a life. There is plenty of evidence that anti-depressants cause mania.
"At least 9 out of 10 adults I've seen in the last two decades who have suffered emotional episodes that could be diagnosed as mania had them in direct response to stimulants or antidepressants–mostly the newer antidepressants such as Prozac."
How common is antidepressant-induced mania? Very common. Several studies have found that 6 to 8 percent of patients exposed to antidepressants will develop a manic disorder. One research study, for example, found in a retrospective study that Paxil produced mania in 8.6 percent of patients exposed. Other studies find the rates as high as 17 percent And if a person has already shown a manic tendency or has experienced a manic-like episode, antidepressants will pu
sh one-quarter to one-third into new manias (For a review, see P. Breggin, Brain-Disabling Treatments in Psychiatry, 2008, pp. 157-165)
I benefitted from Adhd medication prior to trying an ssri. Then I had a manic episode that ruined my life. I was hospitalized against my will and charged a large bill that put me into debt. I had 10k stolen from me by an abusive boyfriend who found me easy to manipulate in that state, my car was impounded at the cost of 5k, and my hoa fined me over 2k when I didn't respond to their letters in time. Plus not being able to work off and on I ended up in debt over 40k.
I have been off all medication for four months. I wish to take the Adhd meds again but I am scared. Aside from that I am very depressed but mostly because the few months I was manic destroyed my finances and reputation. The medication might not have permanently physically damaged me, but the other damages it caused can be just as difficult to recover from in the modern era as any physical disability medication may accidentally cause. At the rates anti depressants are known to cause manic episodes, it is irresponsible to prescribe them to anyone. Mania is much more dangerous than depression.
I've personally been affected by this. You can claim that a doctor who sees a patient for 15 minutes knows better than the patient, and better than the facts. But these claims are empty. If I could go back in time I wouldn't touch any pharmaceutical. I was on for 12 years and I've been robbed of my life. I own a successful technology company and am more functional than I was on medication. Coming off medication almost killed me, and the withdrawal made me look crazy. These medications are poison and make us sicker.
It might be difficult to open your mind on meds, but try. And then reclaim it. It belongs to you.
The bile I always see in these comments/forum threads is pretty shocking as well, there's no need for personal insults and belittling comments in a conversation that should ultimately be fact based. I mean I can understand why a former patient would be angry considering they may feel incredibly victimized and unrepresented by mainstream psychiatry but seeing the people defending pharmaceutical based treatments by resorting to nasty childish insults is pretty disgusting.
If you feel the need to "defend science" you need to show evidence to back up your position like Robert Whitaker has, attacking a persons character(who most likely feels victimized as it is) is about as scientific as the evangelical zealot damning gays to hell.
Could you please elaborate on your claim:
"I reviewed some of the studies he cites and the claims he says are backed up by those studies and I found them to be fallacious at best. Sure, he cites studies, he just contraindicates what the study actually proves. And nothing ticks me off more than this because people believe him just because there is a linked study – no one ever bothers to check that the study says whatever Whitaker says it does."
Which studies? Why were they fallacious in your view?
Selective Serotonin Reuptake Inhibitor. The explanation that the doctors will give you is that it'll cause more serotonin to stay in your brain, making you happier. If that's true, then a reuptake <b>enhancer</b> should reduce your mood, making you depressed. But that's not what happens. SSREs are anti-depressants as well. The "fixing the brain chemistry" argument is entirely based on bunk theories which are contradicted by evidence.
2. Locus standi
Literally, a place to stand. If you haven't even bothered to read the book, you don't have a place to criticize or praise it. It's not a long or complicated book, so there's no excuse. Natasha seems to believe that wilful ignorance is a good idea, and is happy to talk about things she only knows about 3rd or 4th hand.
