According to Robert Whitaker (Anatomy of an Epidemic), the general impression that people have been freed from the ravages of mental illnesses by the excellent pharmaceuticals that started coming out in the 1950s, with each generation bringing better pharmacological remedies, is turning out to be spurious.
While it is true that the permanent hospitalization that was commonly implemented before that era is pretty rare as a modality now, it was largely popular before WW II (says Whitaker) for eugenics reasons (i.e., permanent institutionalization as a means of vastly reducing reproductive opportunities). In a fairly short window between the time when eugenics sentiments became politically incorrect (due to overtones of the Nazis) and the time that thorazine became widespread, approximately 1/3 of patients with even the most serous diagnosis recovered completely in the long run, another 1/3 recovered partially (e.g., living in the community but not fully employed), and 1/3 remained significantly disabled.
Whitaker says (and cites a huge slew of case studies) that all of the efficacy of the psychiatric pharmaceuticals widely used from the 1950s through current era meds falls off to significantly worse than no meds at all when you study long-term efficacy instead of short-term efficacy. In a broad sense, the various drugs do one of four things:
• increases neural receptivity to neurotransmitters of various sorts
• decreases neural receptivity to neurotransmitters of various sorts
• increases speed or efficiency of reuptake of neurotransmitters of various sorts, thus reducing the amount present in the synapses
• decreases reuptake of neurotransmitters of various sorts, thus increasing the amount present in the synapses
In every psych category and pharmaceutical remedy that he examines, Whitaker finds that over time the brain compensates: if receptivity or the amount of neurotransmitter chemicals are increased, the brain reduces the number of receptors to make up for it; if receptivity or the amount of neurotransmitter chemicals are decreased, the brain makes new receptors to compensate in the other direction.
He shows that the optimistic theories about each of the mental illnesses being caused by a “chemical imbalance in the brain”, i.e., specific neurotransmitter chemistry differences setting the mentally ill in each psych diagnosis category apart from the non-ill, were all derived in reverse from assuming that the short term efficacy of the newly-found psychiatric drugs was caused by those drugs addressing an underlying undersupply or oversupply of one or another of the neurotransmitters. And that in every case it has turned out that no such “chemical imbalance” can be demonstrated by the research.
As a consequence, (he concludes / supports with data), we have a burgeoning chronic population diagnosed mentally ill who are NOT recovering at the 1/3-1/3-1/3 pattern rate but instead are overwhelmingly disabled by their mental conditon; the drugs leave people worse off in the long run than if they had not been put on psych meds; their brain chemistries have been modified, not “corrected” or “fixed” by the pharmaceuticals; and although people aren’t being stuck in hospitals on a permanent basis, we have a revolving-door syndrome replacing it.