Equally intriguing is his discussion of anxiety, phobia and post-traumatic stress, all of which he links to faulty activation of the fear system. This is particularly important given our poor understanding of emotional disturbances, a gap that Peter C Whybrow seeks to fill in A Mood Apart (Picador, pounds 17.99). As Whybrow points out, around 20 per cent of the population suffers from a mood disorder, yet less than a third receives treatment. He argues that it is the difficulty in separating self from illness that lies at the root of this extraordinary situation.
Whybrow, a psychiatrist, views mood disorders as breakdowns in the brain's ability to regulate itself that lead to disturbances in emotional expression, in sleeping and eating patterns, and in concentration, memory and decision- making. He draws these threads together in a comprehensive if slightly unfocused examination of mania and depression, brought to life with sensitive descriptions of his own case studies. His favoured course of treatment is one that takes into account both the brain's chemistry (drugs) and its owner's experience (psychotherapy).
Whybrow admits that the recent dramatic increase in mood disorders may have something to do with how they are defined. Yet he also writes that there is nothing special about our diagnostic categories, which are merely tools that can help us identify the neurological systems underlying different moods. But, as David Healy shows in his masterly history of The Antidepressant Era (Harvard, pounds 26.50), this is easier said than done. Healy chronicles the development of antidepressants from their serendipitous discovery in the 1950s to current debates about Prozac. His is a marvellously detailed story, set in the context of shifting ideas about medicine, the growth of the pharmaceutical industry, and wars of ideas between psychoanalysts and biologically oriented psychiatrists.
This utterly compelling read subliminally suggests that psychiatric medicine has been largely governed, not by science, but by social and political forces. Despite great advances in neuroscience over the past decade, it seems that there have been virtually no new beneficial ideas in psychopharmacology. That itself is a bitter pill to swallow.Reuse content