What is going on? Anatomy of an Epidemic challenges readers to think through that question themselves. First, Whitaker investigates what is known today about the biological causes of mental disorders. Do psychiatric medications fix “chemical imbalances” in the brain, or do they, in fact, create them? Researchers spent decades studying that question, and by the late 1980s, they had their answer. Readers will be startled—and dismayed—to discover what was reported in the scientific journals. Then comes the scientific query at the heart of this book: During the past fifty years, when investigators looked at how psychiatric drugs affected long-term outcomes, what did they find? Did they discover that the drugs help people stay well? Function better? Enjoy good physical health? Or did they find that these medications, for some paradoxical reason, increase the likelihood that people will become chronically ill, less able to function well, more prone to physical illness?  This is the first book to look at the merits of psychiatric medications through the prism of long-term results. Are long-term recovery rates higher for medicated or unmedicated schizophrenia patients? Does taking an antidepressant decrease or increase the risk that a depressed person will become disabled by the disorder? Do bipolar patients fare better today than they did forty years ago, or much worse? When the National Institute of Mental Health (NIMH) studied the long-term outcomes of children with ADHD, did they determine that stimulants provide any benefit?  By the end of this review of the outcomes literature, readers are certain to have a haunting question of their own: Why have the results from these long-term studies—all of which point to the same startling conclusion—been kept from the public?  In this compelling history, Whitaker also tells the personal stories of children and adults swept up in this epidemic. Finally, he reports on innovative programs of psychiatric care in Europe and the United States that are producing good long-term outcomes. Our nation has been hit by an epidemic of disabling mental illness, and yet, as Anatomy of an Epidemic reveals, the medical blueprints for curbing that epidemic have already been drawn up.

    This cycle is at the root of all addictions, addictions to drugs, sex, love, cigarettes, soap operas, wealth, and wisdom itself. But why should this be so? Why are we desperate for what we don't have, or can't have, often at great cost to what we do have, thereby risking our peace and contentment, our safety, and even our lives?"The answer, says Dr. Marc Lewis, lies in the structure and function of the human brain. Marc Lewis is a distinguished neuroscientist. And, for many years, he was a drug addict himself, dependent on a series of dangerous substances, from LSD to heroin. His narrative moves back and forth between the often dark, compellingly recounted story of his relationship with drugs and a revelatory analysis of what was going on in his brain. He shows how drugs speak to the brain - which is designed to seek rewards and soothe pain - in its own language. He shows in detail the neural mechanics of a variety of powerful drugs and of the onset of addiction, itself a distortion of normal perception.Dr. Lewis freed himself from addiction and ended up studying it. At the age of 30 he traded in his pharmaceutical supplies for the life of a graduate student, eventually becoming a professor of developmental psychology, and then of neuroscience - his field for the last 12 years. This is the story of his journey, seen from the inside out.

    These five core capacities are associated with biologically based core needs that are essential to our physical and emotional well-being: the needs for connection, attunement, trust, autonomy, and love-sexuality. Recognizing these needs as well as five Adaptive Survival Styles set in motion when the core needs are not met early in life, authors Laurence Heller and Aline LaPierre cut through the seeming complexity of life’s problems.   Explaining that an impaired capacity for connection to self and to others and the ensuing diminished aliveness are the hidden dimensions that underlie most psychological and many physiological problems, they introduce the NeuroAffective Relational Model® (NARM), a resource-oriented, psychodynamically informed approach that, while not ignoring a person’s past, emphasizes working in the present moment. NARM uses somatic mindfulness to re-regulate the nervous system and to resolve identity distortions—such as low self-esteem, shame, and chronic self-judgment—caused by developmental and relational trauma. Heller and LaPierre demonstrate how this therapy helps clients establish connection to the parts of self that are organized, coherent and functional, integrating the role of connection on all levels of experience as it affects a person's physiology, psychology, and capacity for relationship.From the Trade Paperback edition.

