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My guest tonight is Robert Whitaker. He's the author of a new book, Anatomy of an Epidemic, and also the author of Mad in America. He's a writer who has covered articles on the mentally ill and pharmaceutical industry, he's garnered national awards including a George Polk award for medical writing and a National Association of Science Writer Award for best magazine article. He's written for the Boston Globe, and he was named a finalists for the Pulitzer Prize in 1998. Welcome to the show Robert.

Here's the link to the audio podcast: Robert Whitaker: Drugging Kids to Disability. The interview was recorded in 2010 and was just recently transcribed.

Thanks to Tsara Shelton for help with transcript editing.

Rob: This is the Rob Kall Bottom Up Future Health Radio Show, WNJC 1360 AM Washington Township, sponsored by futurehealth.org and opednews.com.

My guest tonight is a return visitor, Robert Whitaker. He's the author of Anatomy of an Epidemic, and the author of Mad in America. This is a book that I think is really important that reveals information about psychiatry and psychiatric medications that I think every person in America ought to know about and seriously consider before taking medication.

Welcome to the show again.

RW: Thanks for having me Rob, I really appreciate it.

Rob: It's a pleasure. So we spoke a couple of weeks ago about some of the findings that what I kind of summarized is that psychiatry has basically sold us a bill of goods that these are medications that are safe and effective and what your book shows, revealing a lot of research...long term research and history, is that the medication is anything but safe and often...and generally found to be not effective in the long run.

RW: Yes, I mean, I think the big...the long term story with psychiatric medications is that they increase the risk that you will become chronically ill. In other words, plagued by chronic psychiatric symptoms, whether it be depression or mood swings, or even psychotic symptoms depending on which class of drugs we're talking about -- that's number one; two -- you do see, you know, often sort of physical problems related to use of the drugs, particularly the benzodiazepines and the antipsychotics -- that can be pretty disabling. And you do see varying degrees of cognitive decline with the different psychiatric medications, again, most pronounced with the benzodiazepines and the antipsychotics, but you see it somewhat with the SSRIs; and then we have this problem that is cropping up especially in people who take...not just cropping up, it's appearing big time especially in people who take cocktails....of early death -- people are dying very early on these medications now. So it is a...when you look long term, what happens to patients in the aggregate as opposed to short term, you get a very different view of the merits of this paradigm of care. And once you do look long term, you really say that we as a society need to rethink this paradigm of care in a very, sort of, fundamental profound way.

Rob: How?

RW: Oh how, I missed that. Yeah, I mean this is such a big question and there are some groups that have contacted me after reading Anatomy and saying -- wow, we have to rethink it and they're, sort of, now talking among themselves, and this includes providers and all....how do we rethink it? And here's part of the problem, psychiatry and actually the pharmaceutical companies, the powers that be have been really effective in selling this story, as you said in your opening about selling us a bill of goods, and selling us a story that these drugs fix known brain diseases -- that's number one -- and therefore standard of care, people who are in the business are almost legally obligated to use these medications, both over the short term and then often over the long term as well. So we have this belief system in place and really a legal system in terms of the standards of care that make reform really, really difficult. And then the other reason that reform is so difficult is that -- and I do write about this in Anatomy of an Epidemic -- is that we do have this storytelling partnership that is formed in the United States, been around now for more than 20 years, in which you have pharmaceutical companies giving money to, you know, doctors/psychiatrists at, you know, very prestigious medical schools to be their speakers, advisors and consultants. Well, since there is that money flow, of course they're going to tell a certain type of story that is beneficial to the sale of these drugs; and then you also have basically pharmaceutical companies funding, you know, a powerful group like the National Alliance on Mental Illness, and they become a powerful voice reinforcing the common wisdom. So we have these mechanisms driven by money that help create societal beliefs; and so the question is how do we, sort of, get beyond that corporate influence to find out what the science really tell us? Because the real how is, we need to know the scientific literature so we can say that we've been sold a bill of goods, and then once you see that scientific literature, then you'll say -- oh, we need to change things, we need to adopt a new approach -- but the problem is the storytelling force in society is so extraordinarily strong.

Rob: Now you've said before on our previous interview that you put the biggest blame on the instructors -- the people who take the money from the pharmaceutical companies who are the professionals in the field.

RW: Right, I do because they're the voice that, in essence, has the...you know that we as a society trust...we trust physicians to tell us what is, you know, what the science is telling us and to test these drugs accurately, and if they find problems, to communicate that to us; and that has not happened in this field. So within...as psychiatry came up with long term outcome studies that didn't support the paradigm of care, they didn't publicize those studies. We know, in fact, that the medical literature is pretty poisoned because they didn't publish negative studies, they spun results, they biased trials by design...we're finding all that out now, it's becoming increasingly clear. And then in addition, psychiatrists who are being paid to be these speakers and advisors in their comments to newspapers and magazines, they would just say nonsense half the time -- they would exaggerate things...the medical literature was bad enough...and then they would spin things another step in their comments to the press. So yes, I blame academic psychiatry at this high level because in my opinion, in our society that's who we're supposed to trust -- it's physicians at prestigious medical schools...their obligation is supposed to be to us, to people, to patients, and unfortunately what you see here is they've been bought out, and in essence, they're giving their fidelity to these pharmaceutical companies and to this marketing of psychiatric drugs. So yes, this is who I do blame and I think this is at the core of the problem.

Rob: Alright now, where I wanted to go today was to talk about specifically drugs that are being prescribed for children.

RW: Right.

Rob: Starting with stimulants, and if you could give a bit of the history of how the...it's not just the drugs, it's also the diagnosis that is part of the problem...a big part of the problem. So if you can give a bit of the history and background that has led to over 2 million children being on stimulant medication...or it's even more than that now.

RW: Well I think it is over...I think it's around 2 million, maybe a little bit more. I'm not quite sure of these numbers...the numbers sometimes are a little bit...depending on which source you use. But let's...it's a number, okay...it's an extraordinary number. So how did this happen? And I think, by the way, that this is a topic if you wanted to list the topics of...which should be at the top of our list as a society as a moral concern, I think this is number one, personally. I think medicating of children is such a national moral question, an ethical question -- we should be having congressional hearings and the society as a whole should be saying -- is this a good thing to do?

So let's start with the stimulants. You know, if you go back, basically, as early as the 1930s...late 1930s, which is when amphetamines were first synthesized, you know, college students began using them to stay up at night and study. But they were...when they were given to kids at a small, sort of, facility for disturbed kids with maybe even some organic brain dysfunction, it was found that it would quiet those kids...it would sort of still their behaviors for whatever reason. And so there was some sense that maybe we can use stimulants for severely disturbed kids to sort of quiet them a little bit, and maybe it would help them focus on schoolwork. So when it was first used in this setting...child setting -- I think it was in Wisconsin...