Another fanatic who refuses to examine the evidence. Must be 'Murican.
wiity wasn't the first to raise that issue, though he does try to exploit the misrepresented data he manipulates as much as possible. surgically removing cancer causes great damage to one's flesh. it is a price to be paid when "do no harm" is weighed with saving lives. btw, he has no documented, credible evidence that the drugs used to treat mental health challenges create a single bio/chemical/electrical alteration in the mind of anyone. he can't even see pain under a microscope, so there is no such thing. pain doesn't exist. any claim that it is real is fraudulent and merely the tactic of all the drug pushing moms, dads, doctors, nurses, throughout the u.s. to exploit naïve crybabies who have been convinced they have booboos
My point is that this discussion needs to be had if we really as a society want to promote the very best health we can, physical and psychological. Whitaker's book is a legitimate part of that discussion, certainly as much as is, say, and article which is based on a stance of refusing to read something that is prejudged as being wrong (or at least not in alignment with the person's stance). Articles in AARP publications recently, or the TED Talks by psychiatrist Ben Goldacre, or my own personal and professional experience with psychotropic medications, suggest that we need to know how well we are doing in satisfying the fundamental tenant of "do no harm" let alone how well we are doing in actually finding real medicines which heal real disorders and diseases. Certainly, one of the fundamental issues raised in Whitaker's book is whether the medications are actually creating a long-term problem which didn't actually exist before, e.g. the relationship between SSRI's and alterations in the physiology of the brain structure. Another is how the diagnoses whch support the treatments prescribed, whether pharmacological or behavioral in nature, are arrived at. As a practicing psychotherapist, I am incredulous at the current number of diagnoses listed in the current Diagnostic and Statistical Manual. How is it that we are as a society so astonishingly mentally disordered, become so astonishingly more "brilliant" in uncovering these previously unrecognized and/or cleverly hidden disorders? And how can we know litterally how to access let alone understand the basis upon which the pharmacological and behavioral interventions are based (see the Goldacre's TED Talks for his discussion regarding his efforts as a prescribing psychiatrist to access the scientific research into psychotropic medication, for example.)
As for refusing to read some discussion which might be upsetting or unsettling to one's assumed point of view, I know that I have to sometimes do a lot of self-talk to get around my own prejudices. Prejudices serve us well when the pre-judging is based on truth and helps avoid choices which might be harmful to oneself or others. On the other hand, prejudice gets it's negative connotation from stances which are of the nature, "don't disturb me with the facts" because I might have to get out of my comfort zone.
Perhaps it would be helpful become willing to look even more closely at what we find potentially dangerous, assuming what seems to me an even more courageous position which might be paraphrased as, "Hold your opinions close, and your opponents opinions even closer." If I'm really clear on what might hurt me, then I can know even more clearly whether what I believe protects me is up to the job.
It makes me wonder how many adults are being over diagnosed incorrectly with bipolar as well, especially the ones with less severe symptoms...
In my humble opinion the few adults who are able to effectively manage their lives without medication were never really bipolar to begin with. Just because a psychiatrist says it's so doesn't always mean it's true. Maybe that person has a personality disorder or maybe there's something else going on with them instead. Some symptoms overlap with other illnesses, and can mimic bipolar disorder. Doctor's are human and have been known on occasion to make mistakes.
Or could it be that the unmedicated bipolar patient is just temporarily in remission only to have it come back with a vengence later on down the road like someone who gets cancer, goes into remission only to get it again in the future
Who knows for sure since there isn't really any scientific medical procedure that can be performed such as a blood test, etc to definitively prove you have it like there is with cancer
Or maybe they truly do have bipolar disorder and don't take medication because they're just in denial or don't like the side effects of the medication or are too shame based to begin with from childhood issues, etc to wanna accept the diagnosis and deal with the associated stigma
How much money has he made selling the garbage he writes?
As per Natasha's post
Aug 26, 2015 - Bipolar Depression - When Will I Feel Better?
In reality they don't help everybody at least to their satisfaction. If they did, they still wouldn't be struggling
after so many years of trial and error
" IGNORE the trolls. It’s better to back off when you immediately smell a troll. They’re trying to get you worked up. It’s their goal"
I agree, eventually they will have no one else to talk to but themselves...
Isn't that something? People bash her when they are fortunate enough to be allowed to comment on here. She doesn't have to let them. She isn't under some kind of legal obligation. This crowd of Anti-psychiatry zealots has some bad apples in it. Some lie, constantly. And no one on their side says a word about it. They expect no one will. When they are challenged, they become like wild demons thrashing around, unable to control themselves.
