This article is an attempt to summarize the book ‘Anatomy of an Epidemic‘ by Robert Whitaker. In this book, the author talks about the role of psychiatric drugs in eventually leaving many patients disabled for eternity. The drugs have been successful in treating the symptoms of mental illness but the treatment has come at a cost, that is, long term disability. There is a wide array of mental diseases but the author talks specifically about four mental illnesses in his book – 1) Schizophrenia, 2) Anxiety, 3) Depression, and 4) ADHD. I will write this article in two parts. Part 1 will express the author’s views on Schizophrenia and part 2 will talk about anxiety and depression.
According to the author, prior to the invention of antipsychotic drugs, 75% of schizophrenia patients were discharged from the hospital within 3 years of a psychotic episode and never had a relapse. The author claims that antipsychotic drugs make patients chronically ill by working on the symptoms of schizophrenia and not the disease itself. Data suggests that patients that were on a higher dose of antipsychotic medication had a higher rate of relapse on withdrawing from the drug. In conclusion patients on antipsychotics didn’t see any long term improvement whereas patients who were never prescribed antipsychotics had a better chance of a full long term recovery.
We have to keep in mind that the author is measuring the success of an antipsychotic drug based on many different factors such as – the patients ability to hold a job and be good at it, have strong social connections with family and friends, being able to hold meaningful conversations, having a sense of purpose in life, etc. and not just keeping psychosis at bay. The patient must be able to fully integrate into society and live life to its fullest. But unfortunately, the data on antipsychotics would suggest that the drug, although successful at keeping psychosis at bay, is failing to provide patients with a meaningful life.
I can relate to the author’s sentiment, that is, long term use of psychiatric drugs can treat the symptoms of mental illness but the side effects from the drugs leave most patients disabled. I have experienced this first hand in my household. My mother has had a few episodes of psychosis over her lifetime and has been taking antipsychotic drugs for the last couple decades. I have observed her mental and social abilities decline over the years while keeping psychosis at bay. She is unable to work, she has no friends, has no social skills and doesn’t have a healthy relationship with her family. I understood that these were side effects of the drugs and something my mother will have to live with. What I didn’t know was that there is an option to treat some cases of psychosis without long term use of drugs, successfully and without the possibility of a relapse.
The author mentions Open Dialogue Therapy from Finland having a very high success rate in treating schizophrenia without long term use of antipsychotics. Open Dialogue Therapy has shown to have better outcomes for the patient as compared to antipsychotic drugs. The approach de-emphasizes the use of drugs and focuses instead on developing a social network of family and helpers and involving the patient in all treatment decisions. Ongoing research shows that over 80% of those treated with the approach return to work and over 75% show no residual signs of psychosis.
The author does warn his readers that there are schizophrenia patients that can’t function without long term antipsychotics and may never be able to fully integrate into society. But the percentage of these patients is very small and majority of patients will recover fully and live a meaningful life, if treated appropriately. And in the author’s mind, long term use of antipsychotics as the first line of treatment is not the appropriate treatment.