Sedated: How Modern Capitalism Created our Mental Health Crisis


James Davies - 2021
    This is an increase of over 500% since 1980 and the numbers continue to grow. Yet, despite this prescription epidemic, levels of mental illness of all types have actually increased in number and severity.Using a wealth of studies, interviews with experts, and detailed analysis, Dr James Davies argues that this is because we have fundamentally mischaracterised the problem. Rather than viewing most mental distress as an understandable reaction to wider societal problems, we have embraced a medical model which situates the problem solely within the sufferer and their brain.Urgent and persuasive, Sedated systematically examines why this individualistic view of mental illness has been promoted by successive governments and big business – and why it is so misplaced and dangerous.

Falling Into the Fire: A Psychiatrist's Encounters with the Mind in Crisis


Christine Montross - 2013
    A new mother is admitted with incessant visions of harming her child. A recent graduate, dressed in a tunic and declaring that love emanates from everything around him, is brought to A&E by his alarmed girlfriend. These are among the patients new physician Christine Montross meets during rounds at her hospital’s locked inpatient ward – and who we meet as she struggles to understand the mysteries of the mind, most especially when the tools of modern medicine are failing us. Beautifully written and deeply felt, Falling into the Fire is an intimate portrait of psychiatry and a moving reminder, in the words of the New York Times, of 'our fragile, shared humanity'

Unhinged: The Trouble with Psychiatry—A Doctor's Revelations about a Profession in Crisis


Daniel J. Carlat - 2010
    As he did in his hard-hitting and widely read New York Times Magazine article "Dr. Drug Rep," and as he continues to do in his popular watchdog newsletter, The Carlat Psychiatry Report, he writes with bracing honesty about how psychiatry has so largely forsaken the practice of talk therapy for the seductive—and more lucrative—practice of simply prescribing drugs, with a host of deeply troubling consequences. Psychiatrists have settled for treating symptoms rather than causes, embracing the apparent medical rigor of DSM diagnoses and prescription in place of learning the more challenging craft of therapeutic counseling, gaining only limited understanding of their patients’ lives. Talk therapy takes time, whereas the fifteen-minute "med check" allows for more patients and more insurance company reimbursement. Yet DSM diagnoses, he shows, are premised on a good deal less science than we would think. Writing from an insider’s perspective, with refreshing forthrightness about his own daily struggles as a practitioner, Dr. Carlat shares a wealth of stories from his own practice and those of others that demonstrate the glaring shortcomings of the standard fifteen-minute patient visit. He also reveals the dangers of rampant diagnoses of bipolar disorder, ADHD, and other "popular" psychiatric disorders, and exposes the risks of the cocktails of medications so many patients are put on. Especially disturbing are the terrible consequences of overprescription of drugs to children of ever younger ages. Taking us on a tour of the world of pharmaceutical marketing, he also reveals the inner workings of collusion between psychiatrists and drug companies. Concluding with a road map for exactly how the profession should be reformed, Unhinged is vital reading for all those in treatment or considering it, as well as a stirring call to action for the large community of psychiatrists themselves. As physicians and drug companies continue to work together in disquieting and harmful ways, and as diagnoses—and misdiagnoses—of mental disorders skyrocket, it’s essential that Dr. Carlat’s bold call for reform is heeded.

Rethinking Madness: Towards a Paradigm Shift in Our Understanding and Treatment of Psychosis


Paris Williams - 2012
    We've learned that full recovery is not only possible, but may actually be the most common outcome given the right conditions. Furthermore, Dr. Paris Williams' own groundbreaking research, as mentioned in the New York Times, has shown that recovery often entails a profound positive transformation. In Rethinking Madness, Dr. Williams takes the reader step by step on a highly engaging journey of discovery, exploring how the mainstream understanding of schizophrenia has become so profoundly misguided, while crafting a much more accurate and hopeful vision. As this vision unfolds, we discover a deeper sense of appreciation for the profound wisdom and resilience that lies within our beings while also coming to the unsettling realization of just how thin the boundary is between so called madness and so called sanity.

The Loss of Sadness: How Psychiatry Transformed Normal Sorrow Into Depressive Disorder


Allan V. Horwitz - 2007
    Warnings that depressive disorder is a leading cause of worldwide disability have been accompanied by a massive upsurge in the consumption of antidepressant medication, widespread screening for depression in clinics and schools, and a push to diagnose depression early, on the basis of just a few symptoms, in order to prevent more severe conditions from developing.In The Loss of Sadness, Allan V. Horwitz and Jerome C. Wakefield argue that, while depressive disorder certainly exists and can be a devastating condition warranting medical attention, the apparent epidemic in fact reflects the way the psychiatric profession has understood and reclassified normal human sadness as largely an abnormal experience. With the 1980 publication of the landmark third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), mental health professionals began diagnosing depression based on symptoms—such as depressed mood, loss of appetite, and fatigue—that lasted for at least two weeks. This system is fundamentally flawed, the authors maintain, because it fails to take into account the context in which the symptoms occur. They stress the importance of distinguishing between abnormal reactions due to internal dysfunction and normal sadness brought on by external circumstances. Under the current DSM classification system, however, this distinction is impossible to make, so the expected emotional distress caused by upsetting events—for example, the loss of a job or the end of a relationship—could lead to a mistaken diagnosis of depressive disorder. Indeed, it is this very mistake that lies at the root of the presumed epidemic of major depression in our midst.