Much of what they do is intended to bait others or to change the subject if they're corned. Engaging in real debate with them is rarely going to occur. That's the sad part. They can't really debate. They rely on a few extremists to do the hard work of research and analysis. Whatever they say, they repeat. Much like a cult, they expect to be taken seriously and they have all the answers--if you ask the right questions. Get them away from their scripts and it becomes a rather sad spectacle.
Dear Unique, would you please explain how you know what "most" here know about BD?
Would you kindly demonstrate the "obvious political agenda" of those Natasha relies upon?
How do I know psychiatry works? I'm a patient. I have been diagnosed (by 3 separate docs, including 1 at Mayo) with bipolar disorder, PTSD, and ADHD. All I know is that when my world came crashing down, I NEEDED to be hospitalized. I was started on meds which helped me feel better. They weren't perfect and I still continue to have to change here and there, but overall, they work. Do I like all of the side effects? Hell no. And because of that, I tried twice under my doc's supervision to go off of them all. I ended up back in the hospital, psychotic. For those of you who could do it, I'm happy for you. But not everyone can DO that. It's irresponsible to promote that here because some patients like me CANNOT do that. And if they listen to you and hope for that outcome, things could throw them into a huge tailspin.
As for Natasha, she actually does have a mental illness. She speaks not only for the scientific details but as someone who does have mental illness and is fighting for all of us who also struggle with that. She says upfront that she's not a doctor. So to bash her so badly here is unfounded. For those of you who are upset for her not moderating this better, I get why you're upset to a degree. But things got a little too personal for people to be rational. In the long run, does it matter so much? IGNORE the ignorance. IGNORE the trolls. It's better to back off when you immediately smell a troll. They're trying to get you worked up. It's their goal. Don't let them get under your skin. And TROLLS that don't have personal experience with MH, you don't belong here. Let us speak in our own forum safely and honestly without fear of being bashed or picked on.
Therefore ends my time on the soap box.
I will answer more questions when the antis begin to try to answer mine--with evidence.
You ask, why is this relevant? Let me ask you, why do you think it is relevant? Any guesses?
I said earlier, "T’is the proof of all the iatrogenic illnesses you lack."
We have established over time the tremendous dangers of drinking alcohol and driving. Over 10,000 deaths result from such behavior every year in America. Plenty of scientifically based data proves this is true. Tons and tons of it.
But, when antis state as fact that psych meds have destroyed long term memory, working memory, processing speed or created other mental illnesses, and simultaneously insist that mental illness doesn't exist for lack of a biological marker, they have a problem. Can't have it both ways.
And, while their rage boils over for the harm psych meds supposedly cause, they use and tolerate the widespread use of drugs that we know, without doubt, kill and seriously harm tens of thousands annually (millions since the end of prohibition) and yet remain strangely silent and passive about it. Based on the literature, many combine alcohol and their prescribed psych meds, even when clearly and adamantly, warned not to do so. And, then they blame the psych meds for the damaging side effects.
In a true debate, we must stay focused on the credible evidence or we waste each other's time. The intent of many antis is not to dig and to study so as to uncover truth as much as it is a demand that they be believed, no matter what.
Stating that as a fact reduces your credibility even further. Gobs of "facts" are tossed around by opponents of psychiatry without supporting evidence. Real, honest debate is not possible as a legitimate exercise in the pursuit of truth without respect for peer reviewed scientific data. It is, therefore, more profitable for your side to be still and then to begin to study, carefully, the factual basis for the views you eventually will hold. IOW, start from scratch. We all have much to learn. Be diligent not to blurt out opinions as facts.
How is this relevant?
As per Betty's post of
September 4, 2015 at 4:40 pm
ANNUAL CAUSES OF DEATH IN THE UNITED STATES
Motor Vehicle Accidents —- 35,369
On average, 6 people died every day from alcohol poisoning in the US from 2010 to 2012. 6 X 365 = 2190 deaths from alcohol poisoning annually.
Every day, almost 30 people in the United States die in motor vehicle crashes that involve an alcohol-impaired driver. This amounts to one death every 51 minutes or nearly 11,000 people every year. Over 10 years that is more than 100,000 deaths related to alcohol impaired drivers. The annual cost of alcohol-related crashes totals more than $59 billion. That is over one-half trillion dollars in 10 years.