Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America by Robert Whitaker

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By the 1970’s, psychiatry was facing a crisis of identity which threatened its very existence. The minor tranquilizers, such as Valium, had been exposed as the dangerous, highly addictive drugs they were, while the major tranquilizers, such as Thorazine, were reviled by current and former patients as instruments of torture. Other medical interventions for mental illness, such as lobotomy and insulin coma, were by then as discredited as bloodletting. About the only other arrow psychiatry had left in its quiver was talk therapy – a tried-and-true alternative, to be sure, but study after study had shown that psychologists and social workers could perform this service just as well as psychiatrists.

Psychiatry’s very reason for being was called into question. Newly minted MD’s were staying away from that specialty in droves, while salaries for psychiatrists were lower than those in any other branch of medicine.

Psychiatry was at a crossroads. Practicing psychiatrists could have directed their efforts towards talk therapy, and accepted the salaries of psychologists or social workers, none of which, last time I checked, were living in cardboard boxes. They could have begun quietly phasing psychiatry as a distinct profession out of existence.

Of course that’s not what they did. Instead, they embarked on a vigorous rebranding campaign, to cloak themselves in the mantle of scientific objectivity under the guise of “biological psychiatry.”

Author Robert Whitaker identifies five key players in this rebranding campaign. The drug companies supplied the financial muscle. The psychiatrists themselves lent the enterprise the appearance of scientific objectivity. The National Institute of Mental Health (NIMH) provided the official government stamp of approval. The National Alliance for the Mentally Ill (NAMI) put a human face on the problem.

The fifth player in this unholy alliance was the Church of Scientology.

Yeah, I know what you’re thinking: Aren’t psychiatry and Scientology enemies? Indeed they are. But to paraphrase a time-honored and well-worn saying: With enemies like these, who needs friends?

It’s hard to imagine an outfit more simultaneously clownish and sinister than the Church of Scientology. When the Scientologists decided to attack psychiatry, they provided the pharmaceutical industry with the perfect straw man to distract attention from what they were doing.

The rebranding campaign worked. The public were told the lie that these drugs correct a chemical imbalance in the brain, just like insulin for diabetes. The “like insulin for diabetes” mantra was repeated so many times that for most people it became an unquestioned fact. Meanwhile, psychiatrists like Peter Kramer were publicly wringing their hands over whether they had the moral right to give us these wonderful pills which, we were told, had the power to make us “better than well.”

It mattered not that science has never explicated the “biological basis” of any mental disorder. It mattered not that the data showed these drugs to be barely distinguishable from a placebo, and that was in short-term studies bought and paid for by the drug companies in which they did everything they could to stack the deck against the placebo and in favor of their own products. It mattered not how grim was the long-term prognosis for patients kept on psychotropic medication. It mattered not how many heart-rending accounts piled up of people who were harmed or killed by these drugs. Anyone who questioned the value of these nostrums was smeared as being a stooge of L. Ron Hubbard, and that was that. “Biological psychiatry” carried the day.

The depredations of our Psychiatric-Industrial Complex continue unabated. Due to skyrocketing rates of mental illness, 850 adults and 250 children are added to the disability rolls every day. Children as young as two are being diagnosed with “depression” and being put on powerful brain-altering drugs. No one knows what the long-term outcome for them will be. This is a gigantic, uncontrolled experiment.

This is not about curing mental illness. This is about manufacturing mental illness, on an industrial scale.

Whitaker winds up with a discussion of the money trail. Sixty percent of mental health care costs in the United States are borne by the taxpayers, and this money is used to grease the skids at every step in the process, from the pharmaceutical company shareholders; to the nationally prominent academic psychiatrists recruited to serve as “Key Opinion Leaders;” to their less-distinguished colleagues who tout Big Pharma’s wares on the local level; to the community psychiatrists who are plied by drug company reps with free dinners and gifts; to the National Alliance for the Mentally Ill, a “patient advocacy organization” financed in a large measure by Big Pharma.

Whitaker provides us with a glimpse into the working of the mind of one of these Key Opinion Leaders, Doctor Joseph Biederman of Massachusetts General Hospital and Harvard Medical School. (Once while being deposed in a lawsuit, Biederman describes his academic rank as “Full Professor;” when the deposing lawyer asked what was above that, he replied, “God.”) Biederman masterminded the creation at Mass General of the “Johnson & Johnson Center for Pediatric Psychopathology,” which he described as a “strategic collaboration” that would “move forward the commercial goals of J & J.” The purpose of the center was to develop screening tests for juvenile bipolar disorder (a diagnostic category largely invented by Biederman) and “alert physicians to the existence of a large group of children who might benefit from treatment with Risperidal,” an antipsychotic drug marketed by J & J.  

Biederman averred that “[P]ediatric mania evolves into what some have called mixed or atypical mania in adulthood, [which] will provide further support for chronic use of Risperidal from childhood through adulthood.” Whitaker noted that this account accurately describes children who are diagnosed with bipolar disorder and put on psychotropic medication. There is no evidence for the existence of such a condition in unmedicated children.

J & J forked out $2 million for the establishment of the Center for Pediatric Psychopathology. During the period 2000 through 2007, for various services rendered, Biederman collected from J & J and other drug companies a cool $1.6 million.

This is the second of two parts

_{Photo via Wikimedia Commons}