Book Review: Anatomy of an Epidemic by Robert Whitaker
The much acclaimed former writer for the Boston Globe, Robert Whitaker, is no stranger to mental health. In 2001, he published the book Mad In America: Bad Science, Bad Medicine, and The Enduring Mistreatment of the Mentally Ill, which details societies disregard for the mentally ill. In his more recent book, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, Whitaker explores the causes of the perceived growth in mental illness over the last 50 years.
The thought-provoking book calls out some of the more pernicious elements of our healthcare system, which has made little progress in curing, or even identifying, the true causes of mental illness. His arguments are extremely well researched and deserving of much thought and attention. At the same time, the book makes some broad declarations that need to be taken in context. Here are a few of the notable points:
There is no magic bullet - We understand so little about the brain that any statements about the short or long term efficacy of drugs must be taken in moderation. Proceed with caution if you are using any medication to treat "the symptoms" of mental health!
Misaligned incentives - pharmaceutical companies have reaped huge profits from mental health drugs over the last 30 years while the merits of some of these medications are questionable at best. Any evidence that discredits the drugs has continuously been met with fierce resistance from the drug makers and their beneficiaries.
Overprescribed generation - by advocating that mental illness is a product of a brain malfunction, we are in essence relegating the mentally ill to a life of pharmaceutical dependence. Whereas, if we took into account that mental health conditions may be a product of many environmental conditions, patients would perhaps be more open to other remedies that have proved to have equally good, and in many cases better, results (diet, exercise, sleep, etc.).
Whitaker gives the reader a lot to chew on, but can also take some liberties in order to get his point across. He has a habit of making blanket statements about the incompetence and deceit of the psychological and pharmaceutical industries, while there are most certainly some highly intelligent and altruistic employees that are diligently trying to solve these complex questions in mental health. Additionally, he tends to ignore a large cohort of the mentally ill population that are either unwilling or unable to treat their condition. For instance, some individuals suffer from actual brain trauma and/or degenerative conditions that require some form of medication. As a society, we need to find other methods of supporting them whether that be through public mental health institutions or advancements in neuroscience.
I was left with a question that has come up fairly consistently in Openminded.org events... What is mental illness versus mental health and should do we treat one versus the other? More to come on this in the coming months.
For a longer summary of the book please see here or you can purchase the book here. Additionally, we've included a few other book reviews below: