Sunday, January 30, 2011

Epidemic or Marketing?


Robert Whitaker's "Anatomy of An Epidemic" discusses the so-called biological psychiatry revolution of the past 30 years. In essence, there has been an explosion of psychiatric disability coinciding with the widespread adoption of the antipsychotics, mood stabilizers, anxiolytics, and stimulants. These drugs have resulted in more disability rather than less and, Whitaker argues, do more harm than good, often creating the very disturbance in brain chemistry they purport to treat. The diagnostic criteria for "mental illnesses" have broadened to the point where a wide variety of human experience has been medicalized and pathologized. It is no coincidence that this has occurred in the context of multi-billion dollar marketing campaigns by the big pharmaceutical companies. Formerly rare disorders have now become, quite literally, epidemics. Bipolar disorder is, perhaps, the best example. Prior to the marketing of the mood stabilizers and anti-psychotics, this was a disorder that occurred infrequently and a had a brief, limited and often non-recurring course. Now, if you have anger issues or are moody, especially if you are female, or if you abuse alcohol or drugs, the odds are you will be diagnosed bipolar. The criteria for the disorder have been broadened so much as to be meaningless. Worst of all, if you believe the marketing hype, there is now an epidemic of bipolar disorder among children. We are now medicating children as young as three or four for a condition that, prior to the introduction of these drugs, was thought not to occur in children. The biological psychiatry revolution has, in essence, expanded the profits of the drug companies by creating disease and disorder. More insidiously, the drug companies have promoted the belief that the individual can do nothing to change his or her life.  Their pitch is that for every human discomfort or distress, well, "there's an app for that" in the form of an expensive medication.

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