Rob: Wait, wait, wait...

RW: What's that?

Rob: You used the term organic brain function as a diagnosis...

RW: Dysfunction -- organic brain dysfunction. In other words there was a thought that these kids had a real neurological problem, a very small percentage of kids. This was the thought in the early 1930s/1940s.

Anyway going forward -- and I can jump forward here, and I really should jump forward -- up until, you know, thorough the 60s, kids were not being medicated because there was a thought that it was too dangerous to be giving kids psychotropic drugs, alright? And Ritalin got introduced initially for...to help people stay awake, if I remember, as a treatment for narcolepsy in adults. But then in the 1970s they began...there was a little bit of use of...the thought was -- Okay, we'll use stimulants...and I think that the term was minimal brain dysfunction -- kids that are really agitated in class and, again, the idea was here that there's a small, small group of kids that may have something organically wrong and maybe we'll use these drugs to help quiet them in class and still their movement.

Then in 1980 there was what opens the floodgates to really using stimulants in a big fashion. And what happens is in DSM-III -- this is the Diagnostic and Statistical Manual prepared by the American Psychiatric Association meeting -- and in DSM-III they said, let's create a manual that basically uses the medical model for psychiatric disorders, and we'll say that these are brain disorders and therefore they need, basically, drug treatments much like insulin for diabetes. Well when they did...in 1980 when they did this new manual, they identified Attention Deficit Disorder as a discrete disorder for the first time, so that now enters the national, sort of, consciousness...Attention Deficit Disorder; and once they have that as a medical disorder -- meaning any kid that is fidgeting too much in class and just isn't paying enough attention -- is now said to be, you know, have a psychiatric condition and how are you going to treat that....you're going to treat that with a stimulant. So this opened the floodgates to (a) a new disorder to be treated with stimulants in a wide percentage of people, a broad percentage of people, particularly boys; and then by 1987 that got redefined as Attention Deficit Hyperactivity Disorder, and that further sort of expanded the boundaries of who should be treated with stimulants.

Now going a step forward, at the same time, the drug companies are starting to become very good at marketing things...helped fund a group called CHADD -- and I forget exactly what that acronym stands for -- but they help fund it and CHADD becomes a mechanism for informing the public and getting out marketing materials saying this is a real disease, it's a brain disease, it's caused by a chemical imbalance -- and even though there had been no sign that it...there was no understanding of any sort of pathology underlying this diagnosis at all...and that these kids needed to take amphetamines like insulin for diabetes -- so the marketing machinery began to crank up.

So this is how we got this explosion of stimulant use in the 1980s, and continued in the 1990s. Now what's interesting is as that happened, were they finding that this was really helping kids? Well they would find that over the short term that the use of stimulants would help kids...they would quiet kids, it would still their behaviors in class, so that meant that kids behavior was more, sort of, acceptable to the teacher in that classroom setting. But they were having a hard time finding as they did even short term studies that it was helping the kid in any way. So were they finding that it was really helping the kid do better in, sort of, in his studies -- getting better grades? No. Did it help them socialize better? No, in fact they would find that the kids tended to become a little bit isolated. How about their sense of self? Well they found that kids said -- Oh I must be a little bit defective if I have this disorder...I'm not quite normal. So that was even bad a little bit for the self-image. How about in terms of creative thinking, creative problem solving -- did they find stimulants helped that? No, they did not. So they weren't really finding, time and time again, that this medication was helping the kids.

Now going forward a little bit on this efficacy story....in the early 1990s, the NIMH, that's the National Institute of Mental Health, says -- Wow, we really don't have any evidence that this is helping kids at the long term...over the long term at all, so let's mount a long term study. It was called the MTA study and the NIMH said -- this is first real good study of any, sort of, child psychiatric disorder of any length of time -- so this is going to be the definitive study. Now they biased the study by design against, you know, in favor of the medication group. I'm not going to go into it but there was a huge bias in favor of the drug. Anyway, at the end of 14 months, they announced that it did seem that the drugs was providing a little bit of benefit. The "ADHD symptoms" -- this fidgetiness, this movement, sort of, maybe talking too much in class -- those ADHD symptoms did seem better in the drug treated group than in the behavioral group. And there was some sense that maybe the drug treated group was doing better on reading. So big announcement -- see, aha, we now have evidence that this helps kids over the long term. But what happened at the end of 3 years? By the end of 3 years being on drug was not a marker of benefit but a marker of deterioration. In other words, their ADHD symptoms were worse...those on medication; they actually...there was some growth suppression; there was no benefit in school at all; unfortunately we didn't hear about that result -- and now go forward at the end of 6 years what did they find? Well they found, again, there was some growth suppression, there was actually worse ADHD symptoms for the kids on medication, there was some functional impairment for the kids on medication...

Rob: What do you mean by functional impairment?

RW: Well there was some sense in terms of, you know, cognitive performance I think is what they were talking about. Unfortunately they didn't...they basically have a scale for that and they really didn't blow out in their report the things exactly what they're talking about, but it's the ability to do certain tasks whether it be homework tasks or maybe it's even some physical tasks...I'm not quite sure all of what that scale, you know, encompasses -- great question and I should know that answer.

But anyway, they weren't showing benefit, you know, greater delinquency...that sort of thing...in other words more likely to get in trouble with the police...the kids on drugs. So as William Tellam, the lead investigator from Buffalo said is we had expected that the kids on medication would do better over the long term -- we did not find that to be the case; there was no benefit, none. So if you have a form of care that provides no benefit, what you have left is all the risk with taking the medications....right? And by the way, there's been a study that was done now by Western Australia -- they also found no benefit. There was a big review of all the, sort of, studies that was done by the Oregon and Health Sciences, a group at Oregon Health Sciences School in Oregon...the state of Oregon -- they found that there's no good quality evidence that these drugs are either safe or effective for kids over the long term. So time and time again we did not find that these drugs were helping kids long term.

So the questions is then why are we still doing it? Because there are risks -- the risks are many, both sort of physical risks or growth suppression; there's a risk that kids will have a psychotic episode; risk that the kids will have a manic episode. And so for example, somewhere between 10 and 25 percent of all kids placed on stimulants today now convert to bipolar illness, and when they convert to bipolar illness because of a, sort of, drug induced psychotic episode, drug induced, sort of, mood swings every day. Now they're put onto a cocktail of drugs and they're really on a pathway to a career as a mental patient. So you see in that data alone, this capacity to do great, great harm, but no one talks about that and we're exposing kids to this risk even though our studies showed no long term benefit. And so that's part of this tragedy that is unfolding today.

Rob: Alright let's talk a little bit about this situation where kids are put on stimulants like Ritalin or Adderall...I'm assuming those are the ones you're referring to. What was the one that was used in the study?

