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.

Cracked: Why Psychiatry is Doing More Harm Than Good


James Davies - 2013
    That’s what psychiatry tells us. But many – even most – will not actually be mentally ill. Thanks to pseudo-science and corporate greed, psychiatry is letting us down. Why is psychiatry such big business? Why are so many psychiatric drugs prescribed – 47 million antidepressant prescriptions in the UK alone each year – and why, without solid scientific justification, has the number of mental disorders risen from 106 in 1952 to 374 today? The everyday sufferings and setbacks of life are now ‘medicalised’ into illnesses that require treatment – usually with highly profitable drugs. Psychological therapist James Davies uses his insider knowledge to illustrate for a general readership how psychiatry has put riches and medical status above patients’ well-being.The charge sheet is damning: negative drug trials routinely buried; antidepressants that work no better than placebos; research regularly manipulated to produce positive results; doctors, seduced by huge pharmaceutical rewards, creating more disorders and prescribing more pills; and ethical, scientific and treatment flaws unscrupulously concealed by mass-marketing. Cracked reveals for the first time the true human cost of an industry that, in the name of helping others, has actually been helping itself.

The Center Cannot Hold: My Journey Through Madness


Elyn R. Saks - 2007
    She has managed to achieve this in spite of being diagnosed as schizophrenic and given a "grave" prognosis—and suffering the effects of her illness throughout her life.Saks was only eight, and living an otherwise idyllic childhood in sunny 1960s Miami, when her first symptoms appeared in the form of obsessions and night terrors. But it was not until she reached Oxford University as a Marshall Scholar that her first full-blown episode, complete with voices in her head and terrifying suicidal fantasies, forced her into a psychiatric hospital.Saks would later attend Yale Law School where one night, during her first term, she had a breakdown that left her singing on the roof of the law school library at midnight. She was taken to the emergency room, force-fed antipsychotic medication, and tied hand-and-foot to the cold metal of a hospital bed. She spent the next five months in a psychiatric ward.So began Saks's long war with her own internal demons and the equally powerful forces of stigma. Today she is a chaired professor of law who researches and writes about the rights of the mentally ill. She is married to a wonderful man.In The Center Cannot Hold, Elyn Saks discusses frankly and movingly the paranoia, the inability to tell imaginary fears from real ones, and the voices in her head insisting she do terrible things, as well as the many obstacles she overcame to become the woman she is today. It is destined to become a classic in the genre.

Let Them Eat Prozac: The Unhealthy Relationship Between the Pharmaceutical Industry and Depression


David Healy - 2003
    Paxil. Zoloft. Turn on your television and you are likely to see a commercial for one of the many selective serotonin reuptake inhibitors (SSRIs) on the market. We hear a lot about them, but do we really understand how these drugs work and what risks are involved for anyone who uses them?Let Them Eat Prozac explores the history of SSRIs from their early development to their latest marketing campaigns and the controversies that surround them. Initially, they seemed like wonder drugs for those with mild to moderate depression patients take just one daily dose, and unlike the tranquilizers that were popular in the 1960s, they supposedly did not lead to addiction. When Prozac was released in the late 1980s, David Healy was among the psychiatrists who prescribed it. But he soon observed that some of these patients became agitated and even attempted suicide. Studies were soon published, citing numerous cases in which patients became anxious and reported increased suicidal thoughts while taking Prozac. Could the new wonder drug actually be making patients worse?Healy draws on his own research and expertise to demonstrate the potential hazards associated with these drugs. He intersperses case histories with insider accounts of the research leading to the development and approval of SSRIs as a treatment for depression. Let Them Eat Prozac clearly demonstrates that the problems go much deeper than a disturbing side-effect of a particular drug. Current FDA regulations encourage drug companies to patent a specific compound and market it effectively to a large population on the basis of minimal effectiveness in a handful of trials.The pharmaceutical industry would like us to believe that SSRIs can safely treat depression, anxiety, and a host of other mental problems. But as Let Them Eat Prozac reveals, this "cure" may be worse than the disease.

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.

Nobody's Normal: How Culture Created the Stigma of Mental Illness


Roy Richard Grinker - 2021
    In Nobody’s Normal, anthropologist Roy Richard Grinker chronicles the progress and setbacks in the struggle against mental-illness stigma—from the eighteenth century, through America’s major wars, and into today’s high-tech economy.Grinker infuses the book with the personal history of his family’s four generations of involvement in psychiatry, including his grandfather’s analysis with Sigmund Freud, his own daughter’s experience with autism, and culminating in his research on neurodiversity. Drawing on cutting-edge science, historical archives, and cross-cultural research in Africa and Asia, Nobody’s Normal explains how we are transforming mental illness and offers a path to end the shadow of stigma. The preeminent historian of medicine, Sander Gilman, calls Nobody’s Normal “the most important work on stigma in more than half a century.”

Driven to Distraction: Recognizing and Coping with Attention Deficit Disorder from Childhood Through Adulthood


Edward M. Hallowell - 1992
    Discusses the causes, symptoms, and treatment of attention-deficit Disorder (ADD).

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."

