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I
n this astonishing and startling book, award-
winning science and history writer Robert Whita-
ker investigates a medical mystery: Why has the
number of disabled mentally ill in the United States
tripled
over the past two decades? Every day 1,100
adults and children are added to the government dis-
ability rolls because they have become newly disabled
by mental illness, with this epidemic spreading most
rapidly among our nation's children. What is going on?
Anatomy of an Epidemic
challenges readers to think
through that question themselves. First, Whitaker
investigates what is known today about the biological
causes of mental disorders. Do psychiatric medications
fix "chemical imbalances" in the brain, or do they, in
fact,
create
them? Researchers spent decades studying
that question, and by the late 1980s, they had their
answer. Readers will be startled—and dismayed—to
discover what was reported in the scientific journals.
Then comes the scientific query at the heart of
this book: During the past fifty years, when investi-
gators looked at how psychiatric drugs affected
long-
term
outcomes, what did they find? Did they discover
that the drugs help people stay well? Function better?
Enjoy good physical health? Or did they find that these
medications, for some paradoxical reason,
increase
the
likelihood that people will become chronically ill, less
able to function well, more prone to physical illness?
This is the first book to look at the merits of psy-
chiatric medications through the prism of long-term
results. Are long-term recovery rates higher for medi-
cated or unmedicated schizophrenia patients? Does
taking an antidepressant decrease or increase the risk
that a depressed person will become disabled by the
disorder? Do bipolar patients fare better today than
they did forty years ago, or much worse? When the
National Institute of Mental Health (NIMH) studied
the long-term outcomes of children with ADHD, did
they determine that stimulants provide any benefit?
By the end of this review of the outcomes lit-
erature, readers are certain to have a haunting
question of their own: Why have the results from these
(continued on back flap)
Also by Robert Whitaker
Mad in America
The Maptnaker's
Wife
On the Laps of Gods
ANATOMY
OF
AN
EPIDEMIC
Magic Bullets,
Psychiatric Drugs,
and the
Astonishing Rise of
Mental Illness
in America
Robert Whitaker
CROWN
PUBLISHERS
New York
Copyright © 2010 by Robert Whitaker
All rights reserved.
Published in the United States by Crown Publishers, an imprint of the Crown Publishing
Group, a division of Random House, Inc., New York.
CROWN and the Crown colophon are registered trademarks of Random House, Inc.
Library of Congress Cataloging-in-Publication Data
Whitaker, Robert.
Anatomy of an epidemic : magic bullets, psychiatric drugs, and the astonishing rise of
mental illness in America / Robert Whitaker.
p. ; cm.
Includes bibliographical references and index.
1. Mental illness—United States. 2. Psychotropic drugs—Prescribing—United States.
3. Psychiatry—United States. I. Title.
[DNLM: 1. Psychiatry—ethics—United States. 2. Psychiatry—history—United States.
3. Mental Disorders—drug therapy—United States. 4. Mental Disorders—
epidemiology—United States. WM 11 AA1 W578a 2010]
RC443.W437 2010
616.8 9—dc22
2009049467
ISBN 978-0-307-45241-2
Printed in the United States of America
Illustrations by Hadel Studio, Westbury NY
10 987654321
First Edition
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