Wednesday, July 20, 2011

Food for Thought

Sigmund Freud and his daughter Anna

I just read two very interesting articles in The New York Review of Books, written by Marcia Angell about the state of psychiatry today. Angell is a Senior Lecturer in Social Medicine at Harvard Medical School and a former Editor in Chief of the New England Journal of Medicine. She is also an outspoken, vehement critic of both the United States' healthcare system and, particularly, the pharmaceutical industry. Here's a quote of hers from a recent PBS interview:

Our health care system is based on the premise that health care is a commodity like VCRs or computers and that it should be distributed according to the ability to pay in the same way that consumer goods are. That's not what health care should be. Health care is a need; it's not a commodity, and it should be distributed according to need. If you're very sick, you should have a lot of it. If you're not sick, you shouldn't have a lot of it. But this should be seen as a personal, individual need, not as a commodity to be distributed like other marketplace commodities. That is a fundamental mistake in the way this country, and only this country, looks at health care. And that market ideology is what has made the health care system so dreadful, so bad at what it does.

The two-part article that I just finished is titled The Epidemic of Mental Illness: Why? and The Illusion of Psychiatry and is partly a review of several new and prominent non-fiction books about the "epidemic" of mental health diagnoses and the concomitant rise in the use of psychopharmacology. It's a shocking article that I can't stop thinking about, and I highly recommend that everyone read it, particularly those that use drugs to combat depression, anxiety and the like, as well as those who debate the merits of medicating children for ADHD and other mental health disorders.  I know this is a controversial subject, but all controversy demands near-constant reflection.

Here are the links:

The Epidemic of Mental Illness:Why?

The Illusions of Psychiatry


  1. Thank you so much for pointing these articles out! It is my opinion that we, as a culture, tend to want to name and "diagnose" things that we see as undesirable with the goal of then being able to "fix" them. What a perfect opportunity for someone to find a product to sell! We have repeated this pattern over and over again with obesity, heart disease, drug/alcohol addiction, etc. etc. When we finally stop catastrophizing things and take the time to look at their origins thoughtfully and deliberately without the urgency of solving the "problem" right this bloody second, we begin to find insights that are valuable.

    I will be chewing on these articles for a while. Thanks again.

  2. I read both articles in their entirety. I have been reading about this phenomenon increasingly for many years, and encounter children in my practice, as young as three or four years old, who have already been prescribed Prozac or Risperdal or a whole cocktail of medications. I read somewhere that there has been an 800% increase in use of psychotropics in children. No matter how you look at that statistic, it's alarming.

    It's an epidemic, and one we need to look at critically, from a societal point of view. We seem to want to "fix" everything, and think a pill is always the way to do it. Sometimes, it just isn't, but we do seek perfection in our culture.

  3. I can only speak for myself but when I lost my previous job and therefore lost my insurance and my meds I came close to dying for lack of them. My entire life became shredded in the course of three years. This included not having the meds I took for my seizure disorder. The more time that passed the less employable I became. I am lucky to have found my present job I was lucky indeed to get hired here and to get back to so-called-normal.

    It is a great shame how many undiagnosed adults and children commit suicide due to untreated depression and bipolar disorders etc. In this big fancy country.

  4. As a psychiatrist, i tell many of my patients that I will help them all I can, but that we are still in the Dark Ages of psychiatry.

  5. The human brain- oh my, how we want to figure it out in all of its complex and eternal mystery. I doubt we ever will.
    And no, a pill does not solve everything at all. But I swear to you- I do not know what I would do without mine. Would I have just recovered, eventually or would I have done something drastic which is where I felt headed, in order to escape the horror I was feeling?
    I do not know.

  6. Thanks for sharing these articles, E, I have passed them along.

  7. This sounds like something I definitely need to read. Heading over there now!

  8. There was a rebuttal by Peter Kramer in the Sunday NYTimes (sorry, don't have the link.)

  9. Peter Kramer's piece isn't really a rebuttal but an Opinion piece that appeared in the Sunday NY Times. The link is here:

    There are those that maintain that Kramer, the author of "Listening to Prozac" and Eli Lilly (the manufacturer of Prozac) were the most influential in the marketing this drug and the disease. I have read that it's called NEUROCAPITALISM.

    It's endlessly fascinating to me.

  10. I think it is vital to keep reading, keep questioning and learning.
    I can , in the space of the same day , be ever so grateful for chemicals , and ever so frightened and cynical.

  11. Fascinating! Read 'em and got one of the books for Kindle! Thanks for the link :D

  12. Just read them both. Ack. Am in between. Am thankful for the drugs on many days and question their efficacy on other days. (At home with my child and also at work...)

    Hate the trial and error and subjectivity of diagnosis, but I don't question that there's something to diagnose. At least that's my perspective from the belly of the beast, which can be a very scary place indeed.

    Thanks for the links, Elizabeth.



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