RW: That's a good question. It might have been Ritalin...it might have been methylphenidate. I think that's what it was, but...oh you're talking about the MTA study...I'm not 100 percent sure -- it could have been one of the newer stimulants...I'm not 100 percent sure.

Rob: Okay, but what you're saying is that the percentage...what's the percentage of kids that are becoming bipolar after being put on this?

RW: Somewhere between 10 and 25 percent.

Rob: And...10 and 25 percent, so if there are 2 million kids on stimulants then we're talking about 200 to 500 thousand kids becoming bipolar after being put on stimulants.

RW: That's correct.

Rob: Well, people who argue that these kids had the potential, these kids were at risk for bipolar anyway...what is the response to that?

RW: Well, you know, they'll say this -- that they were comorbid for bipolar all along and science has made this great leap forward and now they're diagnosing this disease that didn't used to get diagnosed as if they've discovered this...you know, the disease was present all the time. I mean, this is just complete and utter nonsense. Listen, if you look at, say, prior to the use of stimulants were kids getting diagnosed with bipolar illness...say kids younger than 13, 14, prepubertal kids? Well if you go into the medical literature, you'll find that researchers would say -- we just do not see kids with bipolar symptoms, we just do not see kids that have...that go from depression to mania -- we just don't see it...okay...it doesn't exist. Then you follow forward the discovery of bipolar illness. The first, sort of, case studies appear in the late 1970s...I think it's late 1976 at Washington University and this guy says -- aha, I've discovered that kids can become bipolar. This is the beginning of this discovery process. Well then you look and you find that nearly all the kids in his case studies, in fact, have been on either stimulants or antidepressants. In other words...

Rob: What's his name again?

RW: Pardon me?

Rob: You mentioned a specific person who was involved in this. Who was the researcher who did this?

RW: God, I forget...I apologize...

Rob: Is it Biederman?

RW: What's that?

Rob: Biederman?

RW: Well yeah, Biederman is the one who eventually really popularizes it; and so what happens is if you trace this history in 76 you see these case studies, and then you see...I think at the MGH in 1979 where they've got "11 bipolar kids for the first time." And they actually come up with this very idea that the drugs, the stimulants, because the kids have been exposed to stimulants are unmasking bipolar in these kids. Well, the point is before we were using the stimulants kids weren't...there was no unmasking going on -- we weren't getting the bipolar kids.

But then the real jump in bipolar diagnosis -- let's jump ahead -- comes with Biederman with a paper in 1995, and he in fact does say, like -- Aha, I've discovered that so many kids that we are diagnosing with ADHD actually have bipolar illness, and this becomes...it's his paper that becomes the setting...sets the stage for this extraordinary rise in the number of kids getting diagnosed with bipolar illness. Now there's 2 things that are really key to know about this -- one is that, you know, he's seeing this in kids treated with stimulants...okay, that's number one...so it's ADHD kids treated with stimulants that he is saying are comorbid for bipolar and are showing some cycling symptoms, that's number one. Number two -- there's a really revealing, sort of...so at one point eventually Biederman gets deposed by a state attorney general, and the state attorney general is asking Biederman about this rise of the bipolar diagnosis; and he asked Biederman, he says -- well how'd you come up with this juvenile bipolar diagnosis, and he says -- well, I reconceived behaviors that in the past we might have called oppositional defiant disorder -- in other words a kid not paying attention to his parents -- and I reconceived of that as bipolar disorder. So in other words he was just taking an old behavior and giving it a new classification. Now where does that end up? Why is that important? Because the moment he reclassifies oppositional defiant disorder as bipolar disorder, he creates a market for drugs....he creates a market -- he makes those kids now eligible by diagnosis to take an atypical antipsychotic...that's the new drugs coming on the market. So he's helping create a market for the makers of the atypical antipsychotics. Who's a big maker of atypical antipsychotics? It's Jansen Pharmaceutical company -- they make a drug called Risperdal. What do the documents show? The documents show that Jansen began paying...giving a lot of money to Biederman to help grow the market for these drugs. And there is a moment in those documents -- and by the way, he gets well over a million dollars to do this -- there is a moment in those documents where Biederman says to Jansen -- well first of all, I'll help further your commercial goals -- that's number one; two -- he says is...I will help prove that these kids need to be on Risperdal now (these kids that he's reclassified from oppositional defiant disorder into bipolar disorder ) and I'll also give you data that shows that these kids are going to become chronically ill as adults and therefore need to take Risperdal for life. So in those documents you really see that you have a guy at Massachusetts General Hospital with a Harvard degree saying: "I will create lifelong patients for you." And what we're really going to do is take these oppositional defiant kids, which means kids that aren't behaving quite right, and we'll turn them into lifelong consumers of antipsychotic medications, and anybody who has taken an antipsychotic medication knows (a) sometimes you feel very lethargic on these drugs, sometimes you can't feel joy, there's physical problems, metabolic problems, there's all sorts of problems with these drugs and he is saying I will create a market for you Jansen, and in return I get these millions of dollars. So that is the story of how bipolar arose in large part.

Rob: How many kids are being given bipolar medications now?

RW: Oh God, I need to go back to my book right now and actually dig out this number. This is a good question. I think it's at least a half a million kids, so it's at least a half a million kids today on antipsychotic medications, which it's something like...no, you know even that's not right...I think it's more than that. It's something like 2 percent of all kids in the United States today on antipsychotic medications...is that right? Something like that...it's an extraordinary number of kids. It's definitely above 1 percent but I think it's closer now to 2 percent, which is just astonishing when you think about how powerful those drugs are.

Rob: Have you heard anything from Biederman? I mean, I would think that you're making very strong claims about this guy. Hearing this story, he sounds like an evil person who has inflicted upon children a horrible life.

RW: Well, first of all, you know, Biederman has his defenders and his defenders say he's getting needed medical treatment to kids...so there he does have his defenders. Biederman is sort of in, a little, bit gone into hiding because he has run into some ethical problems with the Harvard Medical School and their standards for taking money and all...I don't know exactly where the status of that investigation is. So no I haven't heard from Biederman at all. I've actually now have been starting to get some invitations to speak out at Massachusetts General Hospital in various groups on some of these issues. I think actually there is a recognition that the medicating of kids with antipsychotics can be a real, real, real long term problem. So that's...no, I actually haven't heard backlash for writing this from any sort of powers that be, and I think if I were wrong and this wasn't a real danger and this weren't going on, I'd be hearing left and right about why it was wrong but I haven't heard that.

Rob: And what's your take on Biederman's behavior, his character...do you have one?

