In the book “Anatomy of an Epidemic,” author Robert Whitaker chronicles the epidemic of mental illness in the last 50 years, including schizophrenia, depression and anxiety. In 1955 — the year Thorazine, the first of the drugs to treat mental illness, was used — there were an estimated 355,000 adults hospitalized for mental illness; 30 years later the number had jumped to 1.25 million. By 2007, the number increased to 4 million, an increase of over five times, considering the population almost doubled during the same time.
Especially troubling is the huge increase in these problems in children. The number of young people on disability because of mental illness increased by a factor of 35 from 1987 to 2007, from 16,200 to 561,570. While mental illness has been around for centuries, there has been nothing in history to compare to this explosive increase in the last 50 years.
What is fueling this surge?
The author reaches a very worrisome conclusion: That the cause of this epidemic is the very drugs used to treat these conditions. Initially hailed as miracle cures for mental illness, it appears these drugs have long-term benefits for only a minority of patients. For most, they offer only limited, short-term relief and devastating side effects with longer use.
Whitaker has his critics, including one expert who questions his numbers on the rise of people on disability and his interpretation of research.
Studies have shown fewer relapses, and less dependence on disability or welfare, among patients who are not given these drugs. Dr. Martin Harrow, a researcher in this field, found that while 40 percent of schizophrenic patients not on medications were considered “recovered” after 15 years, only 5 percent of those taking meds reached this point. He commented in 2008, “I conclude that patients with schizophrenia not on antipsychotic medication for a long period of time have significantly better global functioning than those on antipsychotics.”
It seems most patients who have an episode of mental illness recover after a time, but that recovery rate is much lower if they are treated with meds in the early stages. Patients who have been on the meds for more than a few months typically worsen when they try to reduce the dose (and often end up in a hospital if they try to stop suddenly). This is taken as a sign that the drugs are working. But it may also mean the patient’s brain is showing the effects of withdrawal.
A key concept in the promotion of these drugs is the idea that they correct a chemical imbalance in the brain; patients are told the medications are like insulin for a diabetic. But the research does not support this theory. Rather than rebalancing brain chemistry, these drugs create a new dysfunction. This change does suppress the original problem, at least temporarily, but it does not correct it. After long-term use, these chemical changes in the brain become permanent, making it difficult or impossible to get off the drugs.
Even more problematic is the “prescribing cascade” that is triggered. Like any drugs, this class of meds has side effects, and many of them are neurological. Unfortunately, these new symptoms are not recognized as side effects but are seen as signs of a deeper, more serious form of mental illness. The patient is then told they were “latent bipolar” all along. This new diagnosis is then treated by stronger meds, usually an antipsychotic. These “gateway drugs” are typically either meds for depression or a stimulant for ADHD.
The research does suggest that some patients benefit from long-term use of these drugs; this is especially true of the most severe cases. But the indiscriminate use of these meds (Valium was the No. 1 prescription drug in the U.S. from 1968 to 1982, with over 2 billion tablets sold in 1978 alone) appears to have caused far more problems than it has solved.
Our desire for a quick, easy fix, and the pharmaceutical industry’s willingness to provide it, has led us to where all short cuts lead us — less healthy than we were to start with. Next week I will cover the nondrug treatment options for these conditions.
Dr. Michael Noonan practices chiropractic, chiropractic acupuncture and other wellness therapies in Old Town. He can be reached at firstname.lastname@example.org.