Name: What Americans Aren’t Told About Psychiatric Medications | Robert Whitaker
Uploaded: 2026-01-06T18:56:24.000Z
Description: For the past half century, Americans have been told that psychiatric drugs fix chemical imbalances in the brain. But this is nothing but a myth, says journalist Robert Whitaker.

Jan Jekielek is a senior editor with The Epoch Times, host of the show “American Thought Leaders” and co-host of “FALLOUT” with Dr. Robert Malone and “Kash’s Corner” with Kash Patel. Jan’s career has spanned academia, international human rights work, and now for almost two decades, media. He has interviewed nearly a thousand thought leaders on camera, and specializes in long-form discussions challenging the grand narratives of our time. He’s also an award-winning documentary filmmaker, producing “The Unseen Crisis: Vaccine Stories You Were Never Told,” “DeSantis: Florida vs. Lockdowns,” and “Finding Manny.”

Jan Jekielek

NTD Plus

Shows

At a time when our nation is becoming increasingly polarized, media often ignore viewpoints and stories that are worthy of attention. American Thought Leaders, hosted by The Epoch Times Senior Editor Jan Jekielek and his reporting team, features in-depth discussions with important thought leaders on key issues facing America—and Canada, the world—today.

American Thought Leaders

What the End of the Orban Era Means for Hungary and Its Constitution | Marton Sulyok

One Key Fact About America’s Founding That Isn’t Taught Anymore | Eric Metaxas

Is Canada Becoming the CCP’s Backdoor into America? | Former Canadian Intel Analyst Scott McGregor

Bringing you the latest videos, livestreams, and premieres.

Epoch Video

'Killed to Order' LIVE Q&A with New York Times Bestselling Author and Epoch Times Senior Editor Jan Jekielek

Gordon Chang Breaks Down Trump-Xi Summit and What’s Next

How Cartels Force Children Into Prostitution, Drug Dealing and Even Killing | Rosi Orozco

The Charter School Principal Turning Children Toward Plato, Virtue, and the Eternal | Caylan Ford

The CCP’s Greatest Insecurity—and America’s Greatest Weapon | Sam Brownback

Homeopathy Cured Her Disease, Now She’s Fighting for More Access | Paola Brown

Mollie Hemingway: The Untold Story of How One Man ‘Reshaped the Supreme Court’

The Associated Press is an American not-for-profit news agency headquartered in New York City. 

The Associated Press

News

US News

State News

California

More Than 17,000 Under Evacuation Orders as Southern California Wildfire Threatens Homes

Rudy Blalock is a Southern California-based daily news reporter for NTD. Originally from Michigan, he moved to California in 2017 and the sunshine and ocean have kept him here since. In his free time, he may be found underwater scuba diving, on top of a mountain hiking or snowboarding, or at home meditating—which helps fuel his active lifestyle.

Rudy Blalock

40,000 Ordered to Evacuate as Chemical Tank Leaks, Threatens Explosion in California

Video of US Fighter Jet Shooting Down UFO Over Lake Huron Emerges in New Pentagon Files

Ryan Morgan is a reporter for The Epoch Times focusing on military and foreign affairs. He was previously a news writer for NTD. 


Ryan Morgan

Mari Otsu is NTD's White House correspondent based in Washington. 

Mari Otsu

World News

Middle East

Iran

3 US Warships Fend Off Iranian Attacks, Trump Says Ceasefire Still Holds

Mary Man is a writer for NTD. She has traveled around the world covering China, international news, and arts and culture.

Mary Man

Daniel Monaghan is a reporter for NTD News covering culture, social issues, and education. He holds a BA in Political Science and Government.

Daniel Monaghan

China News

Epoch Times Obtains Over 2,000 Unseen Tiananmen Square Photos on 37th Anniversary of the June 4th Massacre

NTD Newsroom comprises teams of reporters, editors, and producers assigned to cover breaking news and other stories.


NTD Newsroom

News you can trust from the U.S. and around the world. Critical information and insight. We cover the stories that others don’t. NTD News Today airs Monday–Friday at 11 a.m. ET.

NTD News Today

US Government Sues Chick-fil-A Over Religious Rights

Sports News

Kyle Busch, Two-Time NASCAR Champion, Dies at 41

Haika Mrema

Medical Plane Crash in New Mexico Mountains Kills 4, Sparks Wildfire

California Mayor Resigns, Will Plead Guilty to Acting as Chinese Agent

Reuters is a news agency owned by Thomson Reuters. It employs around 2,500 journalists and 600 photojournalists in about 200 locations worldwide writing in 16 languages.