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


Robert Whitaker - 2010
    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.

Madness Explained: Psychosis and Human Nature


Richard P. Bentall - 2003
    This groundbreaking work argues that we cannot define madness as an illness to be cured like any other; that labels such as 'schizophrenia' and 'manic depression' are meaningless, based on nineteenth-century classifications; and that experiences such as delusions and hearing voices are in fact exaggerations of the mental foibles to which we are all vulnerable.We need, Bentall argues, a radically new way of thinking about psychiatric problems - one that does not reduce madness to bain chemistry, but understands and accepts it as part of human nature.'Bentall destroys many of the foundations underlying psychiatric thinking' - Oliver James'A monumental study ... brave, well-researched and accessible' - Scotland on Sunday'Bental demystifies psychosis and restores the patient to a proper place with the rest of humankind' - Aaron T. Beck

Lithium: A Doctor, a Drug, and a Breakthrough


Walter Brown - 2019
    And yet, the 1949 discovery of lithium as a cure for bipolar disorder is perhaps one of the most important—yet largely unsung—breakthroughs of the modern era. In Lithium, Walter Brown, a practicing psychiatrist and professor at Brown, reveals two unlikely success stories: that of John Cade, the physician whose discovery would come to save an untold number of lives and launch a pharmacological revolution, and that of a miraculous metal rescued from decades of stigmatization.From insulin comas and lobotomy to incarceration to exile, Brown chronicles the troubling history of the diagnosis and (often ineffective) treatment of bipolar disorder through the centuries, before the publication of a groundbreaking research paper in 1949. Cade’s “Lithium Salts in the Treatment of Psychotic Excitement” described, for the first time, lithium’s astonishing efficacy at both treating and preventing the recurrence of manic-depressive episodes, and would eventually transform the lives of patients, pharmaceutical researchers, and practicing physicians worldwide. And yet, as Brown shows, it would be decades before lithium would overcome widespread stigmatization as a dangerous substance, and the resistance from the pharmaceutical industry, which had little incentive to promote a naturally occurring drug that could not be patented.With a vivid portrait of the story’s unlikely hero, John Cade, Brown also describes a devoted naturalist who, unlike many modern medical researchers, did not benefit from prestigious research training or big funding sources (Cade’s “laboratory” was the unused pantry of an isolated mental hospital). As Brown shows, however, these humble conditions were the secret to his historic success: Cade was free to follow his own restless curiosity, rather than answer to an external funding source. As Lithium makes tragically clear, medical research—at least in America—has transformed in such a way that serendipitous discoveries like Cade’s are unlikely to occur ever again.Recently described by the New York Times as the “Cinderella” of psychiatric drugs, lithium has saved countless of lives and billions of dollars in healthcare costs. In this revelatory biography of a drug and the man who fought for its discovery, Brown crafts a captivating picture of modern medical history—revealing just how close we came to passing over this extraordinary cure.

Crazy Like Us: The Globalization of the American Psyche


Ethan Watters - 2009
    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.

Asylum: Inside the Closed World of State Mental Hospitals


Christopher J. Payne - 2009
    From the mid-nineteenth century to the early twentieth, over 250 institutions for the insane were built throughout the United States; by 1948, they housed more than a half million patients. The blueprint for these hospitals was set by Pennsylvania hospital superintendent Thomas Story Kirkbride: a central administration building flanked symmetrically by pavilions and surrounded by lavish grounds with pastoral vistas. Kirkbride and others believed that well-designed buildings and grounds, a peaceful environment, a regimen of fresh air, and places for work, exercise, and cultural activities would heal mental illness. But in the second half of the twentieth century, after the introduction of psychotropic drugs and policy shifts toward community-based care, patient populations declined dramatically, leaving many of these beautiful, massive buildings--and the patients who lived in them--neglected and abandoned. Architect and photographer Christopher Payne spent six years documenting the decay of state mental hospitals like these, visiting seventy institutions in thirty states. Through his lens we see splendid, palatial exteriors (some designed by such prominent architects as H. H. Richardson and Samuel Sloan) and crumbling interiors--chairs stacked against walls with peeling paint in a grand hallway; brightly colored toothbrushes still hanging on a rack; stacks of suitcases, never packed for the trip home. Accompanying Payne's striking and powerful photographs is an essay by Oliver Sacks (who described his own experience working at a state mental hospital in his book Awakenings). Sacks pays tribute to Payne's photographs and to the lives once lived in these places, "where one could be both mad and safe."