RW: Well I think he's an extreme example of a larger current in American psychiatry, especially in child psychiatry. And that is that the psychiatrists at the top of American psychiatry started becoming...getting paid to create a market for these drugs -- they got paid to create markets for antidepressants in children, and then they got paid to create a market for the use of antipsychotics in children, and then they got paid for the use of creating a market for mood stabilizers in children; so I think he's an extreme example of this, and one of the reasons he's so prominent is because, you know, we didn't have juvenile bipolar illness before and we suddenly had it, and he was the great pied piper of this expansion saying, look I've discovered this disease, so in a sense he's an extreme example, but he's an extreme example of basically something going on within child psychiatry as a whole....and I'll give you an example of what I mean. If you go back to the testing of antidepressants in kids, okay, in pediatric antidepressant trials, virtually all of them failed, even over the short term. In other words, even over the short term they did not show that they were lifting depression better than placebo. But they didn't...the child psychiatrist who ran those studies funded by the drug companies didn't publish those results -- we didn't learn about that until...I forget exactly the year, but I think it was 2002 that the FDA, in a hearing on whether these drugs could stir suicide, announced that 12 of 15 pediatric antidepressant trials had failed. In other words, they weren't...there was no benefit...there was no net benefit, even on the target symptom -- and that means you're exposing these children to all sorts of risks and by the way, one of the risks with antidepressants is, again, the conversion to bipolar illness; something like 25 to 50 percent of youth kept on antidepressants for long term now convert to bipolar illness -- so they're exposing them to all sorts of risks with no benefit on the benefit side. So right there you see this, sort of, moral...abdication of moral responsibly.

And to give you another one, there was also a famous trial....and I'm going to get the...I forget which drug it was, which antidepressant...I think it was Paxil...I'm not sure. It was a study called Study 329...something like that. But anyway, I don't know the precise drug and the precise company...I can't remember it right off hand, but what happened is they announced this group of 21 leading American psychiatrists that the study had found the drug to be safe and effective...okay, that's what they published in a journal. Now what was really going on? Well, it's since come out in legal proceedings that there were memos flying around in the...among the drug company itself saying, you know, this is a negative study, that's number one; you were seeing a lot of side effects in the drug treated group -- I think it was something like 6 percent had suicidal ideation, something like that...that was completely covered up. And you even see in the memos like -- how are we going to spin this study, how are we going to spin this failed study...this dog of a study into this story that's going to appear in the medical literature that tells a drug that is safe and effective? And then you go to that published report, published by the leading child psychiatrist in the country -- they totally hide up the...they totally don't report the adverse effects in the drug treated group; they hide the suicidal problems; they pretend that the one adverse event is something like a headache; and they say that this thing shows efficacy when it didn't. Well what does that tell you? That tells you of a fundamental betrayal of parents and children in order to create a market for these drugs. So is Biederman an anomaly? Well, yes and no. I mean, he's sort of an example of an extreme...and extreme example but if you go and look at this, you're seeing one child psychiatrist after another, at the very top end, who is receiving a lot of money to help promote these drugs and sell this false story. So Biederman is part of a larger problem.

Rob: This is the Rob Kall Bottom Up Radio Show/Future Health Radio Show WNJC 1360 AM reaching Washington Township, South Jersey and Philadelphia. I'm speaking with Robert Whitaker. He's the author of Anatomy of an Epidemic, and we're talking about the betrayal of American people of children who buy psychiatry...how the field has failed or refused or intentionally not reported side effects and huge risks, and the failure of some of the most popular, widely prescribed and used psychiatric medications on adults and children. Sponsored by futurehealth.org and opednews.com, and if you are listening to this on the radio you can hear more of this story and in podcast, and other reports from this radio show at www.opednews.com/podcasts or futurehealth.org/podcasts with an 's' on the end....podcasts. Or you can check out Rob Kall, R-O-B-K-A-L-L on iTunes and download the podcast there.

Now, what you're describing, if you're talking about anti...how many...what percentage...how many kids are on antidepressant medications? We talked about 2 million of them on stimulant medication -- how many are left not taking any medication? And how many of them are on antidepressants?

RW: This is another good question. I think I have this number. Can you hold one half a second? I can find this number in the book...

Rob: Sure, while you're looking I'm just going to talk, because...

RW: Yeah, hold on...I'll be right back with that number, hold on.

Rob: What I'm seeing is a moral collapse. I am seeing a field -- psychiatry, child psychiatry where people are selling their souls, where they're selling their integrity. Now, we're going to be talking about is how this was planned -- this didn't just happen by accident; it wasn't just a couple of doctors taking money from pharmaceutical companies -- there's a history to this and we're going to get into that.

You have some numbers now?

RW: Yeah I do, let me get to this. Sorry about this. I just want to be, you know, accurate on this. Let's see here...because I think I've got numbers at least, both for antipsychotics and for antidepressants here. Oh where is that? You know, I mean they are now saying that like 20 percent of children, you know, have a mental disorder, need to be on drugs -- I mean, that's sort of one of the things we're talking about. Let's see if I can find the actual numbers....shoot.

Rob: While you're looking, we've reported in opednews.com with multiple articles that pharmaceutical companies are working to put into school systems testing for children to assess and diagnose mental illness in children with the goal of coming up with a diagnosis for every single child; and as we're moving toward the new DSM-IV, the Diagnostic Manual for psychiatry, which is basically put together by a bunch of psychologists in some hotel rooms, we're going to see a collection of new diagnoses that will make it easier to diagnose more people as mentally ill or emotionally ill with medical diagnoses. And these are very often just collections of descriptions and behaviors....

RW: Right.

Rob: ...just like Biederman took oppositional defiant disorder and decided well he's going to re-label it, reframe it as childhood bipolar disorder...that's the way you described it.

RW: Right, and listen I have the numbers here about what we're talking about. And these are numbers even, you know, it takes some time for the numbers to catch up, but it seems like right now there's about 3.5 million children and adolescents -- and this is a conservative estimate -- being prescribed stimulants, okay, so that's the number of stimulants...3.5 million children. And even if it's only 10 percent, we're talking about creating 350,000 bipolar youth, and if it's 25 percent we're talking about 6 or 700,00 bipolar youth; now in terms of SSRIs for depression we now have at least 2 million children and adolescents on those drugs -- so if that's, you know, turning somewhere between 25 percent...if that's turning 25 percent into bipolar youth we're talking about another half million bipolar youth. So we're talking like a million kids turned to bipolar, so to speak, and put into this seriously mentally ill camp by being exposed to stimulants and antidepressants. So that gives you a sense of the magnitude of this thing. And this is a "disorder we didn't use to see in children." So it gives you the sense of this extraordinarily iatrogenic, meaning drug caused, pathway that is opened up in our society.

Rob: Now, you know, you take a 9/11...you think of what happened there and you think that less than 3,000 people were killed and then you take a million children into chronically, mentally ill and these are disabled mostly, right? These are children who become adults who stay bipolar and are...what percentage of them are able to work would you say?