Reuters

Trump Calls Iran's Response to Latest US Ceasefire Proposal 'Totally Unacceptable'

Why a Taiwan Invasion Would Trigger Trillions in Global Losses | Amb. Alexander Yui

Over 1,000 CCP-Linked Groups in America: Exposing United Front Operations | Peter Mattis

Why 28- and 29-Year-Olds Are Disappearing From China’s Uyghur Concentration Camps | Ethan Gutmann

Texas AG Ken Paxton Breaks Down Wave of Lawsuits Targeting CCP Surveillance

The Many Hidden Fronts of CCP Unrestricted Warfare | Casey Fleming

Has Xi Jinping Unified His Own Enemies? | Robert Suettinger

How the CCP Dehumanizes Christians in China | Pastor Bob Fu

The Failures of Multiculturalism in the United Kingdom | Peter McIlvenna

From AI Girlfriends to Brain Implants, How the AI Revolution Is Radically Reshaping Our World | Wynton Hall

Most Americans Agree: You Can’t Change Your Sex | Jonathan Butcher

The Woke Movement Has Peaked. What’s Next? | Andrew Doyle

Rob Schneider: Here’s What’s Wrong With Our Culture Today

Why These 9 Institutions Must Be Reformed Post-COVID | Jeffrey Tucker

Canning, Compost, and Chickens: How to Stop Relying on Others for Food | Special Episode

Charles Murray: I Thought Religion Was Irrelevant to Me. I Was Wrong.

Robert Kiyosaki: Why America’s Middle Class Keeps Getting Poorer

The CCP’s Gloves Are Off in Trade War—What’s Next? | Lee Smith

How Tariffs Once Paid America’s Bills–And Why They Could Again | John Gardner

Jeffrey Tucker: Everything You Need to Know About the Fed

Impact of Trump’s Trade, Tax, Energy Policies | Mark Skousen

How Clay Clark Helped Small Businesses Survive—and Thrive—During the Pandemic and Beyond

Eric Trump: How America Can Outcompete China in Manufacturing

EJ Antoni Decodes the Trump Economy and the ‘Big, Beautiful Bill’ Controversy

Here’s What Darwinian Evolution Can’t Explain About the Origins of Species | Stephen Meyer

How ‘Brain Rot’ and the Escapist Virtual World Are Harming Our Youth | Adnan Alkhalili

Treating the Root, Not Just the Symptoms: The Power of Integrative Medicine | Dr. Daniel Monti

Exclusive: Dr. Jay Bhattacharya on How the NIH Is Rethinking Autism, DEI, China Ties, and Gain-of-Function

The False Promise of Antidepressants | Dr. Joanna Moncrieff

Why Steak Is at the Top of the New Food Pyramid | Dr. Shawn Baker

A New Approach to Alzheimer’s? | Lou Reese

Dr. Mehmet Oz: Up to $4 Billion in Health Care Fraud in California

The Evidence of Harm: What the Data Really Show About Pediatric Transgender Procedures | Leor Sapir

An Exclusive, Inside Look at Shen Yun Performing Arts | Special Episode

Epoch Cinema

Cinema

A Little Sketchy TV

Breast Milk, McDonald’s, & Garbage | A Little Sketchy

3-Headed Hydra, NSA, & Cringe | A Little Sketchy

Special

Jubilee Celebrations, Valentines Day, & Selling to China | A Little Sketchy

Freedom Convoy, Ukraine, & Winter Olympics | A Little Sketchy TV

Inside ‘Trump 2.0’ and the Media’s Role in Political Violence | Sean Spicer

He Ran the World’s Biggest Payment Processor; Now He’s Taking on Social Security | Frank Bisignano

Devin Nunes on Ending the Politicization of America’s Intelligence Agencies

Exclusive: Inside SBA’s Crack Down on Loan Fraud Nationwide | Administrator Kelly Loeffler

Exclusive: Kash Patel Talks China Fentanyl, Violent Networks, ‘Burn Bags,’ and More

Andy Ngo: I Was Nearly Killed by Antifa. This is What I Learned.

Eric Trump Opens Up About How Relentless Attacks Impacted Him and His Family

Why Charlie Kirk’s Approach Matters Now More Than Ever | Pastor Jackson Lahmeyer

The Battle Over Alligator Alcatraz, the US Census, and CCP Surveillance | Florida AG James Uthmeier

[RUSH TRANSCRIPT BELOW] For the past half century, Americans have been told that psychiatric drugs fix chemical imbalances in the brain. But this is nothing but a myth, says journalist Robert Whitaker.

