Why I Refuse to Read Anatomy of an Epidemic
Many people here have read Robert Whitaker’s Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America (New York: Crown Publishers). And some of these people will likely claim that the book changed their lives or, at the very least, their view of psychiatry and psychiatric medication.
Well. Ho there. You would think with such a ground-breaking book I would be all over it.
Guess again.
I refuse to read Anatomy of an Epidemic. And yes, some people will fault me for this. But I have a good reason. I refuse to read Anatomy of an Epidemic as I have no desire to be outraged at a misunderstanding of science for 416 pages.
The Poster Child: Robert Whitaker
Robert Whitaker is the poster-child for antipsychiatry, which is his prerogative. If he enjoys talking to throngs of antipsychiatrists then I say, better him than me.
And part of his criticism of psychiatry is well-deserved. I would say that being concerned with the use, and possibly overuse, of some medications and the prescribing of heavy psychotropic medications to children is quite warranted. I take no issue with the fact that debate and concern is appropriate here.
What I do take concern with is his contention that psychiatric medication actually worsens treatment outcomes and causes disability. This is the reason why antipsychiatrits love him and it’s the reason I probably couldn’t stand to be in the same room as him.
Antipsychotics and Mental Illness
Whitaker’s chief whipping boy is antipsychotics and schizophrenia. He cites studies that he says back up his claim that not taking antipsychotics increases the chances of getting well and that antipsychotics induce the symptoms of schizophrenia.
Well that is complete falderal.
You see, Robert Whitaker, it seems, can’t read a study.
Scientific Studies
Studies are very tricky business and if you don’t actually read and entire study, look at the data and really read what the researchers are saying – you might miss something. In fact, you might miss something that changes the entire meaning of the study. Rarely do the researchers themselves miss it, but for some reason, when reading the study, people draw conclusions contrary to the researchers – like Whitaker does.
How do I know this? Well, rather than reviewing his book I reviewed some of the studies he cites and the claims he says are backed up by those studies and I found them to be fallacious at best. Sure, he cites studies, he just contraindicates what the study actually proves. And nothing ticks me off more than this because people believe him just because there is a linked study – no one ever bothers to check that the study says whatever Whitaker says it does.
Whitaker Contrarians - Doctors
Except, of course, the people who do – the doctors. You know, the people who went to medical school for over a decade. You know, the people actually qualified to understand what all the fancy numbers mean. You know, those people.
And I, for one, rely a lot on what doctors make of medical data and they are the ones most able to refute Whitaker’s claims.
Enter E. Fuller Torrey, MD. He wrote a most excellent piece on how Robert Whitaker got it wrong. And chiefly, how his assertions of medication-induced schizophrenia and treatment outcome improvement without medication is wrong. Fuller uses the very studies that Whitaker cites to prove the very opposite of what Whitaker is saying. Because quite honestly, Whitaker either doesn’t understand how to read a study or his misrepresents the data on purpose.
In one case, Whitaker claims that treatment outcomes for schizophrenia have worsened over the past two decades and are now no better than they were a decade ago.
Well, you know, wrong.
The problem with the study Whitaker cites is that it contains a moving target – namely the definition of schizophrenia over time. The way schizophrenia was diagnosed in the 1950s isn’t how it was diagnosed in the 1970s or the 1990s. The diagnostic criteria differed substantially as we learned more about the disease at there was progression of the Diagnostic and Statistical Manual of Mental Disorders. Earlier on, diagnostic criteria for schizophrenia were very broad and so more people who were less sick were diagnosed with schizophrenia whereas now, the criteria are much stricter and people in the category of schizophrenia are much sicker. Fuller states:
When a broad definition of schizophrenia was in vogue, outcomes were better but when a narrow definition was in vogue, outcomes were worse, as would be expected.
In fact, in that very study it showed that treatment outcomes improved in the 1960s and 1970s specifically coinciding with the usage of antipsychotics. At no time in the study do the authors suggest that treatment outcomes have worsened over time. That was just Whitaker’s unsupported claim.
And Fuller goes on to explain more about how Robert Whitaker got the science wrong – and he does – over and over. He gets it wrong, wrong, wrong, wrong. One really starts to wonder how he can call himself a journalist at all.
