Cracked: Why Psychiatry is Doing More Harm Than Good

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Patients have been diagnosed with chemical imbalances, despite that no test exists to support such a claim, and that there is no real conception of what a correct chemical balance would look like.’ (Dr David Kaiser, Psychiatric Times) I will accept his grim indictment of the current state of the pharmaceutical industry (indeed, many reviewers are mentioning Ben Goldacre who has pointed this all out before) James Davies, with a PhD in social and medical anthropology from Oxford, begins with a history of psychiatry starting in the 1970s and a crisis of confidence it faced. A series of experiments questioned the validity and reliability of psychiatric diagnosis. A particularly interesting chapter is about a young psychiatrist who is targeted by a drug company to be trained and spruik their wares and also an exposition of the relevant sales strategies and methods. One might say that these are legitimate methods designed to sell a product (although I have my doubts) without dealing with whether they actually work.

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I found this explanation helpful as I’ve process through the idea that the that chemical imbalance theory has yet to be proved. (“After nearly 50 years of investigation into the chemical imbalance theory, there is not one piece of convincing evidence that the theory is actually correct” (129).) If this theory were true, then chemical imbalances could be cured by intaking the right amount of chemicals (via medication). Davies’ view instead is that pills “don’t cure us - they simply change us” (99). He offers, they are “just providing a temporary and superficial distraction” (100). To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Davies' writing here is excellent. He writes with an easy and engaging style that easily holds the reader's attention. And despite fielding some technical subject matter, Davies presents this content in a manner that will be accessible to even the scientifically illiterate layperson. Points to the author here for this effective communication.

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The theory is that the psychiatric illness is caused by some sort of imbalance in brain chemistry and the drugs will correct this imbalance. However, the imbalance has never been shown to exist. Even in the case of depression the evidence is pretty clear ...as the following citation indicates: Davies seems to side with the view that some form of suffering is natural for humans and the best way to treat it is through social measures or simply managing it. He suggests a path forward for the profession which has four steps: By using this service, you agree that you will only keep content for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services For anyone interested in the sociology of psychiatry and other themes raised in this book, I recommend instead:

Cracked: Why Psychiatry is Doing More Harm Than Good - James

What we expected to find’, said Kirsch lowering his teacup, ‘was that people who took the antidepressant would do far better than those taking the placebo, the sugar pill. We couldn’t have been more wrong.’ And if you look at the graph below you’ll see exactly what Kirsch means.3 Atlantic have bought UK & Commonwealth rights (excluding Canada) in Dr James Davies’s The New Opium:Capitalism, Mental Health and the Sedation of a Nation. The book argues governments now are more preoccupied with sedating us, depoliticising our discontent and keeping us productive and subservient to the economic status quo, than with understanding and solving the real roots of our emotional despair. As a student, you will have be supported not just by those that teach you, but also by the wide range of staff who will be with you throughout your studies.

Being a young medic who will very soon find himself in the chair making referrals to psychiatry and psychotherapy, I considered myself having a deep personal stake in reading what Davies had to say. And I am glad that Davies puts forth his case so convincingly. Being a medical trainee who devoured every moment of soaking every word of psychology at A-Levels where utterly disparate models of human behaviour could co-exist in a curriculum, I went on to get completely disillusioned after reading psychiatry with its all-explained-through biology model taught during medical school. This is a profoundly disturbing look at the world of Big Pharma and shadowy truth: drug companies have been allowed not to publish studies which don't support their research; placebos have proved as effective as Prozac. This is an important book for anyone who has any interest in mental health" The DSM has gone through a number of editions and each time numbers of "new" mental illnesses have been added to the book (82 new illnesses from DSM3 to DSM4). So what are all these "new" mental illnesses. This citation seems academically sloppy and perhaps shows that Davies seeks to oversimplify a complex and murky issue into a one-sided story (though this also might reflect my innate bias against pop-science books).

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First of all, let me say that I completely agree that overmedicalisation is a big problem. Okay, now for the real review. I think this is a really important book. As Peter Hitchens (Mail on Sunday) put it...this "Should be read by every doctor....by everyone in politics and the media, not to mention any concerned citizen".

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Chapter 1 ends questioning the validity of psychiatric diagnoses even if we fix the reliability problem. Even if we could get every psychiatrist to agree on the diagnoses, does that mean it’s a real disease entity, or that we’ve just made a reliable but arbitrary construct? He argues that we need biomarkers to prove it’s a “discrete, identifiable biological disease.” While I agree, I think that psychiatric definitions do a good job of separating normal but different from disease, by often requiring that the disease is disruptive to the patients social relationships or occupational function. What makes psychiatric illnesses, diseases is that they are problematic for people’s lives, and people, whether the patient themselves or their friends and family, want something done about it. I’m unsure if we will be able to find or need to find biomarkers for every disease. While some diagnoses may ultimately be arbitrary, if they are clinically helpful and can show statistical and long-term improvements in patients quality of life, then they are valuable.