Whitaker is the publisher of MadInAmerica.com and is known for his influential critiques of modern psychiatry and psychiatric drug treatment.

It was hypothesized that depression was due to too little serotonin and that schizophrenia was caused by too much dopamine—and that drugs could fix that, just like insulin for diabetes. But that was never backed up by evidence, Whitaker said.

“That was the story that was used to sell a whole second generation of psychiatric drugs and dramatically expand the psychiatric enterprise worldwide,” he said.

In 1999, Whitaker co-wrote a series of articles for the Boston Globe on psychiatric research and became a finalist for the 1999 Pulitzer Prize for Public Service, thereby establishing his reputation in this field. Later, he served as director of publications at Harvard Medical School.

“We have this story that we’re making great progress in diagnosing and treating mental disorders,” he told me.

U.S. spending on treating mental disorders has risen substantially over the past decades, from tens of billions in the late 1980s to more than $100 billion per year today. But there is no evidence, he says, that these drugs improve long-term outcomes. On the contrary, there is plenty of evidence that psychiatric drugs can actually make things worse, he says.

“They actually cause chemical imbalances, increase the chronicity of disorders, increase functional impairment, and you see rising disability rates wherever you see this paradigm of care adopted,” he says.

Certain antipsychotics for schizophrenia, for instance, can actually reduce brain tissue, particularly in the first year, and that’s been associated with cognitive decline and a worsening of symptoms.

Evidence shows that other countries, including developing nations, that have not adopted this same approach have seen much better outcomes, he says.

In this episode, he breaks down his findings from decades of studying this issue. Whitaker is the author of “Mad in America” and “Anatomy of an Epidemic.”

Views expressed in this video are opinions of the host and the guest, and do not necessarily reflect the views of NTD.

RUSH TRANSCRIPT
Jan Jekielek:

Robert Whitaker, such a pleasure to have you on American Thought Leaders.

Well, thanks for inviting me. It’s a pleasure to be here.

What would you say is the biggest myth around mental health or psychiatry today?

I think the myth that has become most well known is the story that the drugs fix chemical imbalances in the brain. So, for example, depression was due to too little serotonin, and drugs that upsurge energy activity in the brain therefore normalize it, like insulin for diabetes. And that was the story that was used to sell a whole second generation of psychiatric drugs and dramatically expand the psychiatric enterprise worldwide, if you look at the number of people getting treated.

The thing was, even as they were pitching that, and it really began to be pitched in the United States in the late 1980s and early 1990s, a drug called Prozac came to market in 1988. It was presented to the public as an incredibly novel drug, a breakthrough medication because it fixes a serotonin imbalance in the brain.

The irony is that was a hypothesis, this idea of chemical imbalances, that was born in the 1960s based on an understanding of how the drugs acted on the brain. So, for example, the first generation of antidepressants both blocked the normal removal of serotonin from that tiny gap, the synaptic gap between neurons. And so they said, oh, look, it’s boosting serotonin reactivity. Maybe depression is due to too little serotonin. That’s in 1965.

Well, they then had to investigate whether people with depression actually have too little serotonin before they go on the drugs. Now, as early as the 1970s, they had to find methods for making that investigation. But even by the early 1970s or late 1970s, people were saying, we aren’t really finding this. In 1984, I believe it was, the NIMH [National Institute of Mental Health] did a big study on this question. And they said, we’re not finding any lesion in the serotonergic system that is abnormal in any way.

In 1998, I believe it was, the American Psychiatric Association’s own textbook said that that story, that idea, the chemical imbalance theory of depression, was no longer valid. They said, we’ve investigated it many ways and we just haven’t found that serotonin is abnormally low in people with depression.

You know, if I may jump in just for a moment, that is astonishing because I suspect that today, I mean, I certainly took this as an obvious fact for years and so do many people, and I suspect even psychiatrists and doctors that are prescribing psychiatric medication.

So this is what was happening in the research literature and actually in psychiatry’s own textbooks when the people that really knew were summarizing the sort of the history of investigation into the low serotonin theory. And then, for example, there’s a famous guy, Stephen Stahl, who writes a book called, Essential Psychopharmacology. It is sort of the book for brand new psychiatrists. And he said, you know, we’ve looked for these and we have not found them. The monoamine thesis, serotonin is a monoamine, it’s just not real. So he said that in 2002.

