Brave New Brain - Conquering Mental Illness in the Era of the Genome - N. Andreasen (Oxford, 2001) WW PDF
Preview Brave New Brain - Conquering Mental Illness in the Era of the Genome - N. Andreasen (Oxford, 2001) WW
BRAVE NEW BRAIN This page intentionally left blank BRAVE NEW BRAIN Conquering Mental Illness in the Era of the Genome NANCY C. A N D R E A S E N OXPORD UNIVERSITY PRESS 2001 OXPORD UNIVERSITY PRESS Oxford NewYork Athens Auckland Bangkok Bogota Buenos Aires Cape Town Chennai Dar es Salaam Delhi Florence Hong Kong Istanbul Karachi Kolkata Kuak Lumpur Madrid Melbourne Mexico City Mumbai Nairobi Paris Sao Paulo Shanghai Singapore Taipei Tokyo Toronto Warsaw with associated companies in Berlin Ibadan V Copyright © 2001 by Nancy C. Andreasen Published by Oxford University Press, Inc. 198 Madison Avenue, NewYork, NewYork 10016 Oxford is a registered trademark of Oxford University Press All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of Oxford University Press. Library of Congress Cataloging-in-Publication Data Andreasen, Nancy C. Brave new brain: conquering mental illness in the era of the genome/Nancy C. Andreasen p. cm Includes bibliographical references and index. ISBN 0-19-514509-7 1. Mental illness. 2. Mental illness—Genetic aspects. 3. Human Genome. I.Title. RC455.4.G4 A53 2001 616.89'042—dc21 00-050141 9 8 7 6 5 4 Printed in the United States of America on acid-free paper IN MEMORY OF GEORGE, WHO HELPED ME BEGIN THE JOURNEY. AND TO TERRY, WHO HELPS ME CONTINUE. This page intentionally left blank C O N T E N T S Preface ix Part I BROKEN BRAINS AND TROUBLED MINDS CHAPTER 1 Brave New Brain Confronting the Burden of Mental Illness 3 CHAPTER 2 A Waking Nightmare Mental Illness and Ordinary People 9 CHAPTER 3 Broken Brains, Troubled Minds Being Blinded by False Dichotomies 25 Part II MIND MEETS MOLECULE CHAPTER 4 The Brain The Mind's Dynamic Orchestra 41 CHAPTER 5 Mapping the Genome The Blueprint of Life... and Death 87 CHAPTER 6 Mapping the Mind Using Neuroimaging to Observe How the Brain Thinks 130 Part III THE BURDEN OF MENTAL ILLNESS CHAPTER 7 Understanding What Mental Illnesses Are The Past Is Prologue to Progress 763 CHAPTER 8 Schizophrenia A Mind Divided 186 CHAPTER 9 Mood Disorders Riding the Emotional Roller Coaster 215 CHAPTER 10 Dementias A Death in Life 253 CHAPTER 11 Anxiety Disorders The Stress Regulator Goes Wild 278 Part IV BRAVE NEW BRAIN CHAPTER 12 O Brave New World Conquering Mental Illness in the Era of the Genome 377 References and Suggested Readings 345 Index 355 P R E F A C E In the early 1980s I wrote a book, The Broken Brain: the Biological Revolu- tion in Psychiatry. It described a major paradigm shift that was occurring in American psychiatry: the movement from a psychodynamic model to a biomedical and neurobiological model. It was written for laypeople, especially those who suffer from mental illnesses and their families, to help them understand how the brain works and how it becomes "bro- ken" in mental illnesses. I also wanted to reduce the stigma associated with mental illnesses by making it clear that they are brain diseases that cause enormous human suffering. I wanted people to understand that the human sufferers should be accorded the same compassion and respect that we accord people with other illnesses such as cancer or diabetes. The Broken Brain was generally a success. It is still in print and is still selling, perhaps because its prediction of a paradigm shift turned out to be true and perhaps because its social message was so important. As time passed, the scientific basis of modern psychiatry continued to advance. By the end of the final decade of the last century, known as the Decade of the Brain, so much had happened that it was time to write a new and different book to describe our growing knowledge about causes and treatments of mental illnesses in the twenty-first century. Hence Brave New Brain. We now have a wealth of powerful new technologies that illuminate the causes and mechanisms of mental illnesses on many different levels. These include the tools of molecular genetics and molecular biology, which are being used to map the genome and identify the genetic basis of many different kinds of illnesses, including those of the mind and brain. In addition, neuroimaging techniques now permit us to visualize and measure the living brain. Psychiatrists may not be able to read minds, as many people used to believe, but they can watch the mind think and feel by using the tools of neuroimaging. The terrain of the brain is being mapped in parallel with the mapping of the genome. The convergence of these two domains of knowledge is one of the most exciting things that is happening in medicine and mental health at the moment. Their conver-
The list of books you might like
