The field of psychiatry appears to be enduring a renewed and, it seems to me, well-deserved assault. Richard Bentall’s fascinating Doctoring the Mind, published in 2009, essentially argued that there are three defects with in practices: no one’s sure of how to explain mental phenomena; no one’s sure of how to diagnose their conditions and no one’s sure of how to treat them. Actually, there are four, and the fourth could be the most important: far too many people are ignoring these uncertainties. Reductionist social and, increasingly, biological hypotheses are adduced as scientific truths; characteristics are wedged inside questionable diagnoses and, of course, Big Pharma-formulated treatments are doled out by the million. It seems to be a lethal mix of complacent ideology and corporate influence.
In the New York Review of Books Marcia Angell introduces recent tomes that offer similar conclusions…
The books by Irving Kirsch, Robert Whitaker, and Daniel Carlat are powerful indictments of the way psychiatry is now practiced. They document the “frenzy” of diagnosis, the overuse of drugs with sometimes devastating side effects, and widespread conflicts of interest. Critics of these books might argue, as Nancy Andreasen implied in her paper on the loss of brain tissue with long-term antipsychotic treatment, that the side effects are the price that must be paid to relieve the suffering caused by mental illness. If we knew that the benefits of psychoactive drugs outweighed their harms, that would be a strong argument, since there is no doubt that many people suffer grievously from mental illness. But as Kirsch, Whitaker, and Carlat argue convincingly, that expectation may be wrong.
At the very least, we need to stop thinking of psychoactive drugs as the best, and often the only, treatment for mental illness or emotional distress. Both psychotherapy and exercise have been shown to be as effective as drugs for depression, and their effects are longer-lasting, but unfortunately, there is no industry to push these alternatives and Americans have come to believe that pills must be more potent. More research is needed to study alternatives to psychoactive drugs, and the results should be included in medical education.
June 29, 2011 at 10:44 pm
I take zoloft personally for my anxiety, but I agree that depression can be over diagnosed.Although I don’t know if the really severe stuff like schizophrenia can be treated without medication same with severe variations of bipolar disorder.
June 30, 2011 at 12:13 am
I can’t proclaim too broadly on the merits of treatments but from personal experience I know what an unsettled “science” psychiatry is. My doctor recommended CBT when I some issues. When I saw another doctor, though, they insisted this would be useless and recommended something else.
Actually, I found things easier to deal with once I’d given up on doctors. Perhaps that was just me.
June 30, 2011 at 3:39 am
Did you give up on doctors entirely?
June 30, 2011 at 10:42 am
Well, I’d go back if I was ill!
July 7, 2011 at 1:08 am
[...] In the middle of this comes a compelling critique of some of psychiatry’s key claims by Richard Bentall, a UK clinical psychologist working within the NHS. In Doctoring The Mind: Why Psychiatric Treatments Fail, Bentall provides a lucid and accessible account of the meagre successes and substantial failures of psychiatry, following on from his earlier Madness Explained. Unlike many critics of the discipline, he remains committed to a scientific understanding, which he calls ‘rational antipsychiatry’. http://bensix.wordpress.com/2011/06/28/do-the-drugs-work-and-can-they-make-you-worse/ [...]
August 4, 2011 at 11:13 am
[...] ‘un.” It’s reductionist thought like that that inspires people to believe that little, coloured pills are the solution to mental [...]
January 29, 2012 at 4:58 pm
[...] This is, of course, especially relevant in a world where hundreds of thousands are fed drugs that may or may not be at all effective. Advertisement GA_googleAddAttr("AdOpt", "1"); GA_googleAddAttr("Origin", [...]