You can find Kenneth Kendler in 2004, who was an editor of Psychological Medicine, a big researcher in this field, and he said this: we have hunted for big simple neurochemical explanations for mental disorders and have not found them. But the public, that’s not what the public was told. The public was told, and you can follow the public pronouncements of the American Psychiatric Association [APA], which was that they had found this, and you saw a website saying that depression is due to too little serotonin; the drugs fix that like insulin for diabetes. So what happened is there was a valid hypothesis. It was investigated, not found to be true.

However, that story, the American Psychiatric Association and the pharmaceutical companies understood was a great way to promote treatment, the selling of drugs, and also elevate the prestige of psychiatry because they now had, like other areas of medicine, a pathology they could talk about, which meant they were real doctors and they had an antidote to a pathology. Now, that’s a story that’s going to greatly boost the legitimacy and the respect society has for a discipline, right? Because they made this great medical advance, which fits into a larger narrative in Western society.

But yes, that’s the biggest myth, and it’s a profound myth, but it’s because telling people there’s something wrong inside your head with your chemistry, and you need this drug to fix that abnormality, when in fact, it was a hypothesis born from understanding how the drugs act on the brain, investigated, and basically fell flat early on in the 70s, 80s, and 90s, and was discarded by the late 1990s within the American Psychiatric Association’s own textbook.

But we weren’t told, when I say we, we the public weren’t told that. In the United States, you can advertise your drugs on TV, right? So there were advertisements that showed you take this antidepressant and it fixed the chemical imbalance, and then the next thing you know, you’re walking on a beach with a beautiful woman or a beautiful man, right? So we had that part of telling the story.

But we also had a guild, meaning the American Psychiatric Association, pronouncing, telling the American public that this was what caused depression and our drugs fixed it. And you can chart those sentiments. You can see that they were telling this on their website. They even put out a press release in 2005, 2006 saying that psychiatrists are experts in fixing chemical imbalances in the brain.

So that’s a long-winded story to tell of how this very simple saying—it’s sort of a way to sell drugs basically—got started in the United States and then spread like a meme around the world until the next thing you know, people around the world were talking about chemical imbalances. But it never had scientific discovery behind it, not the low serotonin theory of depression.

Before I ask you about what these drugs actually do or what we know they do, why don’t you tell me a little bit about yourself and your background and how you got into this space?

My background was as a newspaper reporter. Starting in 1988, I began covering medicine and science for a newspaper called the Times Union in Albany, New York. I actually left daily journalism in 1994, and two things happened. First, I became director of publications at Harvard Medical School. This was at a time when people were talking about evidence-based medicine. We have to adopt evidence-based medicine. One of the thoughts about evidence-based medicine is that doctors can be deluded about the merits of their therapies based on their clinical perceptions. Okay, so you have to have science telling you what really is the best way to do things. That was very prominent in the early 1990s.

The second thing that happened was this: I co-founded a publishing company in 1994 called CenterWatch that looked at the business of clinical trials. The business was dramatic in the clinical testing of new drugs. The point of looking at it from a business perspective is that the spending on clinical trials was dramatically increasing in the late 1980s and 1990s, and it became a field of opportunity. Both academic centers wanted to get pharmaceutical money for testing the drugs. Individual doctors said, hey, listen, I have patients. I can enroll my patients in your clinical trials. So we were actually writing—and I think this is important—about the business opportunities of getting involved in clinical trials of new drugs.

The problem was, as I began reporting on that, I began understanding that having such a financial environment for the testing of drugs was corrupting the testing of drugs and corrupting what the public was told about the actual results from those trials. Those adverse effects were being hidden, and the efficacy was being exaggerated, that sort of thing. That corruption that I began to write about was most noticeable in psychiatry. That’s how I became interested in psychiatry, because the clinical trials of their new drugs were particularly biased by design, particularly. notable for an exaggerated sense of efficacy and safety as they were promoted to the public.

And the way I knew that is I used freedom of information requests to get what the FDA [U.S. Food and Drug Administration] said about these new drugs when the companies were making an application for, say, the new atypicals. And what you saw there with that freedom of information request was that the actual study data was very mixed. The efficacy was pretty marginal. And there were a lot of adverse events that the FDA investigators were saying you were going to see. But that wasn’t part of the message given to the public.

