[NYAPRS Enews] TG: The Mental Illness Industry Is Medicalising Normality

[Harvey Rosenthal]

NYAPRS Note: In the wake of American and European surveys showing a rise
in mental health conditions, here's an opposing view that suggests that
too many of people's struggles are being pathologized into mental
illnesses. 

 

The Mental Illness Industry Is Medicalising Normality

A Reading Group Would Do More To Help Individuals Find Relief Than
Squeezing Their Unhappiness Into A Package Labelled 'Disorder'

By Lisa Appignanesi <http://www.guardian.co.uk/profile/lisaappignanesi>
The Guardian  September 6, 2011

 

In 2000 the World Health Organisation named depression as the fourth
leading contributor
<http://www.who.int/mental_health/management/depression/definition/en/>
to the global burden of disease and predicted that by 2020 it would rise
to second place. I suppose WHO didn't mean it to sound like a target to
be aimed for, but we seem to be rising to the challenge in any case.

A new survey from the European College of Psychopharmacology, a
meta-analysis of a gathered mass of earlier research, reports that a
staggering 164.8 million Europeans - 38.2% of the population - suffer
from a mental disorder
<http://www.psypost.org/2011/09/the-size-and-burden-of-mental-disorders-
in-europe-6831>  in any year. As well as depression, this includes
neural disorders such as dementia and Parkinson's; childhood problems
from ADHD to "conduct disorder"
<http://www.guardian.co.uk/uk/2001/jul/27/schools.education> ; and the
leading anxiety disorders - everything from panic attacks to
obsessive-compulsive disorder to shyness. Depression and anxiety, they
tell us, are disproportionately women's ailments. Men, it seems, become
alcoholics (another illness category) rather than depressives,
particularly in eastern Europe.

Such reports are worrying. They may draw attention to a rising toll of
human suffering, but they pinpoint the imperialising tendency of the
mental health sector. Our ills and unhappiness are squeezed into a
package labelled "disorder" and an ever-proliferating assortment of
supposedly objective diagnostic categories. A cure is somehow promised,
though it rarely seems to come, certainly not for everyone or for ever.

In talking to the press or drafting press releases, researchers often
extrapolate from their material in order to create good copy. The notion
that women are somehow more prone to mental illness often emerges - as
it did in the Daily Telegraph's headline
<http://www.telegraph.co.uk/health/8740278/Women-more-than-twice-as-like
ly-to-be-depressed.html>  on this survey.

According to Hans-Ulrich Wittchen, one of the report's authors, the
reason women suffer nearly twice as much depression and anxiety
disorders as men lies in the changing social pattern in which women take
on work on top of marriage and children. So stay home, ladies, and
you'll be as happy as apple pie; though in the 50s when we stayed home
to bake it, the doctors gave us Miltown
<http://en.wikipedia.org/wiki/Meprobamate>  and Valium to help us take
pain-free care of hubby and the young ones

On the subject of women's greater susceptibility, it's just as well to
remember that women go to doctors far more than men, for all kinds of
ills: indeed the way the stats add up, women's greater incidence of
mental ills just about equals their greater number of visits to the
doctors. If men went to doctors as often as they go to the pub, it's a
fair guess that their unhappiness would be represented as depression or
anxiety as well.

One of the many things that became clear to me as I was working on Mad,
Bad and Sad, my book on the rise and rise of the mind-doctoring
professions over the last 200 years, is that classifications of mental
disorder are hardly absolutes. They are far more often constructs that
mirror their time's aspirations and ways of understanding. They may
reflect subjective experience, but only insofar as we can prod and
organise our inchoate inner lives to fit pre-existing psychiatric tick
lists.

Useful tools for statisticians, the classifications are also useful to
public health administrators, insurance companies, lobbying bodies, or
pharmaceutical companies who need "homogeneous populations" on whom to
carry out drug trials. But I remain to be convinced that these
proliferating classifications help individuals find relief - except, of
course, that momentary relief from giving an expert name to what may
feel like an intractable set of problems.

Over the last 40 years The Diagnostic and Statistical Manual of Mental
Disorders
<http://en.wikipedia.org/wiki/Diagnostic_and_Statistical_Manual_of_Menta
l_Disorders>  - the bible of the psychiatric professions - has spawned
more and more diagnostic categories, "inventing" disorders along the way
and radically reducing the range of what can be construed as normal or
sane. Meanwhile Big Pharma, feeding its appetite for profits and ours
for drugs, has gained an ever greater hold over our mental and emotional
lives, medicalising normality.

The more studies that come along to tell us about the rise in mental
illness, the more we fit our problems and unhappiness into a category of
mental disorder, developing symptoms to take to the doctor in search of
a cure. Humans are suggestible creatures. And doctors like to help: they
provide the pills Big Pharma recommends, though many must now know that
research has shown placebos can work just as well and with fewer side
effects.

If doctors - rather than politicians or teachers or priests or friends
and family - are to be the guardians of our wellbeing, then doctors
really should be provided with new kinds of "treatments" for their
patients. Psycho and group therapy could, of course, be rolled out, and
not just of the 10-week variety: anything that builds up the
individual's inner resources and allows emotions to be reflected on
can't be bad.

But doctors could recommend group running for depression, proved to have
far better effects than SSRIs
<http://www.guardian.co.uk/commentisfree/2008/jan/26/badscience> .
Reading groups, too, offer a definite lift. Mentors for those on street
drugs rather than the legit kind could be provided. As for women, more
free childcare, after-school clubs and husbands who take days off to go
to the doctor with the kids (or sort out that drinking problem) would
lift a depressed mood wonderfully. Then there's poverty, terrible
schools ... could the NHS take those on as well?

http://www.guardian.co.uk/commentisfree/2011/sep/06/mental-illness-medic
alising-normality

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