RW: Well this, again, this is again part of this extraordinary tragedy going on. If you look at what happens once these kids enter into this bipolar diagnosis now -- and remember kids...just we didn't have bipolar kids, you know, before this whole medicating -- it's not just that they become bipolar in the same way that adults get diagnosed with bipolar, they become severely bipolar, meaning they become rapid cyclers, they become...they exhibit, as the juvenile bipolar experts said, a severe form of bipolar illness; and they can expect to become, sort of, chronically severely ill as adults, so that's the pathway that the very experts saying this is a disease that needs to be treated....are saying well, what's the fate that awaits. It's not that the cocktails are expected to allow them to go on to this good full-functioning life; instead these people are going to become chronically ill with rapid cycling, cognitive problems are going to set in, physical problems are going to set in; and you can be assured that these kids on these cocktails -- I've included antipsychotics -- they're going to die early. So what is the future being paved for these kids? It is disability, it is being burdened by, you know, severe psychiatric symptoms, being burdened by physical problems, metabolic disorders, obesity, diabetes, it is being...cognitive decline, where you'll see that on kids on antipsychotics...there's some...basically a cognitive decline begins to set in after 3 to 5 years, you see some shrinkage of the frontal lobes related with antipsychotics -- I mean, when you really put this whole story together, what you see...and the 9/11 comparison with the 3,000 is actually pretty...in its own way, does provide some valuable context -- we have created a think where we take behaviors like, let's say oppositional defiant behavior which means just behaving a way parents don't like, and putting that kid on a path that leads to shortened life, muted life, lots of psychiatric symptoms, cognitive decline -- you're really talking about taking that kid's life away.

And how big is this now? I'll give you some data. The US government accountability office, okay -- and that's this office that looks at, you know, broad themes in our society -- reported in 2008 that 1 in every 15 young adults hitting age 18 is...oh no, excuse me, I'm sorry about that....1 in every 15 young adults 18 to 26 years old is now "seriously mentally ill"...1 in every 15; and this population now is expected to be, sort of, seriously mentally ill for life -- so that gives you a sense of the extraordinary, you know, wrong being done and how we're not allowing so many kids to grow up and make their way in life. 1 in every 15 is getting caught in this web -- that is an astonishing number and...

Rob: I want to reiterate what we did in our last interview, that you have no connection with Scientology because Scientology criticizes the use of psychiatric medications...

RW: No, not this...

Rob: You have...

RW: Can I...

Rob: ...repudiated any connection with that. You never did and never had any connection at all, right?

RW: No, no, none, none, none, none, none, none -- listen I'm a guy that is mainstream science writer, okay? And I'm like...you can't find a guy in the American planet less likely to have any interest in Scientology than I. My background is reporting for newspapers. My background...I was Director of Publications at Harvard Medical School. I'm a guy that I was a Fellow at the Massachusetts Institute of Technology for a year. I'm a guy who believes in mainstream science, okay. I'm a believer in evidence-based medicine. Anatomy of an Epidemic is a book that looks at what their -- by their I mean mainstream biological psychiatry -- their science says; it's a book that looks at what research done by the National Institute of Mental Health...what does that research show. I began this whole story as a believer in the common wisdom. In 1998 I co-wrote a series for the Boston Globe that talked about abuses of psychiatric patients in research settings and one of the contexts, one of the elements of that series was how awful it would be to ever take anybody off psychiatric medications or antipsychotic...you know, take people with schizophrenia off antipsychotic medications because these drugs were like insulin for diabetes...that's because I believed that common wisdom. And finally, just so you know in this book, I actually write about how Scientology has actually been used by the pharmaceutical companies as a conventional way to avoid societal attention on the real research. Because Scientology emerged as this extraordinary critic, this sort of very...what's a word for it...sort of, extreme critic of medications and psychiatry. And the problem was, of course, that Scientology has some of its own crazy stuff that this allows mainstream psychiatrists in the pharmaceutical companies to delegitimize the criticism. They said -- Aha, look this coming from Scientologists; and then they were able to use that to taint...to try to taint people like myself that come from this just as a mainstream believer in science -- what happens is the presence of Scientology in this whole debate it allowed the pharmaceutical companies to go -- Aha, a critic must be a Scientologist....it delegitimized this whole thing.

But bottom...but I want to get back to your question and I'm glad you asked it. I have never been to a Scientology meeting, I have no interest in that thing, and it's just absolutely foreign to any way of thinking that I have, and my background is as a mainstream science writer...and that's how I come at this -- a guy who's been writing for newspapers, magazines and books for more than 20 years.

Rob: Okay.

RW: I hope that was clear (laughs).

Rob: Yeah. Now, one thing you said that really struck me is that because though the narrative, the story that has been repeatedly told and marketed, doctors feel an obligation to prescribe these medications; they may even feel they are at risk of being sued for malpractice if they don't -- is that the case and can you talk a little bit about that more?

RW: Yeah, this is part of the trap we're in a society now....is yes. So what happens again here is that the guys that are being paid by the drug companies, right, to be speakers, advisers, and consultants at these leading academic medical schools, are also the same people that, in essence, set forth standards of care in psychiatric textbooks, in psychiatric journals, etcetera. So they start saying is the standard of care is to do this, well it's to medicate with this drug. And if that doesn't work, it's to medicate to add with this other drug -- and they, in essence, develop protocols that never involve weaning people off, but just in essence if this drug doesn't work...try a second drug and/or try two drugs together, or three drugs together...so the people setting the standard of care, which other doctors are expected to follow and which HMOs and insurance companies reimburse for, are in essence the psychiatrists who are paid by -- not in essence, are the same people being paid by the drug companies to act...to promote these drugs. That's the extraordinary thing going on, and therefore if you are a doctor, if you're a psychiatrist and you, say, don't give somebody a drug, and that person then has a bad outcome, you sometimes can be liable for a lawsuit. But if you follow the standard of care and you give a person a drug and the person has a terrible outcome, you're home free...you were just following the standard of care. So this is in fact a very, very big problem and it is a barrier to reform.

And one of...this sort of stems back from a case -- I think it goes all the way back to the late 70s, maybe early 80s -- where someone was at Chestnut Lodge, a care facility in the northeast, depressed, and they didn't treat him with an antidepressant. Well eventually he was treated with an antidepressant...this particular patient did better on the antidepressant...so then he sued the lodge, the attending psychiatrist, for not giving him the antidepressant right away. And this became a case that made doctors afraid of not following that immediate standard of care of when to medicate and medicating very quickly, etcetera. So yes, this is a big problem.

Rob: There's a kind of knee jerk reaction to medicate.

RW: In essence, yeah, to protect themselves. Now you can use inform consent principles with your patients to...if you laid out all the risks and benefits to your patients and then let the patient make this decision in some ways, you can now avoid that legal liability, but there are some real risks there if you don't give them that...if you don't, sort of, run through that process.

