Having just written and performed a play about a severely-abused, nineteenth-century, domestic servant, I was intrigued to discover that a book has been written about Virginia Woolf's relationship to the women who cooked and cleaned in her various homes. The book is Mrs. Woolf and the Servants: An Intimate History of Domestic Life in Bloomsbury by Alison Light.

Before I talk about my responses to this remarkable book, I want to explain what I was trying to do with my play about the servant--which, by the way, is titled Lace Curtain Irish. It's a one-woman piece, and the one woman is Bridget Sullivan, who was a live-in cook and maid in the home of Andrew Borden of Fall River, Massachusetts. Yes, the Andrew Borden who was the recipient of eleven of the famous "forty whacks" presumably delivered by his daughter Lizzie's axe. The premise of my play is that Bridget was the actual wielder of the much-celebrated and conspicuous-in-its-absence ax (or hatchet).  Everything in the trial transcripts  supports that theory, as well as what is known about the habits, attitudes, history, character, and personality of LIzzie Borden.

Obviously the crime was frenzied and spontaneous--an act of passion. (The Bordens were each dead on the first blow.) Murders that are motivated by desires to inherit generally involve either long-range planning (cumulative doses of untraceable poision) or felicitous  opportunities (finding oneself alone with the victim on the edge of a cliff at night). Crimes involving overkill generally are triggered by immediate and overwhelming circumstances... like abuses of power and/or outright sadism.

Bridget had just been vomiting in the yard on the hottest day of the summer when her mistress, Andrew's wife, gave her the order to wash every window in the house, upstairs and downstairs, inside and out. In 1892, this entailed ladders, buckets, trips to an outdoor pump,brushes, and rags. Not surprisingly, Bridget had only washed a window or two before the arrival of the police and the discovery of Mrs. Borden's mutilated corpse.

One of the first actions by the police was a lock-down of the house. No one was allowed to leave. Oh, except the "Irish girl." She was allowed to leave the house to stay with a friend, taking with her an uninspected bundle of possessions. After all, she was just the maid.

What caught my attention was the fact that Mrs. Borden had been stricken with a bout of vomiting just the day before, and had taken to her bed. In other words, she had good reason to empathize with Bridget's distress and physical debilitation. Why would she insist on a chore that certainly could wait a day-- or even a week?  There can be only two answers: sadism or staggering classism. She either delighted in tormenting Bridget or else she considered the "Irish girl" to be of a different species than herself-- a species impervious to heat and illness, and whose responses were either lazy malingering or ungrateful attempts to cheat her employer out of a day's labor!

Reading Mrs. Woolf and the Servants opened my eyes to the fact that Abigail Borden's attitude toward Bridget was far from unusual. In fact, it reflected prevailing attitudes among the privileged classes of England. Servants were expected to work for little more than room and board. They bought their own uniforms, worked from sunup to sundown, and only had two days off a month. Frequently, the kitchens and washrooms where they worked were in basements, and their rooms were cramped and inadequately heated and ventilated. (Bridget's room was under the eaves and must have been stifling the night before the murders.) Often the servants were assigned names at the whim of their employers who were too lazy to learn their real names. (Bridget had been called "Maggie.") Without pensions or insurance, they relied on the patronage of their employers for support in old age and in sickness. Employers, then as now, had strong incentives to "let go" older workers, in order to avoid the fiscal responsibility for their retirement.

In spite of this appallingly exploitive situation, employers expected loyalty and gratitude from their servants. They saw themselves as role models and mentors for their servants, introducing them to a life of refinement and morals that working-class folks presumably could not be expected to find among their peers. Employers felt entitled to enter a servant's room at any time, and to search their possessions without permission. All of this was for the good of the servant, of course.

This world changed, however, and Virginia Woolf lived through the transitional time. When she and her sister Vanessa moved from the family estate to Bloomsbury, they left behind many of the rigid class roles and formal rituals of their Victorian girlhoods. What they did not leave behind, however, were the servants. But in Bloomsbury, there was no need for the liveried fleet of gardeners, coachmen, personal valets, parlor maids, cooks, charwomen, etc. There would only be a maid and a cook. The uniforms and the hated white caps were gone. The servants could say "Miss Stephens" instead of "Madam." Occasionally, they were even invited to eat with their employers. The middle-class youth of Bloomsbury considered themselves artists, bohemians, radicals, socialists.