    It snuck up on me disguised as a healthy diet, a professional attitude. Being as thin as possible was a way to make the job of being an actress easier . . .” Portia de Rossi weighed only 82 pounds when she collapsed on the set of the Hollywood film in which she was playing her first leading role. This should have been the culmination of all her years of hard work—first as a child model in Australia, then as a cast member of one of the hottest shows on American television. On the outside she was thin and blond, glamorous and successful. On the inside, she was literally dying. In this searing, unflinchingly honest book, Portia de Rossi captures the complex emotional truth of what it is like when food, weight, and body image take priority over every other human impulse or action. She recounts the elaborate rituals around eating that came to dominate hours of every day, from keeping her daily calorie intake below 300 to eating precisely measured amounts of food out of specific bowls and only with certain utensils. When this wasn’t enough, she resorted to purging and compulsive physical exercise, driving her body and spirit to the breaking point. Even as she rose to fame as a cast member of the hit television shows Ally McBeal and Arrested Development, Portia alternately starved herself and binged, all the while terrified that the truth of her sexuality would be exposed in the tabloids. She reveals the heartache and fear that accompany a life lived in the closet, a sense of isolation that was only magnified by her unrelenting desire to be ever thinner. With the storytelling skills of a great novelist and the eye for detail of a poet, Portia makes transparent as never before the behaviors and emotions of someone living with an eating disorder. From her lowest point, Portia began the painful climb back to a life of health and honesty, falling in love with and eventually marrying Ellen DeGeneres, and emerging as an outspoken and articulate advocate for gay rights and women’s health issues. In this remarkable and beautifully written work, Portia shines a bright light on a dark subject. A crucial book for all those who might sometimes feel at war with themselves or their bodies, Unbearable Lightness is a story that inspires hope and nourishes the spirit.

    She recounts the travails of growing up in a large, affluent family where there was a paucity of love and of basics such as food and clothing despite the presence of a chauffeur and a cook. She goes on to recount her early hospitalization for depression in poignant detail, as well as her complex relationship with her mercurial, withholding mother.Along the way Merkin also discusses her early, redemptive love of reading and gradual emergence as a writer. She eventually marries, has a child, and suffers severe postpartum depression, for which she is again hospitalized. Merkin also discusses her visits to various therapists and psychopharmocologists, which enables her to probe the causes of depression and its various treatments. The book ends in the present, where the writer has learned how to navigate her depression, if not “cure” it, after a third hospitalization in the wake of her mother’s death.

    Before Nic became addicted to crystal meth, he was a charming boy, joyous and funny, a varsity athlete and honor student adored by his two younger siblings. After meth, he was a trembling wraith who lied, stole, and lived on the streets. David Sheff traces the first warning signs: the denial, the three a.m. phone calls—is it Nic? the police? the hospital? His preoccupation with Nic became an addiction in itself. But as a journalist, he instinctively researched every treatment that might save his son. And he refused to give up on Nic.

    Updated information is included about the associated features, culture, age & gender features, prevalence, course & familial pattern of mental disorders. The DSM-IV-TR(R) brings this essential diagnostic tool to-date, to promote effective diagnosis, treatment & quality of care. One can get all the essential diagnostic information from the DSM-IV(R) along with important updates not in the '94 edition. Benefit from new research into Schizophrenia, Asperger's Disorder & other conditions. Utilize additional information about the epidemiology & other facets of DSM conditions. Update ICD-9-CM codes implemented since 1994 including Conduct Disorder, Dementia, Somatoform Disorders.Use of the manual DSM-IV-TR classification Multiaxial assessment Disorders usually 1st diagnosed in infancy, childhood or adolescenceDelirium, dementia & amnestic & other cognitive disordersMental disorders due to a general medical condition Substance-related disorders Schizophrenia & other psychotic disordersMood disorders Anxiety disordersSomatoform disordersFactitious disordersDissociative disordersSexual & gender identity disordersEating disorders Sleep disorders Impulse-control disorders not elsewhere classifiedAdjustment disordersPersonality disordersOther conditions that may be a focus of clinical attentionAdditional codes Appendix A: Decision trees for differential diagnosis Appendix B: Criteria sets & axes provided for further study Appendix C: Glossary of technical terms Appendix D: Highlights of changes in DSM-IV text revisionAppendix E: Alphabetical listing of DSM-IV-TR diagnoses & codesAppendix F: Numerical listing of DSM-IV-TR diagnoses & codesAppendix G: ICD-9-CM codes for selected general medical conditions & medication-induced disordersAppendix H: DSM-IV classification with ICD-10 codesAppendix I: Outline for cultural formulation & glossary of culture-bound syndromesAppendix J: DSM-IV contributorsAppendix K: DSM-IV text revision advisers