Trauma and Recovery: The Aftermath of Violence - From Domestic Abuse to Political Terror


Judith Lewis Herman - 1992
    In the intervening years, Herman’s volume has changed the way we think about and treat traumatic events and trauma victims. In a new afterword, Herman chronicles the incredible response the book has elicited and explains how the issues surrounding the topic have shifted within the clinical community and the culture at large. Trauma and Recovery brings a new level of understanding to a set of problems usually considered individually. Herman draws on her own cutting-edge research in domestic violence as well as on the vast literature of combat veterans and victims of political terror, to show the parallels between private terrors such as rape and public traumas such as terrorism. The book puts individual experience in a broader political frame, arguing that psychological trauma can be understood only in a social context. Meticulously documented and frequently using the victims’ own words as well as those from classic literary works and prison diaries, Trauma and Recovery is a powerful work that will continue to profoundly impact our thinking.

How the Brain Lost Its Mind: Sex, Hysteria, and the Riddle of Mental Illness


Allan H. Ropper - 2019
    How does the mind work? Where does madness lie, in the brain or in the mind? How should it be treated?Throughout the nineteenth century, syphilis--a disease of mad poets, musicians, and artists--swept through the highest and lowest rungs of European society like a plague. Known as the Great Imitator, it could produce almost any form of mental or physical illness, and it would bring down a host of famous and infamous characters--among them Guy de Maupassant, Vincent van Gogh, the Marquis de Sade, Friedrich Nietzsche, and Al Capone. It was the first truly psychiatric disease and it filled asylums to overflowing. At the same time, an outbreak of bizarre behaviors resembling epilepsy, but with no identifiable source in the body, strained the diagnostic skills of the great neurologists. It was referred to as hysteria.For more than a century, neurosyphilis stood out as the archetype of a brain-based mental illness, fully understood but largely forgotten, and today far from gone. Hysteria, under many different names, remains unexplained and epidemic. These two conditions stand at opposite poles of the current debate over the role of the brain in mental illness. Hysteria led Freud to insert sex into psychology. Neurosyphilis led to the proliferation of mental institutions. The problem of managing the inmates led to the abuse of lobotomy and electroshock therapy, and ultimately the overuse of psychotropic drugs.Today we know that syphilitic madness was a destructive disease of the brain while hysteria and, more broadly, many varieties of mental illness reside solely in the mind. Or do they? Afflictions once written off as hysterical continue to elude explanation. Addiction, alcoholism, autism, ADHD, Tourette syndrome, depression, and sociopathy, though regarded as brain-based, have not been proven to be so.In these pages, the authors raise a host of philosophical and practical questions. What is the difference between a sick mind and a sick brain? If we understood everything about the brain, would we understand ourselves? By delving into an overlooked history, this book shows how neuroscience and brain scans alone cannot account for a robust mental life, or a deeply disturbed one.

The Noonday Demon: An Atlas of Depression


Andrew Solomon - 2000
    His contribution to our understanding not only of mental illness but also of the human condition is truly stunning.The Noonday Demon examines depression in personal, cultural, and scientific terms. Drawing on his own struggles with the illness and interviews with fellow sufferers, doctors and scientists, policymakers and politicians, drug designers and philosophers, Solomon reveals the subtle complexities and sheer agony of the disease. He confronts the challenge of defining the illness and describes the vast range of available medications, the efficacy of alternative treatments, and the impact the malady has had on various demographic populations around the world and throughout history. He also explores the thorny patch of moral and ethical questions posed by emerging biological explanations for mental illness.The depth of human experience Solomon chronicles, the range of his intelligence, and his boundless curiosity and compassion will change the reader's view of the world.

Mad, Bad, and Sad: Women and the Mind Doctors


Lisa Appignanesi - 2007
    From Mary Lamb, sister of Charles, who in the throes of a nervous breakdown turned on her mother with a kitchen knife, to Freud, Jung, and Lacan, who developed the new women-centered therapies, Lisa Appignanesi’s research traces how more and more of the inner lives and emotions of women have become a matter for medics and therapists. Here too is the story of how over the years symptoms and diagnoses have developed together to create fashions in illness and how treatments have succeeded or sometimes failed. Mad, Bad, and Sad takes us on a fascinating journey through the fragile, extraordinary human mind.

Bedlam: An Intimate Journey Into America's Mental Health Crisis


Kenneth Paul Rosenberg - 2019
    Kenneth Rosenberg trained as a psychiatrist in the late 1980s, the state mental hospitals, which had reached peak occupancy in the '50s, were being closed at an alarming rate, with many patients having nowhere to go. There has never been a more important time for this conversation, as one in five adults — 40 million Americans — experiences mental illness each year. Today, the largest mental institution in the U.S. is the LA County Jail, and the last refuge for many of the 20,000 mentally ill people living on the streets of Los Angeles is LA County Hospital. There, Dr. Rosenberg begins his chronicle of what it means to be mentally ill in America today, integrating his own moving story of how the system failed his sister, Merle, who had schizophrenia. As he says, "I have to come to see that my family's tragedy is an American tragedy. My family's shame is America's great secret."