This must have been enormously confusing for the servants. With the old upstairs/downstairs boundaries gone, where were the new ones? No one seemed to know. The Woolfs would host political meetings in their home which the servants would attend as fellow socialists... at least until it was time to cook dinner. In spite of her repeated attempts to include working-class characters in her books, Virginia would usually end by editing them out of the final revision, acknowledging her near-total ignorance about their lives.

Two things stand out to me from reading about Woolf and her servants:

1) The time when Virginia's cook ordered her out of her room and Virginia pitched a fit.

2) The fact that two of her servants appeared to have been in a relationship of primary intimacy during the eight years when they lived under Virginia's roof and shared a bed in their room together.

The first stands out because Virginia Woolf is famous for her 1929 treatise,  A Room of One's Own, where she argued passionately how women's creativity had been and was continuing to be stunted by their lack of access to a room that was their own. So here we have Nellie Boxall, thirty-seven years old, who has been living with and working for Virginia for eleven years... for five pounds a year, working 341 days per year... and Virginia, who is fighting with her, enters Nellie's room. What does Nellie do? She orders her out. And what is Virginia's reaction? Does she applaud her for defending her territory? Here is Light's description:

"Nellie had got above herself; in reality the room was not 'hers.' Being treated like a servant was so painful and humiliating that Virginia went straight to Leonard and determined to sack Nellie by Christmas. The 'famous scene' was relived in her imagination many times. She found herself muttering  and rehearsing arguments, unable to work, sick and shivery, trembling with anticipation at the day... when she would give Nellie a month's notice. She wrote in her diary as if possessed, copying out replies to Nellie, speaking their parts..." (p. 193.)

Wow. Just wow.

And then there is the fact that Nellie Boxall and Lottie Hope came together to work for the Woolfs in 1916. Nellie was twenty-six and Lottie was a year younger.  These two young women lived, worked, and slept together in a shared bed at Hogarth House for eight years. Before that, they had lived and worked together in Roger Fry's home for five years. Virginia fired Lottie in 1924, but Nellie stayed on for another ten years. In 1941, both of the women moved into a rented home of their own, which Nellie eventually bought,  and where they lived together for another twenty-four years, until Nellie's death. The two were inseparable, being seen together at weddings, funerals, holidays, visiting.

Nellie was the stouter, the butch. Lottie, rumored to have gypsy blood, was the more glamorous. Lottie had been a foundling, raised in the Home for Deserted Children, and Nellie, the youngest of ten, had been orphaned at twelve. Nellie's relationship with Lottie was protective and maternal. They shared a bedroom from the time they were twenty-one until they were thirty- four, and then again from fifty-one until seventy-five. It was an enduring love.

Did Virginia Woolf notice? How could she not? More to the point, what did Nellie and Lottie make of their employer who was not even ten years older then them? Virginia Woolf was a study in chronic discontent, in parsimony, in eating disorders... And then there was her sexless marriage with Leonard--something that would have been difficult to hide from the servants. And friendships? Virginia took malicious delight in writing scathing inventories of her closest women friends in her diaries, and she often peopled her novels with hateful caricatures of them. In the end, she took her own life.

In spite of their oppression, it was  Nellie and Lottie who managed to find a room of their own and to fill it with loyalty and loving companionship. Too bad Virginia never took a page from their book.

If the public knew these things, there would be more focus on how to use these drugs judiciously and there would be more focus on alternative therapies that don’t rely on meds, or that minimize use.

The author spends some time visiting psychiatric facilities in Western Lapland. Here, patients are treated to something called “open-dialogue” therapy. The nurses, psychologists, social workers, and psychiatrists have, for the most part, completed a three-year, 900-hour course in family therapy. According to psychologist Tapio Salo, “Psychosis does not live in the head. It lives in the in-between of family members, and of people. It is in the relationship, and the one who is psychotic makes the bad connection visible. He or she ‘wears the symptoms’ and has the burden to carry them.”

