Kennedy delivered an historic speech on mental illness and retardation. He described sweeping new programs to replace "the shabby treatment of the many millions of the mentally disabled in custodial institutions" with treatment in community mental health centers. This movement, later referred to as "deinstitutionalization," continues to impact mental health care. Though he never publicly acknowledged it, the program was a tribute to Kennedy's sister Rosemary, who was born mildly retarded and developed a schizophrenia-like illness. Terrified she'd become pregnant, Joseph Kennedy arranged for his daughter to receive a lobotomy, which was a disaster and left her severely retarded. Fifty years after Kennedy's speech, E. Fuller Torrey's book provides an inside perspective on the birth of the federal mental health program. On staff at the National Institute of Mental Health when the program was being developed and implemented, Torrey draws on his own first-hand account of the creation and launch of the program, extensive research, one-on-one interviews with people involved, and recently unearthed audiotapes of interviews with major figures involved in the legislation. As such, this book provides historical material previously unavailable to the public. Torrey examines the Kennedys' involvement in the policy, the role of major players, the responsibility of the state versus the federal government in caring for the mentally ill, the political maneuverings required to pass the legislation, and how closing institutions resulted not in better care - as was the aim - but in underfunded programs, neglect, and higher rates of community violence. Many now wonder why public mental illness services are so ineffective. At least one-third of the homeless are seriously mentally ill, jails and prisons are grossly overcrowded, largely because the seriously mentally ill constitute 20 percent of prisoners, and public facilities are overrun by untreated individuals. As Torrey argues, it is imperative to understand how we got here in order to move forward towards providing better care for the most vulnerable.

    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."

    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.

    But it was only when his own son-in the throes of a manic episode-broke into a neighbor's house that he learned what happens to mentally ill people who break a law. This is the Earley family's compelling story, a troubling look at bureaucratic apathy and the countless thousands who suffer confinement instead of care, brutal conditions instead of treatment, in the "revolving doors" between hospital and jail. With mass deinstitutionalization, large numbers of state mental patients are homeless or in jail-an experience little better than the horrors of a century ago. Earley takes us directly into that experience-and into that of a father and award-winning journalist trying to fight for a better way.

    With profound empathy and meticulous research, Shaili Jain, M.D.—a practicing psychiatrist and PTSD specialist at one of America’s top VA hospitals, trauma scientist at the National Center for PTSD, and a Stanford Professor—shines a long-overdue light on the PTSD epidemic affecting today’s fractured world.Post-Traumatic Stress Disorder goes far beyond the horrors of war and is an inescapable part of all our lives. At any given moment, more than six million Americans are suffering with PTSD. Dr. Jain’s groundbreaking work demonstrates the ways this disorder cuts to the heart of life, interfering with one’s capacity to love, create, and work—incapacity brought on by a complex interplay between biology, genetics, and environment. Beyond the struggles of individuals, PTSD has a tangible imprint on our cultures and societies around the world.Since 9/11 and the wars in Iraq and Afghanistan, there has been a huge growth in the science of PTSD, a body of evidence that continues to grow exponentially. With this new knowledge have come dramatic advances in the effective treatment of this condition. Jain draws on a decade of her own clinical innovation and research and argues for a paradigm shift in how PTSD should be approached in the new millennium. She highlights the myriads of ways PTSD care is being transformed to make it more accessible, acceptable, and available to sufferers via integrated care models, use of peer support programs, and technology. By identifying those among us who are most vulnerable to developing PTSD, cutting edge medical interventions that hold the promise of preventing the onset of PTSD are becoming more of a reality than ever before.Combining vividly recounted patient stories, interviews with some of the world’s top trauma scientists, and her professional expertise from working on the frontlines of PTSD, The Unspeakable Mind offers a textured portrait of this invisible illness that is unrivaled in scope and lays bare PTSD's roots, inner workings, and paths to healing. This book is essential reading for understanding how humans can recover from unspeakable trauma. The Unspeakable Mind stands as the definitive guide to PTSD and offers lasting hope to sufferers, their loved ones, and health care providers everywhere.