OK, I’m Getting Worked Up
And see, this is why I can’t stand to read the book because I would have to dissect all of his claims and find out where he was wrong simply because I would feel compelled to do so. I’m that kind of girl. I don’t like falsehoods hanging around for people to pick up and inadvertently digest.
In short, if you like Whitaker’s work, that’s fine, but you might want to read some doctor’s reviews of his work before you start believing everything he wrote because by-and-large, for many of the claims, the science isn’t there. It just isn’t.
Please read Anatomy of a Non-Epidemic - a Review by Dr. Torrey for all the details. More critique here.
You can find Natasha Tracy on Facebook or GooglePlus or @Natasha_Tracy on Twitter.
APA Reference
Tracy, N.
(2012, June 5). Why I Refuse to Read Anatomy of an Epidemic, HealthyPlace. Retrieved
on 2024, November 25 from https://www.healthyplace.com/blogs/breakingbipolar/2012/06/why-i-refuse-to-read-anatomy-of-an-epidemic
Author: Natasha Tracy
As per MMM
" IGNORE the trolls. It’s better to back off when you immediately smell a troll. They’re trying to get you worked up. It’s their goal"
I agree, eventually they will have no one else to talk to but themselves...
Drugs save lives. They grant us new life and hope for our future. The Polio vaccine. Drugs treating AIDS. Anesthetics. On and on and on, including psychotropics.
Psychiatry is not an exact science. It can involve years of trial and error for some people
As per Natasha's post
Aug 26, 2015 - Bipolar Depression - When Will I Feel Better?
In reality they don't help everybody at least to their satisfaction. If they did, they still wouldn't be struggling
after so many years of trial and error
Not every body has the courage or strength, or support system to wait that long
...or self esteem to withstand the stigma of being labeled with a mental illness
BTW drugs are not the ONLY tool in the toolbox. What about ECT?
Whitaker is clueless! The God of the I hate all psychiatrists is so wrong, it is funny.
How much money has he made selling the garbage he writes?
Dear Betty
As a 66 year old Biopsychologist who was trained to evaluate research I know more than MDs who I taught for 10 years. What are your credentials??
No one knows what a synaptic cleft is! Can't think without em.
Interesting article on CHILDREN diagnosed with bipolar disorder, some even as young as 2 years old. Absolutely ridiculous in my opinion
http://www.newsweek.com/us-children-misdiagnosed-bipolar-disorder-67871
That is precious. The I hate psychiatry troll has disappeared. After all her best efforts to bait her outspoken critics failed miserably, she has retreated into her world of make-believe, incapable of surviving in the light of scientific facts and those she cannot fool. Their movement, some are militaristic, to destroy psychiatry is dead in the water. Nice try. Next time, do your homework.
Any psychiatrist who thinks a two year old could possibly have bipolar disorder needs to have THEIR head read. (see link above, dated Sep 9, 2015 @ 3:56 PM from "Psychiatrists Influenced By Big Pharma"
It makes me wonder how many adults are being over diagnosed incorrectly with bipolar as well, especially the ones with less severe symptoms...
In my humble opinion the few adults who are able to effectively manage their lives without medication were never really bipolar to begin with. Just because a psychiatrist says it's so doesn't always mean it's true. Maybe that person has a personality disorder or maybe there's something else going on with them instead. Some symptoms overlap with other illnesses, and can mimic bipolar disorder. Doctor's are human and have been known on occasion to make mistakes.
Or could it be that the unmedicated bipolar patient is just temporarily in remission only to have it come back with a vengence later on down the road like someone who gets cancer, goes into remission only to get it again in the future
Who knows for sure since there isn't really any scientific medical procedure that can be performed such as a blood test, etc to definitively prove you have it like there is with cancer
Or maybe they truly do have bipolar disorder and don't take medication because they're just in denial or don't like the side effects of the medication or are too shame based to begin with from childhood issues, etc to wanna accept the diagnosis and deal with the associated stigma
There is no blood test for pain. Since science can't prove pain is real, it doesn't exist.