Wow. And, even though this practitioner is referring specifically to psychosis, I felt when I read those words that they potentially have much wider application. What if all the folks who bought into the myth of “chemical imbalance in the brain” were to switch over to an understanding that mental illness resides in the spaces between people… between family members, certainly… and friends, but also members of one’s church, classmates, co-workers, between a government and a people, and between other species and ourselves? What if we all took that seriously and began to put the focus on treating those relationships as if our sanity depended on it?

But let’s go back to this “open dialogue” in Western Lapland. Everyone goes to the first meeting with family and patient with the awareness that they “know nothing.” Wow. Really? Yes, really. Those 900 hours have trained them all to be “specialists in saying that we are not specialists.”  In fact, the therapists consider themselves guests in the patient’s home. If the patient runs off, they just ask them to leave the door open so they can hear the conversation.

There is no mention of antipsychotics in the first few meetings. If the patient begins to sleep better and bath regularly, and in other ways reestablish societal connections, the therapists see that the “grip on life” is strengthening and meds will not be needed. Sometimes benzodiazepenes are given short-term for anxiety or sleep problems, but when the problem goes away, the meds are stopped.

Yes, this process takes time. Sometimes up to five years. Teachers and prospective employers are asked to join the dialogue. The focus is on restoring social connections.

 Results? Since 1992 not a single first-episode psychotic patient has ended up chronically hospitalized. The spending is less than any other district in Lapland. Eighty-four percent of the patients had returned to work or to school, and only 20% were on antipsychotics. Families have come to trust the system and call for help at the first sign of psychosis… and, consequently, very few go on to develop schizophrenia.  They have had a 90% drop in new cases of schizophrenia since the early 1980’s.

 
What about alternative therapies for depression? 70% of depressed patients respond to an exercise program. In fact, general practitioners in the UK are writing prescriptions for exercise. And the side effects are fantastic: more strength, better cardiovascular function, lower blood pressure, better sleep, better sex, improved cognitive functioning. Oh, and studies have shown it is not wise to combine exercise with drug therapy.

Then there is the Seneca Center in California, a last-stop for severely disturbed kids. When a child enters the residential program, the question is not “What’s wrong with the kid?” but “What happened to them?” The Seneca Center also does something else interesting. As they chart the life history of the kids, they also chart the medication history… looking for how behavior may have changed after medication. Not surprisingly, these histories regularly tell of psychiatric care that has worsened behavior.  If they can see that a drug did not help, they don't prescribe it.They frequently detox the kids and institute behavior modification techniques to help the kids control their own behavior.

According to the program director, “… feeling in charge of yourself and being responsible for yourself is [sic] the central issue of their lives.” It’s about power. And power in relationships. They provide “mentors” for the kids, and the kids learn that it’s safe to form attachments.

The Seneca Center highlights a major issue in mental health today: The need for social and medical support for detoxing from prescription medications.

Whitaker ends his book talking about an organization in Alaska called PsychRights that mounted a public information campaign in 2002 with judges, lawyers, psychiatrists, and the general public about the outcomes for antipsychotics. The founder of this organization, Jim Gottstein, filed a lawsuit against the state in a forced-drugging case, and won a stunning legal victory in 2006. The Alaska Supreme Court ruled, “Psychotropic medication can have profound and lasting negative effects on a patient’s mind and body. These drugs are known to casue a number of potentially devastating side effects.”

Gottstein has moved on to filing lawsuits on behalf of foster children and children living in poverty. He likens these suits to Brown vs. Board of Education, hoping they will have a similar effect to that watershed lawsuit that ended segregation—in this case changing national attitudes about the drugging of children.

There’s no neat way to sum up these ten blogs. Obviously, I consider it an important book. As an activist, I have seen a country and a generation of activists become progressively more numb and more complacent. I have seen friends change personalities, stop moving forward. I have experienced the suicides and attempted suicides of friends and colleagues—four in this last year. As global warming advances, as resources become more scarce and economies more fragile, as social services are increasingly cut, and as the environment becomes more and more toxic, there has never been so great a need for awareness, for clarity, and—yes—alarm. It is a time for radical honesty, for confrontation of the conflict-of-interest when drug companies have so many financial ties to Congress, to doctors, and to medical schools. It is time for honest studies, for “open dialogue” on a national level.

