Pharma finds its biggest market for psychiatric drugs in the worried well rather than the genuinely mentally ill
In the late 80s and 90s, new SSRIs began to sell widely and rapidly, and after the 90s, antipsychotics began to be prescribed carelessly even to non-schizophrenics. Only a very few people have severe mental illness, many more have mild mental illness, but the real mother lode of market share for psychiatric drugs is the worried well. Pharma wants to strip-mine that mother lode and has achieved fantastic revenues by promoting the idea that many of life’s expectable problems are mental disorders due to a “chemical imbalance” that can be solved with pill popping. However, a shortage of serotonin in the brain has not yet been found in depression patients and an overabundance of dopamine in schizophrenics has yet to be found. The most creative advertisers and the most extensive market research help push product into places it had never been before. The pitch to customers is that life is perfectible, if only they will take the simple brain-toning steps to perfect it.
The subliminal promise is that beyond curing illness, pills can also help achieve a better way of life through chemistry. If you go to the dentist to correct your less-than-perfect teeth, why not go to the doctor to correct your less-than-perfect brains? No one ever need settle for less than happiness and success. Selling new lifestyles works well for selling cars and beers and perfumes and designer clothing—so why not for selling pills?
The message is illustrated with compelling graphic images: the rain stops and the sun shines through when you take an antidepressant; the sad sack becomes the confident leader; the couch potato a well-muscled runner. For kids, the cute little frowning rock becomes the cute little smiling rock. The ads always enjoin us to “Ask your doctor.” Of course, the companies have already wired the doctor with a similar message and have provided him with handy free samples to speed you out of the office immediately after you have popped the crucial question.
References
- Frances, Allen. (2013). Saving Normal CHAPTER 3. Diagnostic Inflation (p. 134). New York, NY: HarperCollins.
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