Rob: This is the Rob Kall Bottom Up/Future Health Radio Show. I'm speaking with Robert Whitaker, the author of Anatomy of an Epidemic. This is 1360 AM, Washington Township. We're sponsored by futurehealth.org and opednews.com.

Robert, in your book you say that, to quote "the literature is hopelessly poisoned." Then you go on to say "the story of research in selective serotonin reuptake inhibitor use in childhood depression is one of confusion, manipulation, and institutional failure." Actually you're quoting [Inaudible 0:47:54] in a 2004 editorial.

RW: Right, I mean...go ahead.

Rob: The history here, you know, this just goes on that this is not an accident. Now I want to take a step now and talk about...you have a chapter on the rise of an ideology...

RW: Right.

Rob: ...that gives us a bit of the history of the politics and the economics of this. Could you talk about that?

RW: Yeah, I think this is important to try to understand how we as a society ended up where we are today, where we have embraced this extraordinary paradigm of care and where we've embraced pathalogizing so many kids, etcetera. What happened was this -- in the 1970s, there was an explosion of this therapist industry, and by that I mean social workers began providing counseling services, psychologists, there were other therapists offering alternative therapies, whatever they might be, and so there was a lot of competition in the marketplace for people who were, sort of, feeling emotional distress of some kind and wanted help, alright. And psychiatrists found themselves -- psychiatry as a profession -- found themselves in competition with all these newly...new groups of therapists. And you'll see in the psychiatric literature saying -- Uh oh, we're now in a fight for our survival and we have to figure out how to compete in this new marketplace. And what they basically decided as a profession, they said -- well what is...what gives us our benefit? What is our competitive advantage over all these other therapists? And what psychiatrists as a profession said is that we're doctors and we can prescribe medications, okay. So we need to tell a story, in essence, if we're going to revive psychiatry -- and by the way, there was a sense that psychiatry was fighting for its survival; the percentage of doctors choosing psychiatry as a specialty was very low; there was a survey why was that so...it was because it was seen that psychiatric therapies were very low in efficacy -- so psychiatry in the 70s was fighting for its survival in the marketplace and as a profession that would attract young psychiatrists as well -- and they made a decision to say we're going to find a refuge in the white coat. We will wrap ourselves in the white coat of physicanhood so to speak, and we will tell a story, in essence, of that our disorders are brain disorders are just like other disorders and infectious medicine, and that our drugs are specific treatments for those brain disorders. In other words, we will make our prescribing powers valuable in the marketplace.

Anyway in 1980, with that sort of -- and by the way the sale of psychiatric drugs was going down in the 1970s so that was part of the change -- so in 1980, psychiatry basically launched this new ideology and that was with the publication of DSM-III, which is the Diagnostic and Statistical Manual; and what the claim that was made is this is a new scientific document, that psychiatric diagnoses prior to this time were vague and unreliable, and they really reflected, sort of, Freudian roots and Freudian notions about neurosis -- and what psychiatry said is now we have a scientific text -- we have these disorders neatly defined, as if they're quantifiable, and these are diseases and we have drugs to treat those diseases...and as they did this, the American Psychiatric Association basically mounted a press...public relations campaign. They formed a press to help tell this story -- the APA Press was founded in 1980, they began doing workshops, training psychiatrists around the country, dealing with the press, newspaper reporters, magazine reporters, television reporters -- telling them how to tell this medical model story (by the way, many of those workshops were funded by the drug companies) -- so it was a story of an organization, a trade organization, that was having difficulties fighting for its survival, not doing well in the marketplace, and coming up with an ideology -- a medical model -- that exalted their place in society; and then also as a trade organization, training itself to sell that story to the public, and doing so in conjunction with pharmaceutical companies which began funding these promotional efforts. So yes, there was a rise of an ideology -- the ideology was the medical model, and you can see how effective it was. They started holding annual, sort of, meetings...even, sort of, press conferences; they started telling about these great advances that were being made in this uncovering of biological causes of psychiatry. And next thing you know...there's a series by John Franklin at the Baltimore Sun that tells about these great advances that we're making; secrets of mental disorders are being discovered -- and it was all nonsense...it was all PR...it was all like selling a product...it was not founded in science.

And then of course what happens is when they get Prozac -- that's a new drug that comes to market in 1987 -- and they really go to town there, in terms of working with the...psychiatry worked with both the NIMH and pharmaceutical companies to start funding something called the DART campaign -- I think that's the right acronym -- in which they would send literature to doctors' offices around the country saying we now know that depression is a brain disease caused by chemical imbalance and people need to get tested, and we have these wonderful new drugs like insulin for diabetes. So we had this very well-oiled, well-financed promotional campaign that was based on selling the drugs but not based on science. So that's the story of the ideological rise and it resulted in an increasing spending on psychiatric medications from around 800 million in 1987 to more than 40 billion dollars today. So you sort of have to...from just a capitalistic point of view, you sort of have to clap and say 'well done.'

Rob: You think there's any chance that this can be turned around with $40 billion in sales? It's hard to imagine lobbyists allowing it to happen...you've got these small state senators from Idaho and Montana, what have you, who basically sell out and block anything from getting done -- I just wonder...is this something that America can save itself from or are we stuck with this...? Well, answer that first.

RW: Yeah, that's a good question. In some ways I think there is a backlash forming. One, there's a backlash forming because it's...everyday it seems like we're hearing new news about how these psychiatric medications were falsely marketed. You'll have state attorney generals suing the drug companies. We here one company after another agreeing to pay a billion dollar settlement for having lied about their drugs and falsely marketed their drugs. So that is making the public quite skeptical about this whole story -- that's number one.

The other thing is that states are going broke trying to pay for these drugs for their Medicaid patients. They can't afford this story any longer; they can't afford so many people going on disability; they can't afford young people going on disability. And that is going to, I think, force some change because as we all know, state budgets are feeling a crunch right now -- the spending on psychiatric drugs is a big part of the problem they have, so there is this backlash coming from financial reasons as well in that this paradigm of care...where we're ending up with more and more people on disability; we're ending up with kids at age 18 going on to a lifelong path of disability -- by the way the 18 year old that goes on disability...it's going to cost society more than a million dollars to sustain that kid...that person over the next 20-25 years with all the medical costs and the, you know, paying for shelter and that sort of thing.

Rob: Perhaps the answer is when the kid is a little fidgety in class and doesn't do his homework, we've got to come up with some new solutions to deal with those kids. And part of the problem -- because I've also been doing a series of interviews on education -- is that our schools are designed to prepare most children to be obedient factory workers and soldiers, and they don't deal with the world we have now where so many kids just don't fit that model, and the education is not preparing them, so that education is broken and maybe there's an unstated alliance between educators...I don't think so, I don't educators are doing this, but what it comes down to is the school system that we have is so broken it's causing the kind of behavior that leads to these kids getting identified and diagnosed, and that puts them into this pathway...10 to 25 percent....