What I take away from the book, and take most seriously, is a new understanding that mental illness resides in the spaces between people. I want to take responsibility for my part in the healing of that space.

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This is the ninth part of my very long blog on Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs and the Astonishing Rise of Mental Illness in America by Robert Whitaker.

Today's blog is on childen… specifically the so-called rise of mental illness among children and young people. What appears to be on the rise is an ideology.

The first thing to understand is that  the prescribing of psychiatric drugs to children is fairly recent. Prior to 1980, very few young people were medicated for mental conditions.

As Whitaker’s book makes clear, it’s all about the story. In fact, no research has ever shown a chemical imbalance in the brain to be the cause of depression or schizophrenia. Research does show that long-term use of psychotropic drugs creates a chemical imbalance in the brain that can be permanent, leading to permanent dependence and disability. Okay.. but the story is this: "Wow!  Good thing you’re on meds, because look how ill you get when you try to get off them! That just PROVES what a terrible imbalance you had before you were diagnosed."  I suppose alcoholics and heroine addicts could try to spin their withdrawals the same way…

Anyway, same thing going on with the drugging of kids:  Spin. Story. Apparently millions and millions of kids who, in the benighted past, were considered bored, rambunctious, temporarily sad, introspective, or angry were (according to “the story”) actually suffering from mental illness that was biological in nature (the elusive “chemical imbalance of the brain” story puts in a pediatric appearance), and FORTUNATELY these kids are now being diagnosed and medicated, and the fact that their mental health is becoming worse and worse just shows what a great thing it is that they are now getting help!

Turns out, depression and mania have always been common among children.  At least, that's the story.

And, here, let me put in a word for my own reasoning capacities. I think there are many and excellent reasons for a decline in the mental health of children. For starts: nutrition. There’s a B-vitamin deficiency in the global food supply (result of depleted soil). Kids eat crap. We all know that. It’s pushed on them. And low-income families have little choice but to load up on high-carb, low-nutrient foods. If we treated our cars the way we treat our bodies, the engines would have seized up long ago. 

Then there is what some have begun to call Nature Deficiency Syndrome. It’s a pretty recent thing that a child can spend months, even years at a time in man-made environments without a day in nature. I think this has a severe impact on perspective, perceptions of reality, being right-sized, etc.  I think that being in nature has many effects on us that are still poorly understood.

And then there is the electronic media thing… staring at screens: TV, DVD’s, WII sports, Nintendo games, texting. We are learning reality from unreality. Not to mention that radiation thing.

And, seriously, WHAT are they watching for 5-8 hours a day? Porn and violence. There have been some hugely ignored studies documenting that children before the age of four register traumatic events they see on film as if these events were real. In other words, they actually develop PTSD from watching people get burned alive, blown up, eviscerated, raped, tortured, and murdered. I remember back in the 1950's, my brother developed a bunch of fear behaviors after seeing the movie "House on Haunted Hill." Which would be considered light-weight today.  Anyway, the research about pornography is equally conclusive and equally ignored: exposure to pornography desensitizes the viewer, impairing their capacity for intimacy, fostering an objectification of (usually) women. Oh, and it teaches rape.

Are children more restless, depressed, aggressive? I wouldn’t doubt it. Is it about chemical imbalance in the brain? Until there is one shred of research to support that theory, I’m going to go with “no.” Is it about how far we have removed ourselves from being an animal species among animal species?  Well, those folks who are actually creating environments to bring us back to that are getting good results.

But let’s get back to “the story.”  Children have been massively mentally ill all along… who knew? 

Let’s look at Attention Deficit Disorder (ADD).  At the turn of the century, a doctor did identify hospitalized children with “violent outbursts… destructiveness, and a lack of responsiveness to punishment.” This was found to be associated with known brain injuries (meningitis, brain tumors, etc.) It was a rare condition.

In 1956 Ritalin went on the market as an alternative to amphetamines for treatment of narcolepsy. It was found helpful for treating these hyperactive kids who were hospitalized for brain injuries. But things didn’t really change until 1980, when ADD made it into the DSM for the first time (Diagnostic Statistical Manual), which, in cynical terms, determines what insurance will and won’t pay for. In 1987, ADD became ADHD (Attention Deficit Hyperactivity Disorder). In 1991, ADHD became covered by an act of Congress, so that now children with the diagnosis were eligible for a range of special services.

