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.

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.

In the Realm of Hungry Ghosts: Close Encounters with Addiction


Gabor Maté - 2007
    Diligently treating the drug addicts of Vancouver's notorious Downtown Eastside with sympathy in his heart and legislative reform in mind can't be easy. But Maté never judges. His book is a powerful call-to-arms, both for the decriminalization of drugs and for a more sympathetic and informed view of addiction. As Maté observes, "Those whom we dismiss as 'junkies' are not creatures from a different world, only men and women mired at the extreme end of a continuum on which, here or there, all of us might well locate ourselves." In the Realm of Hungry Ghosts begins by introducing us to many of Dr. Maté's most dire patients who steal, cheat, sell sex, and otherwise harm themselves for their next hit. Maté looks to the root causes of addiction, applying a clinical and psychological view to the physical manifestation and offering some enlightening answers for why people inflict such catastrophe on themselves.Finally, he takes aim at the hugely ineffectual, largely U.S.-led War on Drugs (and its worldwide followers), challenging the wisdom of fighting drugs instead of aiding the addicts, and showing how controversial measures such as safe injection sites are measurably more successful at reducing drug-related crime and the spread of disease than anything most major governments have going. It's not easy reading, but we ignore his arguments at our peril. When it comes to combating the drug trade and the ravages of addiction, society can use all the help it can get. --Kim Hughes

Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill


Robert Whitaker - 2002
    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.

American Psychosis: How the Federal Government Destroyed the Mental Illness Treatment System


E. Fuller Torrey - 2013
    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.

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.

The Myth of Mental Illness: Foundations of a Theory of Personal Conduct


Thomas Szasz - 1961
    "Bold and often brilliant.”—Science "It is no exaggeration to state that Szasz's work raises major social issues which deserve the attention of policy makers and indeed of all informed and socially conscious Americans...Quite probably he has done more than any other man to alert the American public to the potential dangers of an excessively psychiatrized society.”—Edwin M. Schur, Atlantic

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.

Night Falls Fast: Understanding Suicide


Kay Redfield Jamison - 1999
    Night Falls Fast is tragically timely: suicide has become one of the most common killers of Americans between the ages of fifteen and forty-five.An internationally acknowledged authority on depressive illnesses, Dr. Jamison has also known suicide firsthand: after years of struggling with manic-depression, she tried at age twenty-eight to kill herself. Weaving together a historical and scientific exploration of the subject with personal essays on individual suicides, she brings not only her remarkable compassion and literary skill but also all of her knowledge and research to bear on this devastating problem. This is a book that helps us to understand the suicidal mind, to recognize and come to the aid of those at risk, and to comprehend the profound effects on those left behind. It is critical reading for parents, educators, and anyone wanting to understand this tragic epidemic.

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.

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​.

The Upward Spiral: Using Neuroscience to Reverse the Course of Depression, One Small Change at a Time


Alex Korb - 2015
    Based in the latest research in neuroscience, this audiobook offers dozens of little things you can do every day to rewire your brain and create an upward spiral towards a happier, healthier life.Depression doesn't happen all at once. It starts gradually and builds momentum over time. If you go through a difficult experience, you may stop taking care of yourself. You may stop exercising and eating healthy, which will end up making you feel even worse as time goes on. You are caught in a downward spiral, but you may feel too tired, too overwhelmed, and too scared to try and pull yourself back up. The good news is that just one small step can be a step in the right direction.In The Upward Spiral, neuroscientist Alex Korb demystifies the neurological processes in the brain that cause depression and offers effective ways to get better "one little step at a time". In the book, you'll discover that there isn't "one big solution" that will solve your depression. Instead, there are dozens of small, practical things you can do to alleviate your symptoms and start healing. Some are as simple as relaxing certain muscles to reduce feelings of anxiety, while others involve making small efforts toward more positive social interactions. Small steps in the right direction can have profound effects giving you the power to literally "reshape" your brain.Like most people, you probably didn't wake up one day and find yourself completely depressed. Instead, it probably happened over time, as a series of reactions to difficult situations and negative thinking. But if you are ready to reverse the trajectory of your depression and find lasting happiness, this book will show you how.

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.

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.

Listening to Prozac


Peter D. Kramer - 1993
    But what is Prozac—a medication, or a mental steroid? A cure for depression, or a drug that changes personality? Reported to turn shy people into social butterflies and to improve work performance, memory, even dexterity, does Prozac work on character rather than illness? Are you using it "cosmetically," to make people more attractive? More energetic, more socially acceptable? And what does it tell us about the nature of character and the mutability of self?