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.

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.

The Sociopath Next Door


Martha Stout - 2005
    He’s a sociopath. And your boss, teacher, and colleague? They may be sociopaths too.We are accustomed to think of sociopaths as violent criminals, but in The Sociopath Next Door, Harvard psychologist Martha Stout reveals that a shocking 4 percent of ordinary people—one in twenty-five—has an often undetected mental disorder, the chief symptom of which is that that person possesses no conscience. He or she has no ability whatsoever to feel shame, guilt, or remorse. One in twenty-five everyday Americans, therefore, is secretly a sociopath. They could be your colleague, your neighbor, even family. And they can do literally anything at all and feel absolutely no guilt. How do we recognize the remorseless? One of their chief characteristics is a kind of glow or charisma that makes sociopaths more charming or interesting than the other people around them. They’re more spontaneous, more intense, more complex, or even sexier than everyone else, making them tricky to identify and leaving us easily seduced. Fundamentally, sociopaths are different because they cannot love. Sociopaths learn early on to show sham emotion, but underneath they are indifferent to others’ suffering. They live to dominate and thrill to win. The fact is, we all almost certainly know at least one or more sociopaths already. Part of the urgency in reading The Sociopath Next Door is the moment when we suddenly recognize that someone we know—someone we worked for, or were involved with, or voted for—is a sociopath. But what do we do with that knowledge? To arm us against the sociopath, Dr. Stout teaches us to question authority, suspect flattery, and beware the pity play. Above all, she writes, when a sociopath is beckoning, do not join the game. It is the ruthless versus the rest of us, and The Sociopath Next Door will show you how to recognize and defeat the devil you know.

Chasing the Scream: The First and Last Days of the War on Drugs


Johann Hari - 2015
    On the eve of this centenary, journalist Johann Hari set off on an epic three-year, thirty-thousand-mile journey into the war on drugs. What he found is that more and more people all over the world have begun to recognize three startling truths: Drugs are not what we think they are. Addiction is not what we think it is. And the drug war has very different motives to the ones we have seen on our TV screens for so long.In Chasing the Scream, Hari reveals his discoveries entirely through the stories of people across the world whose lives have been transformed by this war. They range from a transsexual crack dealer in Brooklyn searching for her mother, to a teenage hit-man in Mexico searching for a way out. It begins with Hari's discovery that at the birth of the drug war, Billie Holiday was stalked and killed by the man who launched this crusade--and it ends with the story of a brave doctor who has led his country to decriminalize every drug, from cannabis to crack, with remarkable results.Chasing the Scream lays bare what we really have been chasing in our century of drug war--in our hunger for drugs, and in our attempt to destroy them. This book will challenge and change how you think about one of the most controversial--and consequential--questions of our time.

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.

The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President


Bandy X. LeePhilip G. Zimbardo - 2017
    The public has thus been left to wonder whether he is mad, bad, or both.In THE DANGEROUS CASE OF DONALD TRUMP, twenty-seven psychiatrists, psychologists, and other mental health experts argue that, in Mr. Trump’s case, their moral and civic “duty to warn” America supersedes professional neutrality. They then explore Trump’s symptoms and potentially relevant diagnoses to find a complex, if also dangerously mad, man.Philip Zimbardo and Rosemary Sword, for instance, explain Trump’s impulsivity in terms of “unbridled and extreme present hedonism.” Craig Malkin writes on pathological narcissism and politics as a lethal mix. Gail Sheehy, on a lack of trust that exceeds paranoia. Lance Dodes, on sociopathy. Robert Jay Lifton, on the “malignant normality” that can set in everyday life if psychiatrists do not speak up.His madness is catching, too. From the trauma people have experienced under the Trump administration to the cult-like characteristics of his followers, he has created unprecedented mental health consequences across our nation and beyond.It’s not all in our heads. It’s in his."There will not be a book published this fall more urgent, important, or controversial than The Dangerous Case of Donald Trump...profound, illuminating and discomforting" —Bill Moyers

Hidden Valley Road: Inside the Mind of an American Family


Robert Kolker - 2020
    After World War II, Don's work with the Air Force brought them to Colorado, where their twelve children perfectly spanned the baby boom: the oldest born in 1945, the youngest in 1965. In those years, there was an established script for a family like the Galvins—aspiration, hard work, upward mobility, domestic harmony—and they worked hard to play their parts. But behind the scenes was a different story: psychological breakdown, sudden shocking violence, hidden abuse. By the mid-1970s, six of the ten Galvin boys, one after another, were diagnosed as schizophrenic. How could all this happen to one family?What took place inside the house on Hidden Valley Road was so extraordinary that the Galvins became one of the first families to be studied by the National Institute of Mental Health. Their story offers a shadow history of the science of schizophrenia, from the era of institutionalization, lobotomy, and the schizophrenogenic mother to the search for genetic markers for the disease, always amid profound disagreements about the nature of the illness itself. And unbeknownst to the Galvins, samples of their DNA informed decades of genetic research that continues today, offering paths to treatment, prediction, and even eradication of the disease for future generations.With clarity and compassion, bestselling and award-winning author Robert Kolker uncovers one family's unforgettable legacy of suffering, love, and hope.