What happened? Suddenly there were children in every classroom with this formerly rare, brain-disease side effect. Who was diagnosing? Mostly teachers, not doctors.  A study in 2009 showed that “only a minority of children with this disorder exhibit symptoms during a physician visit.” By 2007, one out of twenty-three children (4-17 years old) were being medicated for ADHD.  It’s called a brain disease, but, again, no research supports this finding. The neuroanatomy appears to be normal. The “chemical imbalance” thing is a drug-marketing claim, not science. Who needs facts when the story is so good?

Do the drugs “work?” Well, the children definitely become subdued, or, in clinical terms, there is a “reduction in movement and engagement with others.” In teacher language that would mean “stops fidgeting and talking to students during class.” In research language, other phrases have been used: “emotionally flat,” “reduced curiosity about the environment,” “socially withdrawn,” “little or no initiative,” “devoid of humor.”

What about the children?  Researchers have found a pervasive dislike for taking the pills among hyperactive kids. Seems that it’s not great for self-esteem. But what about academic performance? If the pills enhance the student’s ability to focus, then wouldn’t that enhance self-esteem?

Ritalin helps with focus on  routine, repetitive tasks, but it does not lend itself to creative problem solving or divergent thinking—both of which are necessary for critical thinking. Ritalin appears to be taking on a sinister tinge: The improvement is in classroom manageability, not academic performance.

And the long term?  Seems to be a growth suppressant (shorter, less weight). Symptoms worsen over time. Greater overall functional impairment.  Oh, gosh… Okay (deep breath): drowsiness, appetite loss, lethargy, facial and vocal tics, insomnia, headaches, abdominal pain, motor abnormalities, skin problems, liver disorders, sudden cardiac death, depression, apathy, anxiety, irritability, obsessive-compulsive disorder, mania, paranoia, hallucination…  reduced ability to experience pleasure. Yeah. Ritalin.

Moving on. By 2002, one in forty children were on anti-depressants. In 2004, the number of children killing themselves on these drugs was so alarming, the FDA started requiring the drug companies to include a warning label that describes the "increased risk of suicide and suicidal thoughts and behavior in children and adolescents given antidepressant medications." A warning. The drugs are still available, still prescribed, and young people are still killing themselves. Read my earlier blog on the failure of antidepressants… Or, if you have a strong stomach, go to the SSRI stories website.

In 1960, researchers were unable to find any cases of manic-depressive syndrome in children. By the late 1960’s, Ritalin began to be prescribed. Some children taking Ritalin began to exhibit manic behavior.  No surprise there. Any parent with a kid on Ritalin can tell you about the daily “crash.” The drug produces arousal followed by dysphoric symptoms. Daily. But this is the very cycle that doctors describe as bipolar!  Every child on a stimulant is a bit bipolar, and the risk of moving on to a full diagnosis is ever-present. Voila! Pediatric bipolar disorder was “discovered.”

As antidepressants began to be prescribed, the numbers rose even higher.  And here was the story: The antidepressants were not causing bipolar.. no, no, no!  They were simply unmasking the bipolar illness that was already there! In fact, by 1995, studies showed that one quarter of children and adolescents diagnosed and medicated for depression would convert to bipolar within two-to-four years.

To sum up: 400,000 children have arrived at bipolar via the ADHD doorway, with at least another half-million on the way through the antidepressant doorway. This is an iatrogenic epidemic, people. Iatrogenic. Look it up. And how bad off are these kids?  In 1987, there were about 16,000 psychiatrically disabled youth on SSI.  Twenty years later? 560,000.

And what about really young kids? About ten years ago, doctors began to prescribe psychotropic drugs to toddlers. In those ten years, the number of children under the age of six who are on SSI has tripled.

Whitaker goes on to interview some of the children who are on these medications. The stories are heartbreaking and also infuriating. What is most upsetting is that the doctors who are attempting to explore other treatment modalities in lieu of medication are finding they can’t get funding, and their work is not being published. 

The next blog will probably be the last… talking about these alternative methods for dealing with mental illness.