So I then went to the Boston Globe, for whom I’d written before, and said, I’ll do a series on abuses of psychiatric patients in research settings because there were also some NIMH trials that were quite abusive towards the patients, and we can talk about. Now, one of the keys here, as you asked me this question, is at this time, I still believed in the chemical imbalance story, so much so that one of the things in the Boston Globe series that we wrote looked at studies in schizophrenia patients in which they took people who were doing fairly well on antipsychotics, and then they conducted what are known as relapse studies.

They took half the people who were maintained on the drug and half the people who were taken off the drug with great regularity. Those who were taken off the drug relapsed at a higher rate. And so we said, and when I called people up, they said, yes, antipsychotics fix a dopamine imbalance in the brain like insulin for diabetes. Would you fund studies that took a drug away from people that supposedly fixed a pathology to see how quickly they became sick again? You would never withdraw insulin from a diabetic to see how fast they became sick again.

So I tell this story to explain that I was a believer in the chemical imbalance story. I was a believer in, therefore, that model of progress that we now had drugs that fixed known chemical imbalances. What happened, though, was this. That narrative that I was a believer in was a narrative of modern, amazing progress. And by the way, in my opinion, if they had actually discovered the molecule that caused madness and could fix it, or the molecule that caused depression and could fix it, I would say that’s the greatest medical discovery in history, given how complex the human brain is, right?

But what happened was, as that series was being published, I came upon two studies that belied that narrative of progress. One was a study by Harvard researchers, published in 1994, which looked at longer-term outcomes for schizophrenia patients. They said these outcomes had declined since the 1970s, not improved, and were now no better than they had been in the first third of the 20th century. Now, we look back at the first third of the 20th century as these dark ages, right? So how can it be that with these modern drugs that fix chemical imbalances, we are no better off than when they put people in showers and did all sorts of harsh somatic treatments? Okay, that was number one.

The second was I then stumbled upon studies done by the World Health Organization [WHO] cross-cultural studies that compared outcomes in three developing countries—India, Colombia, and Nigeria—to longer-term outcomes in the U.S. and 500 developed countries. Now, everybody was diagnosed with schizophrenia by Western doctors in the studies. What they found after the first study was that the outcomes in the developing countries were much, much better than in the developed countries. So much so that they concluded that living in a developed country is a strong predictor that you won’t have a good outcome if you’re diagnosed with schizophrenia.

And I was saying, what? We’re so proud of our medicine. Why would you do better if you’re in India or Nigeria than in the U.S. with all our modern medicine? It was a conundrum, basically, a question I wanted to investigate further.So what the World Health Organization investigators did at that time, after the first such study, hypothesized that maybe the reason for the much better outcomes in the developing countries is that the patients are more medication compliant. They take their antipsychotics with great regularity.

Now, that’s a valid hypothesis. If the drugs are supposed to be so helpful and so essential to treating the disorder or disease, whatever you want to call it, then compliance should be associated with a better outcome. So they measured medication use in the second study, and here’s what they found. In the developing countries, they used the drugs acutely, short-term, but not chronically.

So only a very low percentage were maintained on the drugs. In the U.S. and the other developed countries, of course, that was the standard of care. So suddenly now, I was confronted with studies by the World Health Organization, which I think we all agree is a prominent health organization in the world, that found much better outcomes in poor countries where they didn’t use the drugs long-term. So this too belied what I knew to be true, right?

Now what happened is, after that Boston Globe series, I got a contract to write a book, which became Mad in America. It was really meant to investigate this question: Why would living in a developed country lead to poor outcomes for people diagnosed with schizophrenia, because we had this model of progress?

So the very first thing I did was start calling up people, including some of the people I had called for the Boston Globe series, who had told me that the drugs fixed the chemical imbalance in the brain. I said, can you just show me where you found that too much dopamine is the cause of schizophrenia? Or can you show me where you actually found that too little serotonin is the cause of depression?

And I swear to God, here’s what they said. Oh, we didn’t actually find that; that’s a metaphor for explaining why they should take the drugs like insulin for diabetes. And I said, well, I understand that like insulin for diabetes is a metaphor, but surely you actually found these chemical imbalances, and I just want to read the research where you did. The first person said no, we didn’t really find it; the second person said no, we didn’t really find it.

Then I went to the makers of Risperdal, which is a second-generation atypical antipsychotic, and Risperdal was being marketed as fixing not only a dopamine imbalance in the brain but also a serotonin imbalance in the brain. I actually managed at that time to get to the actual researchers. And you know what they said? Oh yes, that’s just such nonsense. You know, we’re just sort of embarrassed that we say this.