Anyone who thinks a discussion is about defending a position isn't even in the ballpark where science plays. And one of the issues Whitaker looks at is how science itself (my words here) may actually be as guilty of pseudoscience when they are influenced by and dispense data from an influenced position, e.g. psychiatrists in relationship to the pharmasutiscal indistry as spokespersons; the DSM used to give diagnoses which aren't actually clearly defined and which are used to support medicating patients who may in fact not need or will be harmed by these medications (see the discussion above re. how it is possible to diagnose a two-year-old as being bi-polar.)
My point is that this discussion needs to be had if we really as a society want to promote the very best health we can, physical and psychological. Whitaker's book is a legitimate part of that discussion, certainly as much as is, say, and article which is based on a stance of refusing to read something that is prejudged as being wrong (or at least not in alignment with the person's stance). Articles in AARP publications recently, or the TED Talks by psychiatrist Ben Goldacre, or my own personal and professional experience with psychotropic medications, suggest that we need to know how well we are doing in satisfying the fundamental tenant of "do no harm" let alone how well we are doing in actually finding real medicines which heal real disorders and diseases. Certainly, one of the fundamental issues raised in Whitaker's book is whether the medications are actually creating a long-term problem which didn't actually exist before, e.g. the relationship between SSRI's and alterations in the physiology of the brain structure. Another is how the diagnoses whch support the treatments prescribed, whether pharmacological or behavioral in nature, are arrived at. As a practicing psychotherapist, I am incredulous at the current number of diagnoses listed in the current Diagnostic and Statistical Manual. How is it that we are as a society so astonishingly mentally disordered, become so astonishingly more "brilliant" in uncovering these previously unrecognized and/or cleverly hidden disorders? And how can we know litterally how to access let alone understand the basis upon which the pharmacological and behavioral interventions are based (see the Goldacre's TED Talks for his discussion regarding his efforts as a prescribing psychiatrist to access the scientific research into psychotropic medication, for example.)
As for refusing to read some discussion which might be upsetting or unsettling to one's assumed point of view, I know that I have to sometimes do a lot of self-talk to get around my own prejudices. Prejudices serve us well when the pre-judging is based on truth and helps avoid choices which might be harmful to oneself or others. On the other hand, prejudice gets it's negative connotation from stances which are of the nature, "don't disturb me with the facts" because I might have to get out of my comfort zone.
Perhaps it would be helpful become willing to look even more closely at what we find potentially dangerous, assuming what seems to me an even more courageous position which might be paraphrased as, "Hold your opinions close, and your opponents opinions even closer." If I'm really clear on what might hurt me, then I can know even more clearly whether what I believe protects me is up to the job.
"Certainly, one of the fundamental issues raised in Whitaker’s book is whether the medications are actually creating a long-term problem which didn’t actually exist before, e.g. the relationship between SSRI’s and alterations in the physiology of the brain structure" GKG
wiity wasn't the first to raise that issue, though he does try to exploit the misrepresented data he manipulates as much as possible. surgically removing cancer causes great damage to one's flesh. it is a price to be paid when "do no harm" is weighed with saving lives. btw, he has no documented, credible evidence that the drugs used to treat mental health challenges create a single bio/chemical/electrical alteration in the mind of anyone. he can't even see pain under a microscope, so there is no such thing. pain doesn't exist. any claim that it is real is fraudulent and merely the tactic of all the drug pushing moms, dads, doctors, nurses, throughout the u.s. to exploit naïve crybabies who have been convinced they have booboos
Certainly, one of the things raised in witty's books is how much money he can make selling them. The all too eager groupies he's cultivated have absolutely no clue how absurd his theories really are. But, he's given them "a voice" no patients of psychiatry have ever had. (They don't even understand how people like they are have always had the right to be heard.) His preposterous conclusions should be sufficient to scare thinking people half to death. And they do. It is our most vulnerable mentally challenged naive folks he targets.
I like that you vehemently critique a book you admittedly haven't read. Well done.
