When I was a teenager, my best friend’s mother told me that, owing to her long-term addiction to Valium, there were ten years of her life she couldn’t recall. I remember thinking to myself, That’s a Hell of a price to pay.
When I was in my late twenties, Eli Lilly’s multibillion-dollar drug Prozac first burst onto the market, and I remember asking a friend, “What is going to happen to all these people making alterations in their brain chemistry, ten or twenty years down the road?”
Well, the results are coming in, and it’s worse than I had imagined. It’s worse than anyone could have imagined.
The so-called “first generation” of psychotropic drugs appeared in the 1950’s, featuring “major tranquilizers” such as Thorazine, “minor tranquilizers” such as Miltown and Valium, antidepressants such as iproniazid and imipramine, antipsychotic drugs like haloperidol, and lithium for mood stabilization. The “second-generation,” including Selective-Serotonin Reuptake Inhibitors (SSRI’s) like Prozac, “Atypical antipsychotics” like Zyprexa, and anti-anxiety drugs like Xanax, made its debut in the 1980’s. As a society, we now spend over 40 billion dollars a year on prescription psychotropic medications. One in eight Americans is currently taking one or more of these drugs. With all this relentless medicating, we ought to expect that the rate of mental illness should have gone down.
In fact, the proportion of Americans disabled by mental illness has skyrocketed.
That makes no sense, no sense at all, if you believe these drugs are ameliorating mental illness. But it makes perfect sense if you accept that these drugs are causing mental illness.
That’s an astounding charge, but author Robert Whitaker makes it stick. In a methodical, workmanlike fashion, via an exhaustive survey of the peer-reviewed medical literature as well as first-hand interviews with doctors and patients, he builds an overwhelming case that these “medicines” a doing more harm than they are alleviating. Far more.
The facts speak for themselves. Following the introduction of the first generation of psychotropic drugs, the proportion of Americans disabled by mental illness tripled. After the second generation of drugs was introduced, that proportion doubled again – to six times what it was in 1955.
There’s more. In 1955, only about 50,000 Americans were confined to state and county mental hospitals because of so-called “affective disorders” – major depression, anxiety, and bipolar disorder. Today, an astounding 1.5 million Americans are on the disability rolls for these conditions.
The plague has spread to children, as well. In 1987, at the dawn of the “second-generation” era, there were about 16,000 children receiving SSI disability payments for mental illness. Today that number has risen to over half a million – a thirty-five fold increase. Before the introduction of psychotropic drugs, bipolar disorder was diagnosed in children so rarely that most psychiatrists believed that juvenile bipolar disorder simply did not exist. Today, as many as one in fifty prepubertal children is estimated to suffer from this condition.
In the same time that the number of people disabled by mental illness has soared, outcomes have become almost unimaginably worse. There was a time within living memory, when depression, anxiety, mania, and even psychosis were rare and largely self-limiting conditions. Most people who had these conditions suffered them only once, or at most twice in a lifetime. Then they got better and got on with their lives.
Today, acquiring a label such as “depression,” “anxiety,” “ADHD,” “bipolar,” or “schizophrenia” is often a start down a road to crippling life-long disability and an early death.
How can this be? In the 1970’s and 80’s, the media heralded the new era of “Biological Psychiatry.” Science was said to be on the verge of disclosing the causes of mental illness in terms of deficits or surpluses of various brain chemicals. Drugs could be designed to correct these imbalances, just as insulin corrects the chemical imbalance that leads to Type I Diabetes, and patients suffering from mental illness could be restored to health and wholeness.
These hopes have not been realized. Science has not determined the biological cause of any mental illness. Simplistic explanations of mental illness as being the result of a deficit of this neurotransmitter or an excess of that one, are about as scientifically based as the Four Humors Theory. Psychiatrist Joseph Glenmullen had noted that “In every case where such an imbalance was thought to be found, it was later proved to be false.”
Contrary to what people have been led to believe, these drugs do not correct any known chemical imbalance in the brain. In fact, they create an imbalance. The brain adapts to the imbalance wrought by the drug, resulting in changes in brain functioning that often persist after the drug is withdrawn.
In plain English, these drugs are highly addictive.
There’s more. MRI studies have shown that many of the drugs have been shown to cause long-term, measurable changes in brain morphology, including shrinkage of the frontal lobes of the brain.
In plain English, these drugs cause brain damage.