So as I began to write a report on Mad in America, which would trace the treatment of the seriously mentally ill in the United States from colonial times until today, I started with this sense that we have a modern narrative of progress that isn’t science-based. And so that’s how I got into this because I had one belief system. I had reported on that belief system.

I had been rewarded for that belief system because that Boston Globe series was a finalist for the Pulitzer Prize in public service. And yet now after that, I’m suddenly doubting whether one element of that, the relapse studies, were really as abusive as they might have been, because maybe there was a good reason to see if people could come off.

So for your listeners, it’s important to know. I was a believer in the narrative. I was a reporter who called up scientists and quoted what they said, calling up the leading figures in any particular field of medicine. I was rewarded for that. And I began down a different path of challenging that narrative or questioning that narrative when I began to find evidence that belied that narrative of progress.

It seems to be very rare in the field right now to question this narrative. I’m aware of, you know, a handful of people that do it very publicly. It’s sort of shocking. Why do you think that is?

Well, there are two different reasons. So let’s say you’re a psychiatrist, and you begin challenging the narrative that governs your field, and that the field itself has built its reputation around. Now, what’s going to happen? Are they going to listen to you? Or are they going to kill the messenger? Are they going to oust you from the tribe? Now, in the United States, the leading schizophrenia doctor at the NIMH, the head of schizophrenia studies in the 1970s, was a man named Loren Mosher, okay?

And he ran a study, a very famous study in the 70s called the Soteria House, where they took, and it was a randomized study, where they took newly diagnosed psychotic schizophrenia patients, and they were either treated conventionally in the hospital with drugs, or they were taken to a house, which was called the Soteria House, an ordinary house staffed by ordinary people.

And the idea here was that by being with people, their psychosis would abate, and they could learn to be with others. The way medications were used in that house was they didn’t put them on antipsychotics right away because they wanted them to be emotionally engaged with each other and with the staff. Now, if people weren’t getting better after some time, they did use dosages, and then they would see who could come off. So it was a selective use model.

Now, what happened? That model, the Soteria arm, had equally good short-term outcomes, and the abatement of psychotic symptoms was just as good over six weeks there as in the hospital, and they had better two-year outcomes. So Loren Mosher now says, in terms of medication use, 40 percent never used the drugs, 40 percent used them temporarily, and only 20 percent long-term, okay? He says we need to rethink the use of these drugs, okay? Because clearly many people can do better without them and that a selective use model, in fact, would lead to better aggregate outcomes.

So what happened? They ran this experiment for 10 years; they did a second house to show that it could be replicated. What happened to Loren Mosher? He was fired from his position and pushed out. And why was he fired? He was fired because that story was so threatening to the story that the American Psychiatric Association guild wanted to tell, which was that its drugs were very effective because that’s what’s becoming their product, not talk therapy, but drugs. His research and a couple of other studies of this type really undercut that story.

Now, they had two chances there, American Psychiatric Association: either listen to the science and respond, which threatened the guild’s image, or oust that person. Well, they chose to oust that person. And I can tell you other such stories in terms of what happens to people, professionals. who once upon a time were seen as leading scientists, good scientists, and said, wait a minute, this science doesn’t support the story that we’re telling. Well, guild interests are very strong. The financial interests are very strong. In psychiatry, we have those guild interests merging with the interests of the pharmaceutical companies.

So you can really come under attack as a professional, no matter what your reputation was before, if you begin to break with your tribe. And I use tribe deliberately. It becomes a tribe, a medical tribe. So that’s an explanation for why professionals are hesitant to break with their tribe. It’s not good for their career.

Before you give me the other reason, what happened to you after you published Mad in America?

Okay, so this is the second part. So I know I’m a reporter, right? It’s really interesting if you’re a reporter. When you cover—like, so I had a sort of normal start, I didn’t just start covering science, right, and medicine, I started covering business and politics. And when you’re covering business and politics, you’re sort of trained to say, you know, don’t trust everything they say, okay? Because they’re selling a story through you to the public. And try to use documents to sort of like really see if what’s happening with the business or the politicians. But don’t just go call people up and trust what they’re saying, okay?

Then you get moved to the medical desk or the science desk. And all of a sudden, you’re sort of given different walking orders. And your walking orders are this: these people are really brilliant, these people in white coats, biologists and all. And they’re people of integrity. They love science, and they love the beauty of science, and they want to maintain the integrity, and they’re open-minded people, okay?

Theoretically, science is a story of the evolution of one idea replacing the other, okay? Your job is to interpret what they say so it’s understandable for a lay public. You’re no longer expected to question what you’re being told because they’re elevated. They’re now, you know, people in white coats; they have an elevated status, a prestigious status. This is who we believe in our society: the scientists, the medical experts, okay?