Madhouse: A Tragic Tale of Megalomania and Modern Medicine


Andrew Scull - 2005
    It shows how a leading American psychiatrist of the early twentieth century came to believe that mental illnesses were the product of chronic infections that poisoned the brain. Convinced that he had uncovered the single source of psychosis, Henry Cotton, superintendent of the Trenton State Hospital, New Jersey, launched a ruthless campaign to “eliminate the perils of pus infection.” Teeth were pulled, tonsils excised, and stomachs, spleens, colons, and uteruses were all sacrificed in the assault on “focal sepsis.”Many patients did not survive Cotton’s surgeries; thousands more were left mangled and maimed. Cotton’s work was controversial, yet none of his colleagues questioned his experimental practices. Subsequent historians and psychiatrists too have ignored the events that cast doubt on their favorite narratives of scientific and humanitarian progress.In a remarkable feat of historical detective work, Andrew Scull exposes the full, frightening story of madness among the mad-doctors. Drawing on a wealth of documents and interviews, he reconstructs in vivid detail a nightmarish, cautionary chapter in modern psychiatry when professionals failed to police themselves.

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'

The Prison Doctor


Amanda Brown - 2019
    From miraculous pregnancies to dirty protests, and from violent attacks on prisoners to heartbreaking acts of self-harm, she has witnessed it all. In this memoir, Amanda reveals the stories, the patients and the cases that have shaped a career helping those most of us would rather forget.

The Deepest Well: Healing the Long-Term Effects of Childhood Adversity


Nadine Burke Harris - 2018
    Nadine Burke Harris was already known as a crusading physician delivering targeted care to vulnerable children. But it was Diego — a boy who had stopped growing after a sexual assault — who galvanized her journey to uncover the connections between toxic stress and lifelong illnesses.The news of Burke Harris’s research is just how deeply our bodies can be imprinted by ACEs—adverse childhood experiences like abuse, neglect, parental addiction, mental illness, and divorce. Childhood adversity changes our biological systems, and lasts a lifetime.  For anyone who has faced a difficult childhood, or who cares about the millions of children who do, the scientific insight and innovative, acclaimed health interventions in The Deepest Well represent hope for preventing lifelong illness for those we love and for generations to come​.

Girl in the Dark


Anna Lyndsey - 2015
    She was ambitious and worked hard; she had just bought an apartment; she was falling in love. But then she started to develop worrying symptoms: her face felt like it was burning whenever she was in front of the computer. Soon this progressed to an intolerance of fluorescent light, then of sunlight itself. The reaction soon spread to her entire body. Now, when her symptoms are at their worst, she must spend months on end in a blacked-out room, losing herself in audio books and elaborate word games in an attempt to ward off despair. It was during this period she began to write this book.

Bellevue: Three Centuries of Medicine and Mayhem at America's Most Storied Hospital


David M. Oshinsky - 2016
    From its origins in 1738 as an almshouse and pesthouse, Bellevue today is a revered public hospital bringing first-class care to anyone in need. With its diverse, ailing, and unprotesting patient population, the hospital was a natural laboratory for the nation's first clinical research. It treated tens of thousands of Civil War soldiers, launched the first civilian ambulance corps and the first nursing school for women, pioneered medical photography and psychiatric treatment, and spurred New York City to establish the country's first official Board of Health. As medical technology advanced, "voluntary" hospitals began to seek out patients willing to pay for their care. For charity cases, it was left to Bellevue to fill the void. The latter decades of the twentieth century brought rampant crime, drug addiction, and homelessness to the nation's struggling cities problems that called a public hospital's very survival into question. It took the AIDS crisis to cement Bellevue's enduring place as New York's ultimate safety net, the iconic hospital of last resort.

Administrations of Lunacy: A Story of Racism and Psychiatry at the Milledgeville Asylum


Mab Segrest - 2020
    After more than a decade of research, the celebrated scholar and activist Mab Segrest locates the deep historical roots of this startling fact, turning her sights on a long-forgotten cauldron of racial ideology: the state mental asylum system in which psychiatry was born and whose influences extend into our troubled present.In December 1841, the Georgia State Lunatic, Idiot, and Epileptic Asylum was founded. A hundred years later, it had become the largest insane asylum in the world with over ten thousand patients. Administrations of Lunacy tells the story of this iconic and infamous southern institution, a history that was all but erased from popular memory and within the psychiatric profession.Through riveting accounts of historical characters, Segrest reveals how modern psychiatric practice was forged in the traumas of slavery, the Civil War, Reconstruction, and Jim Crow. Deftly connecting this history to the modern era, Segrest then shows how a single asylum helped set the stage for the eugenics theories of the twentieth century and the persistent racial ideologies of our own times. She also traces the connections to today’s dissident psychiatric practices that offer sanity and create justice.A landmark of scholarship, Administrations of Lunacy restores a vital thread between past and present, revealing the tangled racial roots of psychiatry in America.

Brain on Fire: My Month of Madness


Susannah Cahalan - 2012
    Days earlier, she had been on the threshold of a new, adult life: at the beginning of her first serious relationship and a promising career at a major New York newspaper. Now she was labeled violent, psychotic, a flight risk. What happened?In a swift and breathtaking narrative, Cahalan tells the astonishing true story of her descent into madness, her family’s inspiring faith in her, and the lifesaving diagnosis that nearly didn’t happen.