Unbroken Brain: A Revolutionary New Way of Understanding Addiction


Maia Szalavitz - 2016
    But despite the unprecedented attention, our understanding of addiction is trapped in unfounded 20th century ideas, addiction as a crime or as brain disease, and in equally outdated treatment.Challenging both the idea of the addict's "broken brain" and the notion of a simple "addictive personality," The New York Times Bestseller, Unbroken Brain, offers a radical and groundbreaking new perspective, arguing that addictions are learning disorders and shows how seeing the condition this way can untangle our current debates over treatment, prevention and policy. Like autistic traits, addictive behaviors fall on a spectrum -- and they can be a normal response to an extreme situation. By illustrating what addiction is, and is not, the book illustrates how timing, history, family, peers, culture and chemicals come together to create both illness and recovery- and why there is no "addictive personality" or single treatment that works for all.Combining Maia Szalavitz's personal story with a distillation of more than 25 years of science and research, Unbroken Brain provides a paradigm-shifting approach to thinking about addiction.Her writings on radical addiction therapies have been featured in The Washington Post, Vice Magazine, The Wall Street Journal, and The New York Times, in addition to multiple other publications. She has been interviewed about her book on many radio shows including Fresh Air with Terry Gross and The Brian Lehrer show.

Lost Connections: Uncovering the Real Causes of Depression - and the Unexpected Solutions


Johann Hari - 2018
    He was told—like his entire generation—that his problem was caused by a chemical imbalance in his brain. As an adult, trained in the social sciences, he began to investigate this question—and he learned that almost everything we have been told about depression and anxiety is wrong. Across the world, Hari discovered social scientists who were uncovering the real causes—and they are mostly not in our brains, but in the way we live today. Hari’s journey took him from the people living in the tunnels beneath Las Vegas, to an Amish community in Indiana, to an uprising in Berlin—all showing in vivid and dramatic detail these new insights. They lead to solutions radically different from the ones we have been offered up until now.Just as Chasing the Scream transformed the global debate about addiction, with over twenty million views for his TED talk and the animation based on it, Lost Connections will lead us to a very different debate about depression and anxiety—one that shows how, together, we can end this epidemic.

Asylums: Essays on the Social Situation of Mental Patients and Other Inmates


Erving Goffman - 1961
    It focuses on the relationship between the inmate and the institution, how the setting affects the person and how the person can deal with life on the inside.

Mind Fixers: Psychiatry's Troubled Search for the Biology of Mental Illness


Anne Harrington - 2019
    She shows how the stalling of early twentieth century efforts in this direction allowed Freudians and social scientists to insist, with some justification, that they had better ways of analyzing and fixing minds.But when the Freudians overreached, they drove psychiatry into a state of crisis that a new “biological revolution” was meant to alleviate. Harrington shows how little that biological revolution had to do with breakthroughs in science, and why the field has fallen into a state of crisis in our own time.Mind Fixers makes clear that psychiatry’s waxing and waning biological enthusiasms have been shaped not just by developments in the clinic and lab, but also by a surprising range of social factors, including immigration, warfare, grassroots activism, and assumptions about race and gender. Government programs designed to empty the state mental hospitals, acrid rivalries between different factions in the field, industry profit mongering, consumerism, and an uncritical media have all contributed to the story as well.In focusing particularly on the search for the biological roots of schizophrenia, depression, and bipolar disorder, Harrington underscores the high human stakes for the millions of people who have sought medical answers for their mental suffering. This is not just a story about doctors and scientists, but about countless ordinary people and their loved ones.A clear-eyed, evenhanded, and yet passionate tour de force, Mind Fixers recounts the past and present struggle to make mental illness a biological problem in order to lay the groundwork for creating a better future, both for those who suffer and for those whose job it is to care for them.

Awakenings


Oliver Sacks - 1973
    It recounts the life histories of those who had been victims of the 1920s encephalitis lethargica epidemic. Sacks chronicles his efforts in the late 1960s to help these patients at the Beth Abraham Hospital in the Bronx, New York.

Divided Minds: Twin Sisters and Their Journey Through Schizophrenia


Pamela Spiro Wagner - 2005
    But as the twins approached adolescence, Pamela began to succumb to schizophrenia, hearing disembodied voices and eventually suffering many breakdowns and hospitalizations.Divided Minds is a dual memoir of identical twins, one of whom faces a life sentence of schizophrenia, and the other who becomes a psychiatrist, after entering the spotlight that had for so long been focused on her sister. Told in the alternating voices of the sisters, Divided Minds is a heartbreaking account of the far reaches of madness, as well as the depths of ambivalence and love between twins. It is a true and unusually frank story of identical twins with very different identities and wildly different experiences of the world around them.

Good Reasons for Bad Feelings: Insights from the Frontier of Evolutionary Psychiatry


Randolph M. Nesse - 2019
    With his classic Why We Get Sick, Dr. Randolph Nesse helped to establish the field of evolutionary medicine. Now he returns with a book that transforms our understanding of mental disorders by exploring a fundamentally new question. Instead of asking why certain people suffer from mental illness, Nesse asks why natural selection has left us all with fragile minds.Drawing on revealing stories from his own clinical practice and insights from evolutionary biology, Nesse shows how negative emotions are useful in certain situations, yet can become overwhelming. Anxiety protects us from harm in the face of danger, but false alarms are inevitable. Low moods prevent us from wasting effort in pursuit of unreachable goals, but they often escalate into pathological depression. Other mental disorders, such as addiction and anorexia, result from the mismatch between modern environment and our ancient human past. And there are good evolutionary reasons for sexual disorders and for why genes for schizophrenia persist. Taken together, these and many more insights help to explain the pervasiveness of human suffering, and show us new paths for relieving it by understanding individuals as individuals.