"The Crazy State of Psychiatry" by Marcia Angell

"The Crazy State of Psychiatry" is an essay discussing the increase of the diagnosis and treatment of mental illnesses in the US in the past decades. The author, Marcia Angell, is a medical doctor and a lecturer at Harvard Medical School and is already well written on issues including the disconcerting practices of pharmaceutical companies. Throughout the piece she raises a series of questions: why are the numbers of cases of mental illnesses increasing? Do the psychoactive drugs generally used to treat these illnesses really work? If not, why are they so prevalent? She then presents answers to these questions by laying out the opinions of three other authors. These are Irving Kirsch, a psychologist, Robert Whitaker, a journalist, and Daniel Carlat, a psychiatrist. In the past fifty years, the theory has developed that mental illnesses are caused by chemical imbalances in the brain. However, the authors quoted in this essay contest that this theory, which was developed after the creation of the first chemically-altering psychoactive drugs, is not correct. In answering her overarching questions, Angell cites data that shows that these drugs are not much more effective than simple placebos. This leads her to explore how the interests and promotions of pharmaceutical companies are what have increased the prevalence of psychoactive drugs. Angell greatly appeals to the ethics of her readers as she reveals the financial and political motivations of companies and practices behind the treatment of mental illnesses. She also presents quite an unsettling explanation of how these less-than-perfect drugs may be increasing illness symptoms. Overall the essay incites a wariness of current psychoactive drugs and their manufacturers and calls for the return to alternative methods of treatment for mental illnesses

Do psychoactive drugs really work? Studies have shown that they are not much more effective than placebos. (Cartoon by Chris Madden)

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