Now, you’re a reporter, and you’re going to begin undercutting them? Newspapers don’t want to; they’re really loath to do that because the editors don’t know the research, the actual research literature. They know the conventional narrative. They know this is the narrative they sell to the public.

And now you as a reporter are saying, but wait a minute, that’s not based in science. They’re not really—or that not only based in science, that their own science contradicts it. They’re just really not in a position to be open-minded to that because they don’t have enough knowledge about the actual literature or even how to read it. And it goes against an even much larger narrative, which is that we trust scientists and we trust medical doctors, especially if you go back 25 years ago.

So what happened to me, I think it’s the real key to understand, is in that first book, Mad in America, it goes from colonial times until today, sort of talking about the abuses up to the time when antipsychotics arrived in asylum medicine, which was in 1955. You can talk about the dark old days, okay? Because that’s sort of part of the official history.

But then the idea is we had the psychopharmacological revolution, this great advance in care. Now, what I did in this going forward was show that there wasn’t a great advance in care, as documented in their own research literature, as documented in NIMH-funded studies.

What I followed was NIMH-funded research. And as you follow that research across time, and I’ll talk about this tomorrow, you find a very different narrative. You find a narrative where right away, there was worry that maybe antipsychotics were increasing the chronicity of schizophrenia. By 1980, there was even a thought—no, there was evidence and a conclusion—that it seems that the drugs, what antipsychotics do, is block dopamine receptors. In response to that, your brain goes through this compensatory response, trying to maintain a homeostatic equilibrium. And it does that by increasing the density of its dopamine receptors.

Your brain now is more biologically vulnerable to psychosis than it was in the first place. And the researchers concluded this has two problems. When you try to come off the drugs, it’s not that the natural disorder returns, of course the disorder does, but rather you’re going to have this withdrawal effect. And if you stay on the drug because of this, you’re likely to become sort of chronically psychotic.

You’re basically telling me this is causing brain damage, aren’t you?

Well, yes, the antipsychotics cause brain change. Two things, if you want to talk about antipsychotics, then I’ll finish up my story. Antipsychotics are known to cause abnormalities in neurotransmission, okay? So like antidepressants. And there’s a 1996 paper by Steven Hyman, who was the director of the NIMH at that time, that sums all this up. So you have something, a drug that perturbs the normal activity of neurotransmitters in the brain, okay? It either blocks receptors or it blocks the reuptake of that molecule from the synaptic gap.

Now your brain, being this extraordinary neuroplastic organ, what does it do? It goes through some compensatory adaptations to try to maintain this normal functioning. And as Steven Hyman said, at the end of this compensatory process, your brain is operating in a manner that is both qualitatively and quantitatively different from normal. So rather than being normalizing drugs, which are abnormalizing drugs, that was seen as a problem regarding why these drugs could make you more biologically vulnerable to psychosis.

By the way, the antidepressants, if you look in the research literature, they say it’s this compensatory process that may be the reason you end up with a greater chronicity of depression once you go on that drug. But there’s a second element: Since you talk about brain damage with antipsychotics, in the 1990s, of course, what do we get in medicine? We get MRI technology, right? So now with MRI technology, we can measure brain volumes.

Now, a very famous researcher, who was editor-in-chief of the American Journal of Psychiatry, so this isn’t some critic, named Nancy Andreasen. She came up with a theory that schizophrenia is a neurodegenerative disease characterized by brain volume loss, okay? So she begins a big study of, I think, 500 patients, young patients diagnosed with schizophrenia. And she finds that, especially during the first year, there is a shrinkage of brain tissue, a pretty notable, like 6 to 7 percent in volume.

And then she reports, but she’s saying at this time, that’s the disease, okay? Then she reports, as this brain shrinkage happens, you get a worsening of the negative symptoms, you get a worsening of cognitive function, and you get most functional impairment. So she’s saying this is our problem. The drugs don’t stop that brain shrinkage.

However, there have been researchers giving antipsychotics, both the first generation and second generation antipsychotics, to macaque monkeys, and they suffered the same brain shrinkage. Now, monkeys don’t have schizophrenia. So then the question became, is it the drug or the disease that causes the brain shrinkage?