I would wonder why I read this. I liked the reviews. But how can you critique a book without reading the facts in Robert Whitaker's Anatomy of an Epidemic. I was look for some critique of the weakness of his discovery. I do like Gary K. Glenn's comment, "Please don't disturb me with the facts." I think we need to look at the facts in a well balance way. I appreciate the Natasha Tracy's comment about reading research article. One has to be train in that and most people in medicine and mental have been trained to read critically. What is most concerning is that there is a bias driven by money. It is common knowledge that pharmacy companies have influenced how we see what "works" and what "doesn't work." Something needs to be done about this.
I have a lot of issues with this piece, but I'll address only two.
1. SSRIs
Selective Serotonin Reuptake Inhibitor. The explanation that the doctors will give you is that it'll cause more serotonin to stay in your brain, making you happier. If that's true, then a reuptake enhancer should reduce your mood, making you depressed. But that's not what happens. SSREs are anti-depressants as well. The "fixing the brain chemistry" argument is entirely based on bunk theories which are contradicted by evidence.
2. Locus standi
Literally, a place to stand. If you haven't even bothered to read the book, you don't have a place to criticize or praise it. It's not a long or complicated book, so there's no excuse. Natasha seems to believe that wilful ignorance is a good idea, and is happy to talk about things she only knows about 3rd or 4th hand.
Another fanatic who refuses to examine the evidence. Must be 'Murican.
http://www.theguardian.com/society/2016/jan/28/common-antidepressant-could-put-children-a…
Could you please elaborate on your claim:
"I reviewed some of the studies he cites and the claims he says are backed up by those studies and I found them to be fallacious at best. Sure, he cites studies, he just contraindicates what the study actually proves. And nothing ticks me off more than this because people believe him just because there is a linked study – no one ever bothers to check that the study says whatever Whitaker says it does."
Which studies? Why were they fallacious in your view?
You're argument to trust the doctors doesn't hold up. If you read the book you'll know how Whitty explains how big Pharma dupe doctors and buy them off. Also, my doctors put me on anti-depressants when I was 14 and continued prescribing then for 10 years. Not one of the 6+ doctors during this time wrote me a referral for therapy. Luckily it was a low dose and after some therapy I've been off meds for 3 years now. It was hard coming off and it does feel like they permanently changed my brain, but I was so young when I started I'll never know for sure.
I think he raises some valid arguments and it seems very unscientific that those on the supposed "correct" side of the science of psychiatry would refuse to hear theories that don't confirm to their preconceived notions.
The bile I always see in these comments/forum threads is pretty shocking as well, there's no need for personal insults and belittling comments in a conversation that should ultimately be fact based. I mean I can understand why a former patient would be angry considering they may feel incredibly victimized and unrepresented by mainstream psychiatry but seeing the people defending pharmaceutical based treatments by resorting to nasty childish insults is pretty disgusting.
If you feel the need to "defend science" you need to show evidence to back up your position like Robert Whitaker has, attacking a persons character(who most likely feels victimized as it is) is about as scientific as the evangelical zealot damning gays to hell.
Meds work wonders most of the time in most people who take them as prescribed, which often means no booze. No wonder the opponents hate them so.
Antony is cute. He wants the vast majority of scientists, researchers, medical doctors, psychologists to prove witty is wrong with facts. Nice one, Ant.
Isn't it true that taking amphetamines (as prescribed) for ADHD can cause a patient to develop "bipolar illness?"
to doppelganger - Is it true? Well, the FDA has stated that ADHD amphetamines can cause bipolar illness - as well as psychosis and aggressive behavior. So, IF you can believe the FDA, then yeah, it's true.
Why don't you read the short summary then, and provide an educated comment?
http://www.cchr.org/sites/default/files/Anatomy_of_an_Epidemic_Psychiatric_Drugs_Rise_of_…
I've personally been affected by this. You can claim that a doctor who sees a patient for 15 minutes knows better than the patient, and better than the facts. But these claims are empty. If I could go back in time I wouldn't touch any pharmaceutical. I was on for 12 years and I've been robbed of my life. I own a successful technology company and am more functional than I was on medication. Coming off medication almost killed me, and the withdrawal made me look crazy. These medications are poison and make us sicker.