RW: Right. 1 in 15 enters adulthood with a severe mental illness.

Rob: Horrible.

RW: Listen now you're talking about....what's that?

Rob: It's horrible.

RW: It's horrible...well, I do think now you're talking about another thing that is profound --and that is...have we created a society that is able to raise children in a healthy way? And I think the answer is no. And if you want to talk about raising children in a healthy way, I think you have to talk about everything from diet, food -- you know, what sort of food do kids get, how are schools organized -- are the schools organized so the kids get out to go out and play, you know, every 2 hours and run off some energy...there's that; how interesting are the school days; you know, when the kids go home what is the home life like at night...I mean, as you know families are economically stressed like crazy now -- and I think in that sense we have a huge societal failure. If we have 1 in every 15 kids -- and by the way the General Accountability Office said that was an undercount because it wasn't even counting kids in institutions and all...and homeless kids and all -- if we have that number of our kids entering adulthood with a severe mental illness that's leaving them quote "functionally impaired" then what you're talking about -- quite apart from the drugs -- is a society that doesn't know how to raise kids all that well anymore...at least it's failing a significant percentage of kids. And so I think you do have to talk about everything from diet to possibilities of exercise, to what sort of opportunities for socialization are happening, how stressed are families in terms of trying to meet economic needs -- that is a huge, huge, huge story and...but I do think it needs to be addressed. Very good question.

Rob: [Inaudible 0:59:27]...another. Now I have a long history of working in the world of biofeedback and neurofeedback. Now biofeedback and neurofeedback have long had the goal of providing alternatives to drugs and the idea of biofeedback is basically -- and there are different versions of neurofeedback in particular -- but in the last 20 some years, neurofeedback has come into its own as an approach that teaches kids and adults how to learn how to voluntarily control your brainwaves to start producing more attentiveness and more focus, but voluntarily with your own self regulations. Some of the models are based on a pathology oriented approach that the brain is broken and needs to be fixed; others are based on teaching kids to be more balanced and just use general self-regulation skills. What's your take on this? I know you've had some experience with biofeedback in another realm, is that correct?

RW: Yeah, that's true. Well let me speak about, first of all, in the big realm of what you're talking about and in the personal realm. The big realm, I think...that sort of approach is basically saying to the child or the youth -- it gives them a sense of self agency, and by that I mean is that's telling the child you can do things if you're feeling, you know, these emotional stress or you have behaviors that are so problematic to others -- you can take control of those things; it's not that you need to be fixed by a pill that you're quote "defective," but that you have the capacity, the potential to make these changes, and it might mean doing biofeedback, it may mean doing exercise programs, yoga -- whatever it might mean. But the beauty of that whole thing is just from the outside, it's an optimistic idea and it's also an idea that is self-responsibility as well. In other words, it's empowering to that child in addition. And it's not telling to child --you're broken for life. So all those things are really great right from the beginning -- self agency, self-responsibility, optimism, and it's not telling the kid they're broken for life. So I think this is the sort of things we really need to be exploring, absolutely.

Now in terms of biofeedback, my oldest daughter who is 29 years old now, had a physical condition called Raynaud Syndrome, where blood wasn't getting to her toes and her fingers, etcetera. Well she did biofeedback for that, for this very physical condition, and in fact, it became quite effective -- it's a way she now learned to deal with that problem. So it's an example of...and I guess what happens is she somehow learned biofeedback to open up, you know, the vessels...the blood vessels in some sort of way...that sounds mysterious...

Rob: I can tell...I can talk a little bit about that...

RW: Okay you talk about it -- it was mysterious to me.

Rob: Biofeedback for Raynaud's Syndrome is basically temperature or thermal biofeedback where you put a temperature sensor on the fingertips and teach a person how to warm their hands...they warm their hands by relaxing the muscles in...that surround blood vessels, and as they relax their hands get warmer.

RW: Alright, there you go.

Rob: When poets talked about how as you relax your hands and feet get warmer, it took scientists hundreds of years past the poets to figure out what the poets already knew. But that's the basic idea...very simple, it's very inexpensive -- I am pleased to say that one of my inventions...a temperature biofeedback card was on the Dr. Oz show on Monday, and you can see information about that on the futurehealth.org website.

RW: Great.

Rob: The bottom line is your daughter didn't need any drugs or medication either, right?

RW: No, she managed to...no, she didn't need that. And she also had a problem with some arthritis...juvenile arthritis as a kid, and it seems like the biofeedback and also diet has helped her avoid, you know, regular use of the arthritis medications as well -- so much so that she actually played rugby in college at a very high level; so whether...that was part of this self-agency we think of even arthritis...I mean, there was a time when my daughter in high school had trouble gripping a pencil and all, but she did biofeedback, she did dietary changes...and you know, every once in a while she gets a flare up but she's managed to deal with that as well without being on the regular like...you know, she was prescribed Celebrex for a while and that sort of thing -- she got off those medications.

Rob: A good story. Now you...it's interesting because your book gives, like, a chapter on the history with a lot of statistics and a lot of background research, and then you profile some of the people who are victims like, except for the children factor, you have Lost in Seattle -- you talked about a young woman you called Jasmine born in 1988; can you give an example that you have off the top of your head of one of these kids who were put on medications and how it affected their lives?

RW: Well yeah, I mean the Jasmine story is tragic beyond belief. You know, she was doing fine...I mean, she was this outgoing kid as a kid; she did have a little bit of an anxiety problem that led to some bedwetting at night and so, I forget exactly what grade it was...she was getting ready to go off to summer camp and she was nervous about going to summer camp and, you know, wetting her bed at night. So she went to a doctor...the doctor prescribed a tricyclic -- an antidepressant -- don't even ask, but that is used sometimes for bedwetting; well then what happened is she started having a bad reaction to that tricyclic and she started becoming basically homicidal, which is a thing that can happen...and very agitated, etcetera. Instead of, sort of, saying like she's having a bad drug reaction, she now starts getting psychiatric diagnoses and pretty soon she's got a bipolar diagnosis. And you've got to go back to the beginning -- what was her problem in the beginning? She had some anxiety that apparently was associated with bedwetting at night, but other than that she's doing well in school, she's outgoing, she's this infectious...by infectious I mean, a sort of, gregarious child socially; and she gets exposed to a drug, and when she has a bad reaction, instead of the doctor saying -- Aha, this is a risk with the tricyclic -- you can get this sort of mania, you can get this sort of agitation, and you can get even this homicidal ideation; instead of saying maybe the drug is causing the problem, it was blamed on the kid -- Aha, this must mean that she has some underlying psychiatric disorder -- this became this whole, sort of, medication...one medication after another was thrown at her. Finally she's put on antipsychotics, she gets the bipolar diagnosis, and the eventually she wants to come off those antipsychotics because, you know, they're causing weight gain and they're isolating her, and as she comes off she has a bad reaction, which is one of the real risks of going on the drugs in the first place -- and you see this deterioration in her life, place by place...and where is she ended up today as a young woman? Mute, in a group home, seemed to be hopelessly ill, you know, with basically...you know, she has no life -- her life is gone. And so now she's diagnosed with severe schizophrenia, etcetera, and you know, basically mute, no life whatsoever, lost to the world -- and where did we start out? We started out with a kid with a bedwetting problem.