So Nancy Andreasen and researchers went back and said, yes, it’s the drug. And now there have been something like 26 other studies saying it’s the drugs, antipsychotics, older drugs and newer drugs. So you probably haven’t heard of that. The public’s not told of this, but in the research literature, there’s a line of research that you can trace that shows that the drugs shrink brain tissue, particularly in the first year, and that shrinkage, not surprisingly, is associated with a worsening of symptoms, functional impairments, etc.

Now, you ask what happened to me. So I had a good reputation as a journalist. That series for The Boston Globe was a finalist for the Pulitzer Prize. I won some other awards. The book came out and it got a mixed reaction. There were some actually nice reviews by non-psychiatrists, but then there were some really brutal attacks.

My favorite one was by a psychiatrist named Latorre. He said he used to be a good journalist, but now it seems like he’s writing like he’s a Scientologist, which is a way of saying that you can’t trust a thing he’s saying. So there was a real attack on my character as a journalist, you know what I mean? And my agent at that time, because at that time I just wanted to make a living writing books, she said to me, Bob, don’t write about psychiatry anymore. It’s too controversial. It was definitely some pretty brutal attacks.

And I will say something personally as well. Sometimes your friends even began looking at you with a little bit of like, did you go off the deep end here, Bob? Is this a conspiracy? Because they don’t know, right? And so they think that maybe you went off the deep end, you have some anti-drug bias, and all you’ve done is follow the research literature. So it was tough. But I will say two things happened.

There were some nice reviews. It was sort of cited eventually as one of the best science books of that year, 2002. And most important of all was people with lived experience, people who’ve had these diagnoses said, thank God someone finally told our story. You actually listened to us. So that was quite rewarding. Anyway, I would say I was basically banned from writing about psychiatry at that point from major media because I was seen as biased.

And then when I wrote Anatomy, I wrote two other books that sort of rejuvenated my reputation as a reliable narrator of science. And then I returned with Anatomy of an Epidemic. Anatomy of an Epidemic is a frontal assault on that narrative, okay, because it’s looking at how these drugs alter long-term outcomes. The first review that appeared about five minutes after midnight on the publication date likened me to a south African dictator who, by virtue of denying that AIDS was caused by a virus, had caused hundreds of thousands of people to die, and my book was as dangerous as that south African dictator. So I was likened to an AIDS denier. Five minutes later, I got my radio interviews canceled, no more newspaper reviews. It was a very effective way to shut down that book initially.

So I first came across Anatomy of an Epidemic in Laura Delano’s book, where she, of course, was in the system for years on all sorts of cocktails of psychiatric medications. And she came across the book. It was kind of an emotional, seminal moment in the book because she realizes that everything she believed might not be entirely true. I’m guessing you’ve gotten a few people who have reached out to you.

Yes, this is what has been the most rewarding thing of my professional life or just one of the most rewarding things in my whole life. I have received so many calls and emails that say, like, I read your book and my life changed because I saw myself not as someone chronically ill, which is the story, but as someone who got psychiatrized and diagnosed because we also greatly expanded the use of diagnoses.

And then the next thing you know, I went down this rabbit hole of drugs. I got worse and worse, and I was told I was treatment resistant or whatever, and I was seriously ill. And then I saw when I read your book, a different past for myself, that in fact, I was a relatively abnormal person. I was having a difficult time, or even if I was having an extremely difficult time, I could have had every chance to have that as an episode, and my life would have been totally different. And like many people like Laura, then, with that new understanding of their past, could envision a different narrative going forward.

Of course, what Laura envisioned was a narrative off medication and just sort of resuming a real life and not a life as a mental patient. And I’ve heard that story over and over again. And the reason it’s convincing is because what they can do is see in the narrative of science that I tell with all these citations, and they can go to those sources, and they can see that science was, in fact, not telling of chemical imbalances, not telling of discrete diseases, like bipolar is necessarily very different from schizophrenia, and of drugs that can cause two things: a chronification of symptoms, greater functional impairment, and a movement from a less severe diagnosis to a more severe diagnosis.

You see people getting initially a diagnosis of anxiety or depression and the next thing you know they got a bipolar diagnosis. Same thing with ADHD [Attention deficit hyperactivity disorder]; you can move from ADHD to bipolar. So they suddenly had a tale of science that allowed them to understand their past differently and, equally important, an optimistic vision for what could be their future.

Latest

Paywall Related

Free for Subscribers

Conversations on current and trending topics.

Health &amp; Science

Latest and breaking news, documentaries, movies, and lifestyle content on NTD+.
 
Empower your knowledge and elevate your spirit with NTD+, your go-to destination for truthful news, insightful documentaries, and captivating lifestyle content that enriches your life.