It might be difficult to open your mind on meds, but try. And then reclaim it. It belongs to you.
I suspect that bipolar 1 disorder has been manufactured by psychiatry. While I think bipolar 2 or unipolar disorders probably exist biologically, I think mania is caused by medication in certain people. Since a full blown manic episode is required to diagnose bipolar 1, this is why I suggest it has been created by pharma.
I have yet to meet someone who experienced a full blown manic episode who hadn't been on psych meds prior to the episode. I'm talking about the type of mania that requires hospitalization. Mania is terrifying to experience and can easily ruin or end a life. There is plenty of evidence that anti-depressants cause mania.
"At least 9 out of 10 adults I've seen in the last two decades who have suffered emotional episodes that could be diagnosed as mania had them in direct response to stimulants or antidepressants–mostly the newer antidepressants such as Prozac."
How common is antidepressant-induced mania? Very common. Several studies have found that 6 to 8 percent of patients exposed to antidepressants will develop a manic disorder. One research study, for example, found in a retrospective study that Paxil produced mania in 8.6 percent of patients exposed. Other studies find the rates as high as 17 percent And if a person has already shown a manic tendency or has experienced a manic-like episode, antidepressants will pu
sh one-quarter to one-third into new manias (For a review, see P. Breggin, Brain-Disabling Treatments in Psychiatry, 2008, pp. 157-165)
I benefitted from Adhd medication prior to trying an ssri. Then I had a manic episode that ruined my life. I was hospitalized against my will and charged a large bill that put me into debt. I had 10k stolen from me by an abusive boyfriend who found me easy to manipulate in that state, my car was impounded at the cost of 5k, and my hoa fined me over 2k when I didn't respond to their letters in time. Plus not being able to work off and on I ended up in debt over 40k.
I have been off all medication for four months. I wish to take the Adhd meds again but I am scared. Aside from that I am very depressed but mostly because the few months I was manic destroyed my finances and reputation. The medication might not have permanently physically damaged me, but the other damages it caused can be just as difficult to recover from in the modern era as any physical disability medication may accidentally cause. At the rates anti depressants are known to cause manic episodes, it is irresponsible to prescribe them to anyone. Mania is much more dangerous than depression.
"Isn’t it true that taking amphetamines (as prescribed) for ADHD can cause a patient to develop “bipolar illness?”"
Now, that is fascinating. A rabid anti-mental health zealot, who knows perfectly well mental illness does not exist, tries to win an argument that indeed mental illness doesn't exist, claims that it does, as long as it's amphetamine induced, thinking she can slide that little inconsistency past someone far smarter than she can imagine and get away with it. Listen girls, I'm mentally ill. You better be nice to me or I'm tellin!
"How common is antidepressant-induced mania? Very common. Several studies have found that 6 to 8 percent of patients exposed to antidepressants will develop a manic disorder." BP
Dear BP, where are the bio-markers which prove those tests are accurate? They aren't anywhere. They don't exist. You see the problem?
Shame on you. The hallmark of science is the ability to criticize it in a thorough way. You refuse to read the book and yet rely on others criticisms. If you think MDs know much about critically evaluating research you are sadly mistaken. As a PHD bio psychologist who has spent 10 years teaching in a Medical School and the a subsequent 13 years working in the pharmaceutical industry I have reviewed the studies that Whitaker cites and find them credible. He has also. Dry successfully defended his points of view against the critics you have cited and his responses have been cited in other links. In talking with him I find he is not antipsychiatry or antimedicine. But a very clear and lucid thinker who has pointed out that when you really delve into the literature there are very very serious concerns about the psychiatric medications we are using. What are your credentials to evaluate the research he has cited? Many package inserts for these meds now cite as side effects the very symptoms they are meant to treat. I could go on but can't really have a dialogue with someone who refuses to even read nor be able to evaluate what she is reading and instead relies on others criticisms. You do a great disservice to your readers. You should know that Mr Whitaker has agreed to appear in public forums including Grand Rounds to discuss his and others ideas. I tried to get the the Medical School I taught at to invite him to give a lecture. After a non-biased scientist in Community Medicine reviewed his work he thought it was a good idea but then came back and said they did not have any money for an honorarium to pay him. This from the head of that Department which has discretion over a very large budget.