Now this may be an extreme example, but it tells you of a paradigm of care where when things go bad, you never look at whether the medications may be causing that but you keep saying -- oh, this must mean there's something underlying going on with the kid -- it's the kid's fault, the kid has a psychiatric ailment -- and then you just keep throwing more drugs at that kid, and next thing you know you've got a kid on a cocktail, their life is disappearing, and they're getting ever worse. And this is an extreme example of that but, as in terms of illustrating a larger problem, where you take a kid with no known biological problem, put them on psychiatric medication, and years later you see psychiatric problems, physical problems, and a dramatic worsening -- that is all too common. So that's the tragedy you see in that story.

Rob: So what's the answer?

RW: Well the answer, first of all, is honest science...and being honesty. And so the answer is for people to start saying (a) we don't know what causes psychiatric ailments, (b) with the kids, that they have no known pathology, okay...stop saying that they have...it's a brain disease when you can't tell us what the brain disease is, okay...just say we don't know what's going on to cause these behaviors -- and obviously a lot of times it has to do with environment, that's number one; stop saying that these drugs fix a known disease and are thus like insulin for diabetes -- that's not true. What these drugs do is perturb neurotransmitter systems and that perturbation the drug tries to adapt to it and, frankly, that can cause a lot of long term problems. (3) do research designed to look at the harm the drugs can do. So for example, there was a study done in which they gave Zyprexa, which is an atypical antipsychotic to monkeys -- that led to a rather dramatic shrinking of the monkey's brain in the course of a year. Well if that's so, we need research...more research of that sort so that we can say, giving atypicals to kids will shrink their brains and that's going to cause this cognitive decline over time -- we need to know that, right? Rather than...when that research was done with the monkeys, did they follow up with any research? No. Why not? Because if you follow up with that research you're not going to be prescribing atypical antipsychotics to kids, because you don't want to shrink their brains. But that's an example of a society, in essence, that's protecting the market for atypical antipsychotics rather than protecting the kids.

So the answer is...put the kids' interest first, figure out...look at these drugs in the sense that they can cause harm; be honest and say that we don't know anything, sort of, biologically wrong, and look what's happening long term with this paradigm of care; and if it's turning out badly, which it is, think of something differently...but put the kids first and be honest...and do science that is meant to also investigate the harm that this paradigm of care can have and communicate that to the public -- that's what we need and that's what we don't have. We do not have honest science.

Rob: Let me ask you this. Are you alone or are there other people calling for what you're calling for?

RW: Oh, I actually think where, in terms of the kids, there's a growing sense that something horrible has gone on and that we really need to rethink this. And I am getting letters from all over...I'm getting letters from provider groups saying we have to change -- and I'm talking about mainstream people.

Rob: Is there an organization, a foundation, a group....

RW: What is forming is there's a group of providers...and there's a lot of, sort of, impetus coming to this from providers in Oregon, but you know I've put people in touch with Oregon, Ohio -- I'm talking again mainstream providers -- North Carolina, Massachusetts -- and they're now meeting on via the internet, with hoping to plan a conference in the early 2011, which really will talk about -- let's rethink this whole paradigm of care and lets develop a paradigm of care that puts, sort of, social support at the center of things and use as drugs in a much more minimal fashion...much more selective fashion. And as part of that I think they can look at children and say, maybe we should just completely abandon the use of medications in this age group, or at least dramatically, dramatically curtail it. So that's happening and that's hopeful.

Rob: Are there any particular organizations that exist right now that are talking to you, that are having you speak...

RW: Oh sure. Well, I'll give you an example. Yes, I'm doing a lot of keynote talks. I've got talks scheduled for like the behavioral therapy groups...believe it or not I'm giving a grand rounds at Massachusetts General Hospital in early 2011 to the psychiatry department -- that's an example of an openness; I went to speak out to a group called Hillside in western New York that delivers children services. So I am getting asked to speak a lot on this. There's an organization called ICSPP that just had their annual meeting -- they are very much against...

Rob: What's that?

RW: That's called the International Center for the Study of Psychiatry and Psychology. And I think there's a little bit of confusion about that group but you can go to ICSPPonline.org and you'll find that group. They are very much against the medicating of kids...I was a keynote speaker there. So yeah, there is...there's I think some different groups forming along this whole issue.

Rob: Any other voices, any other particular people, any doctors, any faculty members, any leaders of healthcare like the Surgeon General or anything like that...

RW: No, not the Surgeon General or anything like that. Well, you know of course there has been doctors like Dr. Breggin out there in the past; there's doctor named Dr. Grace Jackson who has written a very good book about this; there are doctors that have written books about ADHD saying that this is crazy; there's someone named Paula Kaplan who has written about how, you know, bad the DSM is -- so there are people, yeah, writing about this.

What I'm hoping -- and I am hearing from some mainstream psychiatrists and academics -- that they need to rethink this paradigm of care. I hope they go public with this and don't just send...keep on sending me their emails privately. But I am speaking at like a number of professional groups, especially in the spring, as their keynoter --behavioral groups, groups devoted to psychotherapy...that sort of thing. I've even...believe it or not there's even been a review I believe posted on a American Psychiatric Association website that actually praises Anatomy of an Epidemic so let's hope that....I think the book makes a call to conscience ultimately because it does say here's your research literature, look what's happening...are you going to do something about it? And I think a number of people are responding. I hope they really do something fundamental.

Rob: Okay. Well, keep on doing...do you have another book in the works?

RW: No, I have been so busy with promoting this one and speaking out at...I need to get the next book topic. But I want to thank you, Rob, for giving me the time these two times...these two days...I really appreciate it. It's an important subject that you're talking about.

Rob: Thank you so much. It's Robert Whitaker, author of Anatomy of an Epidemic. And what's your website again?

RW: You can either go to madinamerica.com, that's M-A-D-I-N-A-M-E-R-I-C-A.com or robertwhitaker.org.

Rob: Okay. This is the Rob Kall Bottom Up Radio Show and the Future Health Show, WNJC1360 AM. Thanks. Come back for more. Hang on a second Robert, don't hang up...I'm going to stop the recording now.

RW: Okay.