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.

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 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.

Psychodynamic Psychotherapy: A Clinical Manual


Deborah L. Cabaniss - 2010
    This book offers a practical, step-by-step guide to the technique of psychodynamic psychotherapy, with instruction on listening, reflecting, and intervening. It will systematically take the reader from evaluation to termination using straightforward language and carefully annotated examples. Written by experienced educators and based on a tried and tested syllabus, this book provides clinically relevant and accessible aspects of theories of treatment processes. The workbook style exercises in this book allow readers to practice what they learn in each section and more "actively" learn as they read the book.This book will teach you:About psychodynamic psychotherapy and some of the ways it is hypothesized to work How to evaluate patients for psychodynamic psychotherapy, including assessment of ego function and defenses The essentials for beginning the treatment, including fostering the therapeutic alliance, setting the frame, and setting goals A systematic way for listening to patients, reflecting on what you've heard, and making choices about how and what to say How to apply the Listen/Reflect/Intervene method to the essential elements of psychodynamic technique How these techniques are used to address problems with self esteem, relationships with others, characteristic ways of adapting, and other ego functions Ways in which technique shifts over time This book presents complex concepts in a clear way that will be approachable for all readers. It is an invaluable guide for psychiatry residents, psychology students, and social work students, but also offers practicing clinicians in these areas a new way to think about psychodynamic psychotherapy. The practical approach and guided exercises make this an exceptional tool for psychotherapy educators teaching all levels of learners.This book includes a companion website: www.wiley.com/go/cabaniss/psychotherapywith the "Listening Exercise" for Chapter 16 (Learning to Listen). This is a short recording that will help the reader to learn about different ways we listen.Praise for Psychodynamic Psychotherapy: A Clinical Manual"This book has a more practical, hands-on, active learning approach than existing books on psychodynamic therapy."Bob Bornstein, co-editor of Principles of Psychotherapy; Adelphi University, NY"Well-written, concise and crystal clear for any clinician who wishes to understand and practice psychodynamic psychotherapy. Full of real-world clinical vignettes, jargon-free and useful in understanding how to assess, introduce and begin psychotherapy with a patient. Extraordinarily practical with numerous examples of how to listen to and talk with patients while retaining a sophistication about the complexity of the therapeutic interaction. My trainees have said that this book finally allowed them to understand what psychodynamic psychotherapy is all about!"--Debra Katz, Vice Chair for Education at the University of Kentucky and Director of Psychiatry Residency Training"This volume offers a comprehensive learning guide for psychodynamic psychotherapy training."--Robert Glick, Professor, Columbia University

Doctoring the Mind: Is Our Current Treatment of Mental Illness Really Any Good?


Richard P. Bentall - 2009
    It lay in biological solutions, focusing on mental illness as a problem of the brain, to be managed or improved through drugs. We entered the Prozac Age and believed we had moved far beyond the time of frontal lobotomies to an age of good and successful mental healthcare. Biological psychiatry had triumphed.Except maybe it hadn't. Starting with surprising evidence from the World Health Organization that suggests that people recover better from mental illness in a developing country than in the first world, Doctoring the Mind asks the question: how good are our mental healthcare services, really? Richard P. Bentall picks apart the science that underlies our current psychiatric practice. He puts the patient back at the heart of treatment for mental illness, making the case that a good relationship between patients and their doctors is the most important indicator of whether someone will recover.Arguing passionately for a future of mental health treatment that focuses as much on patients as individuals as on the brain itself, this is a book set to redefine our understanding of the treatment of madness in the twenty-first century.

The Intelligent Clinician's Guide to the DSM-5


Joel Paris - 2013
    Written by a celebrated professor of psychiatry, this reader-friendly book uses evidence-based critiques and new research to point out where DSM-5 is right, where it is wrong, and where the jury's still out. Along the way, The Intelligent Clinician's Guide to the DSM-5(R) sifts through the many public controversies and clinical debates surrounding the drafting of the manual and shows how they inform a modern understanding of psychiatric illness, diagnosis and treatment. This book is necessary reading for all mental health professionals as they grapple with the first major revision of the DSM to appear in over 30 years.

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

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

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.

The Emperor's New Drugs: Exploding the Antidepressant Myth


Irving Kirsch - 2009
    Professor Irving Kirsch knew this as well as anyone. But, as he discovered during his research, there is a problem with what everyone knows about antidepressant drugs. It isn't true.How did antidepressant drugs gain their reputation as a magic bullet for depression? And why has it taken so long for the story to become public? Answering these questions takes us to the point where the lines between clinical research and marketing disappear altogether.Using the Freedom of Information Act, Kirsch accessed clinical trials that were withheld, by drug companies, from the public and from the doctors who prescribe antidepressants. What he found, and what he documents here, promises to bring revolutionary change to the way our society perceives, and consumes, antidepressants.The Emperor's New Drugs exposes what we have failed to see before: depression is not caused by a chemical imbalance in the brain; antidepressants are significantly more dangerous than other forms of treatment and are only marginally more effective than placebos; and, there are other ways to combat depression, treatments that don't only include the empty promise of the antidepressant prescription.This is not a book about alternative medicine and its outlandish claims. This is a book about fantasy and wishful thinking in the heart of clinical medicine, about the seductions of myth, and the final stubbornness of facts.

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.

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.

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.

Crazy: A Father's Search Through America's Mental Health Madness


Pete Earley - 2006
    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.

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.