Pharma companies exploit the fuzziness between mild mental disorder and being probably well to extend diagnosis and sell more drugs
At the extremes, the distinction between the completely well and the clearly sick is perfectly plain and not the least bit amenable to fudging. In contrast, the much fuzzier distinction between the mildly ill and the probably well is easily and frequently manipulated, as the threshold for diagnosing mental disorders are somewhat arbitrary and can be adjusted, and psychiatric diagnosis is dependent on subjective judgement rather than empirical tests. Most normal people have at least occasional mild and transitory symptoms (e.g., sadness, anxiety, sleeplessness, sexual dysfunction, substance use) that can easily be misconstrued as full fledged mental disorder.
I believe this can be attributed to an increasing propensity for left hemisphere cognition, as the left hemisphere inhibits the right more than the right inhibits the left. The need to sort more and more unique individuals into generic categories may involve an over-dominan left hemisphere.
- The right hemisphere allows for the recognition of uniqueness and familiarity, while the left only re-presents generic categories of things.
- The right hemisphere has broad, global, and flexible attention, while the left has narrow attention, narrow reductionistic mechanistic view
- Desire to grasp and control emotion by putting it into acceptable boxes
The business model of the pharmaceutical industry also benefits from extending the realm of illness—using creative marketing to expand the pool of customers by convincing the probably well that they are at least mildly sick. Disease mongering is the fine art of selling psychiatric ills as the most efficient way of peddling very profitable psychiatric pills. Manipulating the market is particularly easy in the United States because we are the only country in the entire world that allows drug companies the freedom to advertise directly to consumers.
Neurologically I also see this as caused by an excessive left hemisphere perspective. The right hemisphere is capable of identifying emotional expression, whereas the left hemisphere generally remains emotionally neutral. The increasing scope of what’s considered mental illness seems to Indicate that more and more of emotional expression is being seen as strange and mystifying. The end goal seems to be the unrelenting cheerfulness of the left hemisphere: The right frontal lobe has a depressive stance, where as the left shows undue cheerfulness.
Disease mongering cannot occur in a vacuum—it requires that the drug companies engage the active collaboration of the doctors who write the prescriptions, the patients who ask for them, the researchers who invent the new mental disorders (Psychiatrists must run field trials for each new set of diagnostic criteria to prevent unpleasant surprises), the consumer groups that advocate for more treatment, and the media and Internet that spread the word. A persistent, pervasive, and well-financed “disease awareness” campaign can create disease where none existed before. And psychiatry is especially vulnerable to manipulation of the normal/disease boundary because it lacks biological tests and relies heavily on subjective judgments that can be easily influenced by clever marketing (see psychiatric diagnosis is dependent on subjective judgement rather than empirical tests).
References
- Frances, Allen. (2013). Saving Normal CHAPTER 1. What’s Normal and What’s Not? (p. 50). New York, NY: HarperCollins.
Metadata
Type:🔴 Tags: Psychiatry Status:⛅️