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It was not my intention to write so many blogs on Anatomy of an Epidemic, but I have lost so many friends, acquaintances, and colleagues to this iatrogenic “epidemic,” I find that every time I want to skip a chapter, there is a nagging compulsion that haunts me until I include the material.

This was the case with Whitaker's chapter on bipolar. I had covered anti-psychotics, neuroleptics, antidepressants… and I just wanted to move on to conclusions. But my  conscience would not let me.

So, here we go: Robert Whitaker on bipolar...

He opens the chapter with a report on the 2008 American Psychiatric Association annual meeting, which he attended. Because of new disclosure guidelines, Whitaker was able to access information about some of the speakers. One example: Joseph Biederman of Massachusetts General who led the way in popularizing juvenile bipolar disorder received research grants from eight drug companies, was a “consultant” to nine of them, and served as a “speaker” to eight. The enmeshment between medical professionals and pharmaceutical companies has apparently become so routine and so widely accepted, no one thinks to ask if this connection might constitute conflict of interest. In fact, failure to have these connections is likely to call into question one's medical credentials. But that's another chapter.

The fact is this:  outcomes for bipolar have dramatically worsened since the “discovery” (read “accidental blundering onto questionably useful, but decidedly marketable side effects while developing drugs for other purposes”) of psychiatric drugs.  To what does “worsened” refer?  Increased chronicity, functional decline (as in "becoming disabled"), cognitive impairment, and physical illness… all of which, the author notes, can be EXPECTED to show up with patients taking the usual bipolar cocktail that often includes an antidepressant, a mood stabilizer, a bezodiazepine, an antipsychotic, and maybe a stimulant.

In the past, bipolar disorder was considered extremely rare. In 1955, the rate appears to have been about one in every 13,000. Outcomes were very positive. Whitaker cites a number of studies illustrating that about 50% hospitalized for mania did not have a recurrence. Seems that 70-80% used to end up “socially recovered”…  that is,  married, working, home-owning.  Okay, somewhat heterosexist and capitalist criteria, but at least they were not institutionalized, not on disability payments, not lying on the couch or in bed.

So, what’s the scenario today?  One in forty people are diagnosed as bipolar. WHAT? From one in 13,000 to  one in 40? And, no, that huge a difference can’t be explained just by saying that medicine has expanded the boundaries of the diagnosis. It has definitely done that, but there is obviously something more significant going on.

Okay… dirty little secret: Studies show that one-to-two thirds of patients hospitalized for bipolar episodes have abused (used?) illicit drugs… specifically stimulants, cocaine, marijuana, and hallucinogens. These weren’t all that popular and available until the 1960’s. So that's part of the epidemic.

But there’s something else…  The American Psychiatric Association in 1993 admitted that “all antidepressant treatments, including ECT [electroconvulsive, or "shock" therapy], may provoke manic episodes.”  In fact, 20-40% of patients diagnosed with depression convert to bipolar.  One study notes that 60% of bipolar patients turned that way after exposure to antidepressants. 

Even more sadly, withdrawing the antidepressant that produced the mania will not alter the condition. In other words, antidepressant-induced bipolar disorder is neither temporary or reversible.

And, yes, doctors (and keep in mind the tremendous amount of money that many receive from drug companies for endorsing their products) expanded the diagnosis. You no longer need to be hospitalized in order to get a bipolar diagnosis. You no longer need to have four days of “elevated, expansive or irritable moods.” You just need two. So now, 5% of the population is bipolar. But even that’s not good enough.  In 2003, the former head of the National Institute for Mental Health (NIMH) said that many folks can suffer from “subthreshold” symptoms of depression and mania. The new name is “bipolarity spectrum disorder.” 6.4% of American adults are apparently affected, and some optimistically declare that it’s more likely that  25% are somewhere on the bipolar spectrum! Talk about expanding markets!

Page after page after page of studies in Whitaker's book illustrate how the antidepressants destroy the symptom-free interludes, which, of course, destroys functionality. Frankly, it makes for depressing reading: “induction of mania,” “induction of rapid cycling,” “increase in number of episodes,” “chronic depression,” “cognitive impairment.” Finally, in 2008, the NIMH released their findings on bipolar treatment: “the major predictor of worse outcomes was antidepressant use, which about 60% of patients received.”

