We Just Get Keep Getting Smarter and Smarter, and Pretty Soon We're as Good as We Are Now
Categories: Staff Picks , Nonfiction , Health & Nutrition
One of my high-school teachers got off topic and repeated her personal anecdotes a lot. I've forgotten Latin, but I remember the anecdotes. One was about a big, strong husky boy who nevertheless didn't try out for the football team because he was "yellow." Some other boys beat him up, and the Latin teacher was glad. Then again, she thought, he probably had dementia praecox (or else he would have been on the team), so his "yellowness" wasn't exactly his own fault.
Dementia praecox, I knew, had not been a diagnosis since the 1950s, when we became enlightened and started using good drugs (Thorazine) instead of bad surgeries (lobotomy), and the word "schizophrenia" replaced "dementia praecox." Then things got even better in the '90s, when atypical antipsychotic medicines with fewer side effects were created.
According to Robert Whitaker's 2002 Mad In America, though, I've been completely wrong.
Whitaker walks the reader through treatments for serious mental illness from colonial times (the "spinning cure," hydrotherapy) through the horrors of the early 20th century (eugenics, lobotomy, insulin comas) to the present (drugs). His thesis is that the only treatment that has proven effective has been one where the patient has been able to find asylum in the positive sense--food, shelter, safety, interesting activities, and respect. Otherwise, patients are more likely to get better with no treatment than with medications.
Whitaker believes that medications exist because of pharmaceutical companies' greed and psychiatrists' desire to keep control of mental-health care rather than ceding it to non-physicians. He claims that the "atypical" generation of antipsychotics came to replace the "typical" ones simply because the older ones were about to become available as cheap generics. The older ones were initially called "chemical lobotomies," Whitaker says, and the idea that antipsychotics actually helped people get better was a marketing tool.
He says that even the FDA was skeptical about the efficacy of atypical antipsychotics. He doubts whether the term "schizophrenia" should exist at all, because the diagnosis is often subjective and convers such a large range of symptoms.
Well, I've never thought of these things before. It never occurred to me that psychiatrists, or even a lot of nonpsychiatrists, wouldn't be able to agree whether a patient had schizophrenia or not. On one hand, the FDA's statements, those I could access easily, don't seem to me quite as skeptical as Whitaker portrays them. On the other hand, the high-school boy shouldn't have been beaten up or forced to play football, and I hope he's doing okay now.