    Why then was she driving through Chicago fantasizing about her own death? Why was she envisioning putting an end to the isolation and sadness that still plagued her in spite of her achievements?Enter Dr. Rosen, a therapist who calmly assures her that if she joins one of his psychotherapy groups, he can transform her life. All she has to do is show up and be honest. About everything—her eating habits, childhood, sexual history, etc. Christie is skeptical, insisting that that she is defective, beyond cure. But Dr. Rosen issues a nine-word prescription that will change everything: “You don’t need a cure, you need a witness.So begins her entry into the strange, terrifying, and ultimately life-changing world of group therapy. Christie is initially put off by Dr. Rosen’s outlandish directives, but as her defenses break down and she comes to trust Dr. Rosen and to depend on the sessions and the prescribed nightly phone calls with various group members, she begins to understand what it means to connect.Group is a deliciously addictive read, and with Christie as our guide—skeptical of her own capacity for connection and intimacy, but hopeful in spite of herself—we are given a front row seat to the daring, exhilarating, painful, and hilarious journey that is group therapy—an under-explored process that breaks you down, and then reassembles you so that all the pieces finally fit.

    Death and illness touch us all, but even the everyday sufferings of loneliness and fear are traumatic. In The Trauma of Everyday Life renowned psychiatrist and author of Thoughts Without a Thinker Mark Epstein uncovers the transformational potential of trauma, revealing how it can be used for the mind’s own development.Western psychology teaches that if we understand the cause of trauma, we might move past it while many drawn to Eastern practices see meditation as a means of rising above, or distancing themselves from, their most difficult emotions. Both, Epstein argues, fail to recognize that trauma is an indivisible part of life and can be used as a lever for growth and an ever deeper understanding of change. When we regard trauma with this perspective, understanding that suffering is universal and without logic, our pain connects us to the world on a more fundamental level. The way out of pain is through it. Epstein’s discovery begins in his analysis of the life of Buddha, looking to how the death of his mother informed his path and teachings. The Buddha’s spiritual journey can be read as an expression of primitive agony grounded in childhood trauma. Yet the Buddha’s story is only one of many in The Trauma of Everyday Life. Here, Epstein looks to his own experience, that of his patients, and of the many fellow sojourners and teachers he encounters as a psychiatrist and Buddhist. They are alike only in that they share in trauma, large and small, as all of us do. Epstein finds throughout that trauma, if it doesn’t destroy us, wakes us up to both our minds’ own capacity and to the suffering of others. It makes us more human, caring, and wise. It can be our greatest teacher, our freedom itself, and it is available to all of us.

    It is the story of Dave Pelzer, who was brutally beaten and starved by his emotionally unstable, alcoholic mother: a mother who played tortuous, unpredictable games—games that left him nearly dead. He had to learn how to play his mother's games in order to survive because she no longer considered him a son, but a slave; and no longer a boy, but an "it." Dave's bed was an old army cot in the basement, and his clothes were torn and raunchy. When his mother allowed him the luxury of food, it was nothing more than spoiled scraps that even the dogs refused to eat. The outside world knew nothing of his living nightmare. He had nothing or no one to turn to, but his dreams kept him alive—dreams of someone taking care of him, loving him and calling him their son.

    Despite her flapping arms and shaking legs, she continued to speak clearly and was able to finish her speech. It was as if she had suddenly become two people: a calm orator and a shuddering wreck. Then the seizures happened again and again. The Shaking Woman tracks Hustvedt’s search for a diagnosis, one that takes her inside the thought processes of several scientific disciplines, each one of which offers a distinct perspective on her paroxysms but no ready solution. In the process, she finds herself entangled in fundamental questions: What is the relationship between brain and mind? How do we remember? What is the self?During her investigations, Hustvedt joins a discussion group in which neurologists, psychiatrists, psychoanalysts, and brain scientists trade ideas to develop a new field: neuropsychoanalysis. She volunteers as a writing teacher for psychiatric in-patients at the Payne Whitney clinic in New York City and unearths precedents in medical history that illuminate the origins of and shifts in our theories about the mind-body problem. In The Shaking Woman, Hustvedt synthesizes her experience and research into a compelling mystery: Who is the shaking woman? In the end, the story she tells becomes, in the words of George Makari, author of Revolution in Mind, “a brilliant illumination for us all.”