Let me just cut to the chase: In 1955 there were about 12,700 patients hospitalized for bipolar. Today, there are about SIX MILLION adults with the illness, and 83% are “severely impaired.”

And if you have loved ones, as I do, who have been diagnosed and who are on the usual drug cocktails for bipolar, then you can skip the narratives at the end of the chapter. I’m sure the stories will be familiar. Whitaker puts a human face on this tragedy, interviewing patients whose lives illustrate the stages of cognitive impairment and loss of functionality. The descriptions from those who have gotten away from the drugs and managed to survive are telling. One patient notes, “Honestly, it felt like I was waking up for the first time in five years… I had gotten back to being myself again. I felt like the drugs took away everything that was me.”

As terrifying and/or debilitating as episodes of mania or depression can be, it might be helpful for doctors to keep in mind the fact that longterm outcomes for both schizophrenia and manic-depressives are consistently better for patients who are not treated with psychiatric drugs.

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 “With psychiatric medications, you solve one problem for a period of time, but the next thing you know you end up with two problems. The treatment turns a period of crisis into a chronic mental illness”…

This quotation by a patient opens the tenth chapter of Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astounding Rise of Mental Illness in America.  This is the seventh part of a blog about the book.

The author offers an interesting exercise in logic: What if there was a virus that makes people sleep 12-14 hours a day, move slowly, and appear emotionally disengaged? What if this virus made blood sugar levels and cholesterol levels soar? What if patients with the virus were developing diabetes… especially children and young adults? And some were even dying from pancreatitis?  And then government studies were discovering that the virus was having these effects because it was blocking an astounding multitude of critical neurotransmitter sites in the brain:  dopaminergic, sertononinergic, muscarinic, adrenergic, and histaminergic?  And imagine that this virus was shrinking the cerebral cortex causing cognitive impairment…   Scary virus, no?  And then the author delivers the punchline: He has just described the effects of Eli Lilly’s best-selling antipsychotic drug Zyprexa.  And, yes, millions (including children) are taking it. And, yes, BILLIONS have been paid out and continue to be paid out in settlements by Lilly …

But Zyprexa continues to be sold. Why? Hold that question…

Whitaker’s research for the book takes the reader down some of the back alleys, where we find the researchers who consistently find, over and over, that there were no such things as "chemical imbalances" in the brain causing mental health conditions… who are finding in study after study that these psychiatric drugs are causing permanent brain damage and drug dependencies. What happened to them? They were fired, demoted, censored, discredited, had their funding withdrawn, their positions revoked.  This was not the story that people wanted to hear. And this is still going on. (Good thing Scientologists don't believe in psychiatric drugs... Now anyone who questions the practice can be equated with Scientologists and believing in aliens!)

What’s going on?  Let’s follow some of the money…

Eli Lilly’s value increased nearly tenfold between 1987 and 2000.  The head of the psychiatric department at Emory received $960,000 from one drug company just to promote Paxil and Wellbutrin. In 2006, drug companies gave physicians in Minnesota $2.1 million dollars.  The totally accidental and random discovery of drugs that affect the brain and the very focused and intentional marketing of them has ushered in what amounts to a psychotropic Gold Rush.

And who pays the bill? In 2008, the US spent $170 billion on mental health services, which was twice as much as in 2001.  By 2015, the cost is estimated to be almost twice as high. About 60% of this is paid by the US government via Medicare and Medicaid. We’re all paying the bill.

But money is not the primary cost. The highest price is the cost to our mental health. Whitaker makes an argument that is difficult to refute that the current mental health epidemic in this country is an iatrogenic one.

The eighth blog on this issue will be focused on solutions. Stay tuned!

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Click here to go on to Part 8.

This is the fifth part of a series of blogs in response to Robert Whitaker’s book Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America.

Whitaker reviews the scientific research to demonstrate that the psychiatric drugs were discovered by accident, and were not intentionally developed to treat mental diseases. The theory of a chemically imbalanced brain was put forward after these drugs began to be prescribed and, according to Whitaker, this theory has not been supported by studies. As he noted, researchers did not find chemical imbalances in the brains of mental patients, but these imbalances did turn up after use of psychiatric drugs.