    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'

    With a muckraker's passion, Whitaker argues that modern treatments for the severely mentally ill are just old medicine in new bottles, and that we as a society are deeply deluded about their efficacy. Tracing over three centuries of "cures" for madness, Whitaker shows how medical therapies have been used to silence patients and dull their minds. He tells of the eighteenth- and nineteenth-century practices of "spinning" the insane, extracting their teeth, ovaries, and intestines, and submerging patients in freezing water. The "cures" in the 1920s and 1930s were no less barbaric as eugenic attitudes toward the mentally ill led to brain-damaging lobotomies and electroshock therapy. Perhaps Whitaker's most damning revelation, however, is his report of how drug companies in the 1980s and 1990s skewed their studies in an effort to prove the effectiveness of their products. Based on exhaustive research culled from old patient medical records, historical accounts, numerous interviews, and hundreds of government documents, Mad in America raises important questions about our obligations to the mad, what it means to be "insane," and what we value most about the human mind.

    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.

    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.

    Braided with that history is the moving story of Powers's beloved son Kevin--spirited, endearing, and gifted--who triumphed even while suffering from schizophrenia until finally he did not, and the story of his courageous surviving son Dean, who is also schizophrenic.A blend of history, biography, memoir, and current affairs ending with a consideration of where we might go from here, this is a thought-provoking look at a dreaded illness that has long been misunderstood.

    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.

    The DSM is the bible of psychiatry; the go-to place to find out who is sick and who is not. Because it will radically stretch the boundaries of what is and what is not a psychiatric illness, DSM 5 will dramatically change how lives are lived. Under DSM 5's new definitions, millions of people now considered normal will be diagnosed as mentally ill, causing unnecessary, costly, and sometimes dangerous treatments for misidentified 'patients' who don't really need them.Will the DSM 5 destroy what is considered normal?Frances argues that DSM 5 offers a radical and reckless set of proposals that will overnight turn 'normal' people into 'mental patients'. Everyday aches, pains, disappointments, stresses, and existential sufferings are being reframed as mental illnesses with such exuberance that it is getting hard for anyone to get through life without a psychiatric diagnosis. Is grief a useful, inevitable and poignant sign of a broken heart or is it Major Depressive Disorder? Are temper tantrums a normal part of childhood or a sign of mental illness? Are you nervous about an upcoming presentation or job interview or do you have Mixed Anxiety Depression? If you don't remember a face or a fact once in a while, do you have Dementia?Frances maintains we all have psychiatric symptoms from time to time, but this doesn't mean we are all flirting with mental illness. Whenever we arbitrarily add a new 'disease', we subtract from what previously was 'normal' and lose something of ourselves in the process. Not all human suffering can or should be labeled and treated away. The grief and sorrows, the stresses, the disappointments, the aches and pains, the slings and arrows, the innate and acquired inequalities, the set-backs, the stumbles, the emotional gut-shots; this is part of life and of living in a complex and not always fair society- they should not all to be explained away as psychiatric disease.

    Jails in New York, Los Angeles, and Chicago each house more people with mental illnesses than any hospital. As many as half of all people in America's jails and prisons have a psychiatric disorder. One in four fatal police shootings involves a person with such disorders.In this revelatory book, journalist Alisa Roth goes deep inside the criminal justice system to show how and why it has become a warehouse where inmates are denied proper treatment, abused, and punished in ways that make them sicker.Through intimate stories of people in the system and those trying to fix it, Roth reveals the hidden forces behind this crisis and suggests how a fairer and more humane approach might look. Insane is a galvanizing wake-up call for criminal justice reformers and anyone concerned about the plight of our most vulnerable.

    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.

    Forced to remain inside until they'd "proven" themselves sane, all eight emerged with alarming diagnoses and even more troubling stories of their treatment. Rosenhan's study broke open the field of psychiatry, closing down institutions and changing mental health diagnosis forever. But, as Cahalan's new research shows, very little in this saga is exactly as it seems. What really happened behind those closed asylum doors, and what does it mean for our understanding of mental illness today?