Anatomy of an Epidemic by Robert Whitaker Read Free Book Online

diagnosis. She had first seen a therapist because she
cried too much
. There had been no mania—her sleeplessness and agitation hadn’t arisen until after she had beenplaced on an antidepressant. Could she just have been a moody teenager who had some growing up to do?
    “I had always thought before that I was one of those cases where the illness was clearly biological,” she says. “It couldn’t have been situational. Nothing had gone terribly wrong in my life. But then I thought, well, I came out as a lesbian, and I had no family support. Duh. That could have been kind of stressful.”
    The mood stabilizers were the last to go, and on November 22, 2006, Dorea pronounced herself drug free. “It was fabulous. I was surprised to find out who I was after all these years,” she says, adding that having shed the bipolar label in her own mind, her sense of personality responsibility changed, too. “When I was ‘bipolar,’ I had an excuse for any unpredictable or unstable behavior. I had permission to behave in that way, but now I am holding myself to the same behavioral standards as everyone else, and it turns out I can meet them. This is not to say that I don’t have bad days. I do, and I may still worry more than the average Joe, but not that much more.”
    Dorea’s research at Massachusetts General Hospital focuses on how vascular activity affects brain function, and given that her struggles with “mental illness” can seemingly be chalked up as a case of misdiagnosis—“I have this fantasy of being undiagnosed as bipolar,” she says—it may seem that her story is irrelevant to this book. But, in fact, her story raises a possibility that could go a long way toward explaining the epidemic of disabling mental illness in the United States. If you expand the boundaries of mental illness, which is clearly what has happened in this country during the past twenty-five years, and you treat the people so diagnosed with psychiatric medications, do you run the risk of turning an angst-ridden teenager into a lifelong mental patient? Dorea, who is an extremely smart and capable person, barely escaped going down that path. Hers is a story of a possible
iatrogenic
process at work, of an otherwise normal person being made chronically sick by diagnosis and subsequent treatment. And thus we have to wonder: Do we have a paradigm of care that can, at times,
create
mental illness?
The Parents’ Dilemma
    Early during the course of my reporting for this book, I met with two families in the Syracuse area who, a few years back, had been faced with deciding whether to put their children on a psychiatric medication. The reason that I had paired these two families up in my mind was that they had come to opposite conclusions about what was best for their child, and I was curious to know what information they had at their disposal when they made their decisions.
    I first went to see Gwendolyn and Sean Oates. They live on the south side of Syracuse, in a pleasant house perched on a slight hill. A gracious, biracial couple, they have two children, Nathan and Alia, and as we spoke, Nathan—who was then eight years old—spent most of the time sprawled out in the living room, drawing pictures in a sketchbook with colored pencils.
    “We began to worry about him when he was three,” his mother says. “We noticed that he was hyperactive. He couldn’t sit through a meal, he couldn’t even sit down. Dinnertime consisted of him running around the table. It was the same thing in his preschool—he couldn’t sit still. He wasn’t sleeping either. It would take us until nine thirty or ten p.m. to get him down. He would be kicking and screaming. These were not normal temper tantrums.”
    They first took Nathan to his pediatrician. However, she was reluctant to diagnose him, and so they took him to a psychiatrist, who quickly concluded that Nathan suffered from “attention deficit hyperactivity disorder.” His problem, the psychiatrist