Why is it so important to you people to damage those of us with brain disorders? I'm not going to argue with you, as that would be pointless. I just wonder why it's so important to you to engage in this dangerous, and probably deadly obssetion. I have bipolar disorder. I am far, far better as a result of treatment The notion that all of the doctors who specialized in psychiatry have joined together in a grand conspiracy to purposely destroy their patients is well; crazy.
See, that's the thing about the kind giant conspiracy you embrace. It's impossible to keep all the conspirators in line. Yes, Oswald killed Kennedy. No, the aliens did not crash at Rosswell, and my doctors do not meet in secret conclaves to devise new ways to harm me.
What you do accomplish is the rather sick goal of encouraging very sick people from getting help. Like many others, I survived the period from onset to diagnosis and treatment; barely. With the help of extremely well educated doctors, I do more than survive. I live. Why would you dedicate your life to hurting those who doctors have helped? Honestly, what do you gain from it?
I agree with it, I share this statement. I always said to my baby who has never believed for me, haha!:D
Okay you write this. "In fact, in that very study it showed that treatment outcomes improved in the 1960s and 1970s specifically coinciding with the usage of antipsychotics. At no time in the study do the authors suggest that treatment outcomes have worsened over time. That was just Whitaker’s unsupported claim." Whitaker doesnt claim this at all in the book, he only mentions the study as something that picked whitakers curiosity about the subject. Fuller is dishonest in what he writes about what whitaker have claimed.
Schizophrenia has a "shifting definition" because the DSM publishers "shift" the definition to conform to "subjective" understanding and interpretations, and coincidentally, with "new" drugs on the market. DSM diagnosis are at best subjective evalulations, reflective of trends, not hard science. There is no "blood test", "xray", or other diagnostic tool for schizophrenia and mental illness other than "personal evaluation and interpretation". One individual can see 5 different psychiatrists and walk away with 5 different diagnosis. As a social worker for juvelines, I one time took a juvenile to a mandatory "psychiatric" evaluation in order to be considered for a residential treatment center. Within 5 minutes, literally, of our "interview" in the office, the juvenile was "diagnosed" as bipolar and medication offered. When I refused the medication, the psychiatrist was shocked, and asked me what I was there for then. So I, as a consumer, get to determine my illness and treatment, it would seem.
I wonder if you would also be scared to read the book ‘ Side Effects’ by Alison Bass that tells the story of the infamous prosecution of Glaxo Smith Kline ( makers of Paxil ) that resulted in conviction of GSK for fraud, illegal promotion of an anti depressant to youth under 18 years of age and other illegal practises by the U.S. Department of Justice for $3 Billion. This is just the tip of the iceberg. Time to hide under the blankets. Psychiatric drug reactions are the third largest cause of death in America. That’s a great endorsement for these extremely well researched drugs and their long term effects. Let’s see what happens to all the Psychiatric drug cheerleaders when they take any of these Psychiatric drugs for a month. Let’s see the results for a trial like that!!
if meds destroy you, don't take them. there are many who receive benefits from them that outweigh the side effects. leave them be.
Terrible critique of this book. "Here's my opinion on this book that I HAVE NOT READ". What a great way to show how "scientific" you are.
To NT: some major mistakes you have made
- RW stands by the substance of his research, evidence and opinions - I doubt he sees himself or sets himself up to be a 'poster-child'.
- He studies independently and does not just listen to 'anti-psychiatrists' - which you seem happy to do the opposite as your post relates to this and you have not read the book.
- Many 'scientific' published papers leave out important details, water them down and misinterpret and/or misreport them. Relating to drug companies being fined huge amounts by courts of law for lying.
-Most doctors are not trained or interested to read or critique papers nor drug regulation.
-NB: I am permanently disabled after a short low-dose benzodiazepine prescription for allergies.
Pages of published evidence exactly matching every element experienced.
Was previously working and studying full time.
-I understand though because I can hardly bear to read drug papers on small groups of children and the several deaths are not even mentioned in the summary !