The side effects are not limited to the brain. They also include cardiovascular ailments, respiratory problems, metabolic illnesses, diabetes, kidney failure… the list goes on an on. Psychiatrist David Healy has observed, “When it comes to dead bodies in current psychotropic trials, there are a greater number of them in the active treatment groups than in the placebo groups. This is quite different from what happens in penicillin trials or trials of drugs that really work.” In fact, the life expectancy of patients labeled “mentally ill” is reduced by as much as fifteen to twenty-five years.
In plain English, these drugs kill.
The human cost is staggering. Whitaker fleshes out his book with first-hand interviews with current and former patients, or in some cases with their surviving loved ones. Again and again the same heart-breaking story is told: a young person, with an entire lifetime of hope and promise in front of him, is labeled as “mentally ill” and put on medication. The benefits of these drugs are usually ephemeral, but these side effects are not. Patients are prescribed more drugs, stronger drugs, and higher doses, resulting in an ever-downward spiral. Someone who seemed to be suffering from nothing more than standard-issue teenage or twenty-something angst ends up on permanent disability, or worse.
Monica Briggs was born in Wellesley, Massachusetts, the daughter of two college professors. In the Fall of 1985, when she went away to Middlebury College in Vermont, she appeared to have a bright future ahead of her. “I thought I’d go to school, marry, have a chocolate Labrador, and a home in the suburbs, with the SUV.” But like many college freshmen, before and since, she had trouble adapting and went home. In another era, she might have spent the next year living with her parents, sacking groceries or waiting on tables, and then returned to college the next year with a renewed sense of purpose. But that was not to be her fate.
Instead she was labeled as suffering from “depression” and was prescribed desipramine. As often happens to people taking antidepressants, she became bipolar, rapidly cycling between depression and mania. In despair, she attempted suicide by swallowing a handful of sleeping pills. She was put on lithium as a mood stabilizer as her doctors tried one antidepressant after another. Over the next fifteen years she was hospitalized thirty times. Somehow she managed to earn a degree from Massachusetts College of Art and Design during this period. But in 2001 she attempted suicide, and after her mother died in 2002, she suffered a psychotic breakdown and was put on SSDI.
Today, although she now manages to work part-time, she still is on SSDI. The lithium, she says, has destroyed her ability to create artwork, and she suffers from tremors and thyroid problems.
As a boy, Hal Flugman was short and fat, and the other kids picked on him a lot. He suffered from panic attacks, for which he received counseling. “I was living with it, dealing with it,” he recalls, but after a particularly nasty attack left him hospitalized at the age of eighteen, a doctor prescribed Klonopin. “I was worried about the side effects, too,” he recalled. “But the doctor said the side effects would go away in a couple of weeks.”
They did not. For several years, Hal was living on his own, trying to make it as a guitarist, but his career failed, a failure he blames on the Klonopin, which he says both took away his finger dexterity and stifled his ambition. “I felt like a zombie,” he explained. At the age of 29, he admitted defeat, moved back home with his parents, and went on disability. A few years later, he was sent to a detox facility to try to kick his addiction to Klonopin, with horrendous results. “Month after month, I got worse and worse. I couldn’t sleep, and the symptoms – the most debilitating was this feeling that I was dead. I felt that my brain was ripped out of my head, like I wasn’t even a living thing…They don’t understand that the drug changes the whole biology of your brain, and that your brain doesn’t work right anymore.” He was put back on Klonopin.
Hal’s assessment: “Klonopin ruined my life. It takes away your drive, and in the morning you don’t want to get out of bed, because you feel so groggy. I don’t even know what it’s like to feel normal. This is my world. Things don’t get me as excited as most people because I’m in a constant state of sedation.” To top it all off, the Klonopin no longer seems to be working, and the anxiety attacks have returned with a vengeance. “I’ve come to accept that this is my life,” he concludes.
Scott Sexton was a newly minted MBA who had just accepted a position at a major accounting firm. After breaking up with his fiancée he was hospitalized for depression and put on a drug cocktail that included Zyprexa. Soon he was sleeping twelve to sixteen hours a day, and taking pills to stay awake the rest of the time. His weight ballooned from 185 pounds to 250. “He had a beer belly, and his cheeks looked like a chipmunk,” his mother recalled. Nevertheless, her faith in the psychiatric profession never wavered. “I had always told him to take his meds,” she recalled. “I said, 'Scott, if I ever find out you are off your meds I will shoot you.'”
She didn’t need to. On Thanksgiving Day 2006, he was hospitalized for pancreatitis, a known complication of Zyprexa. Doctors kept him on the drug until he died a few days later.
How did we get into this mess? This is a question I shall take up in Part 2 of this essay.
This is the first of two parts.
Photo via Wikimedia Commons