    Her journey there began when, overwhelmed by anxiety as she completed her doctoral studies in London, England, she found relief by dosing herself with alcohol and tranquillizers. She then embarked on what would turn out to be a decades- long psychoanalysis.The analysis dredged up acutely painful memories of an unhappy and confusing childhood back in Saskatoon. As Taylor struggled to cope with these, she would twice be re-admitted to Friern. She took refuge in day-care institutions and a psychiatric hostel, all the while continuing her therapy, which eventually put her on the road to recovery.This searingly honest, beautifully written memoir is the narrative of the author’s madness years, set inside the wider story of our treatment of psychiatric illness: from the great age of asylums to the current era of community care, ‘Big Pharma’, and quick fixes. It is a meditation on her own experience as well as that of millions of others – both in Europe and in North America – who have suffered, are suffering, and will suffer from mental illness.

    But behind her seemingly flawless façade lay a dangerous secret—for the better part of her life Cheney had been battling debilitating bipolar disorder and concealing a pharmacy's worth of prescriptions meant to stabilize her moods and make her "normal."In bursts of prose that mirror the devastating highs and extreme lows of her illness, Cheney describes her roller-coaster life with shocking honesty—from glamorous parties to a night in jail; from flying fourteen kites off the edge of a cliff in a thunderstorm to crying beneath her office desk; from electroshock therapy to a suicide attempt fueled by tequila and prescription painkillers.With Manic, Cheney gives voice to the unarticulated madness she endured. The clinical terms used to describe her illness were so inadequate that she chose to focus instead on her own experience, in her words, "on what bipolar disorder felt like inside my own body." Here the events unfold episodically, from mood to mood, the way she lived and remembers life. In this way the reader is able to viscerally experience the incredible speeding highs of mania and the crushing blows of depression, just as Cheney did. Manic does not simply explain bipolar disorder—it takes us in its grasp and does not let go.In the tradition of Darkness Visible and An Unquiet Mind, Manic is Girl, Interrupted with the girl all grown up. This harrowing yet hopeful book is more than just a searing insider's account of what it's really like to live with bipolar disorder. It is a testament to the sharp beauty of a life lived in extremes.

    But is it possible America's most troubling impact on the globalizing world has yet to be accounted for? In "Crazy Like Us," Ethan Watters reveals that the most devastating consequence of the spread of American culture has not been our golden arches or our bomb craters but our bulldozing of the human psyche itself: We are in the process of homogenizing the way the world goes mad. America has been the world leader in generating new mental health treatments and modern theories of the human psyche. We export our psychopharmaceuticals packaged with the certainty that our biomedical knowledge will relieve the suffering and stigma of mental illness. We categorize disorders, thereby defining mental illness and health, and then parade these seemingly scientific certainties in front of the world. The blowback from these efforts is just now coming to light: It turns out that we have not only been changing the way the world talks about and treats mental illness -- we have been changing the mental illnesses themselves.For millennia, local beliefs in different cultures have shaped the experience of mental illness into endless varieties." Crazy Like Us" documents how American interventions have discounted and worked to change those indigenous beliefs, often at a dizzying rate. Over the last decades, mental illnesses popularized in America have been spreading across the globe with the speed of contagious diseases. Watters travels from China to Tanzania to bring home the unsettling conclusion that the virus is us: As we introduce Americanized ways of treating mental illnesses, we are in fact spreading the diseases.In post-tsunami Sri Lanka, Watters reports on the Western trauma counselors who, in their rush to help, inadvertently trampled local expressions of grief, suffering, and healing. In Hong Kong, he retraces the last steps of the teenager whose death sparked an epidemic of the American version of anorexia nervosa. Watters reveals the truth about a multi-million-dollar campaign by one of the world's biggest drug companies to change the Japanese experience of depression -- literally marketing the disease along with the drug.But this book is not just about the damage we've caused in faraway places. Looking at our impact on the psyches of people in other cultures is a gut check, a way of forcing ourselves to take a fresh look at our own beliefs about mental health and healing. When we examine our assumptions from a farther shore, we begin to understand how our own culture constantly shapes and sometimes creates the mental illnesses of our time. By setting aside our role as the world's therapist, we may come to accept that we have as much to learn from other cultures' beliefs about the mind as we have to teach.

    We may feel tired, cynical, numb, or like we can never do enough. These, and other symptoms, affect us individually and collectively, sapping the energy and effectiveness we so desperately need if we are to benefit humankind, other animals, and the planet itself. Through Trauma Stewardship, we are called to meet these challenges in an intentional way--not by becoming overwhelmed but by developing a quality of mindful presence. Joining the wisdom of ancient cultural traditions with modern psychological research, Lipsky offers a variety of simple and profound practices that will allow us to remake ourselves--and ultimately the world.