Tag Archives: drug companies

Contagious Mental Health

Lynne says:

I ran into an article not long ago in The New York Times, The Americanization of Mental Illness by Ethan Watters, based on his forthcoming book, Crazy Like Us: The Globalization of the American Psyche, discussing how the American way of mental illness being exported along with other American products such as rock n’ roll, Coca Cola, and anorexia.

The classic case of Western media-induced anorexia happened on the Polynesian island of Fiji, where eating disorders were unknown for 3,000 years until television became available in 1995. A 1999 New York Times article describes what Dr. Ann E. Becker, director of research at the Harvard Eating Disorders Center of Harvard Medical School, found when she investigated shifts in body image and eating practices in Fiji over a three-year period.

Before 1995, Dr. Becker said, there was little talk of dieting in Fiji. ”The idea of calories was very foreign to them.” But in the 1998 survey, 69 percent said that at some time they had been on a diet. In fact, preliminary data suggest more teen-age girls in Fiji diet than their American counterparts.
Study Finds TV Alters Fiji Girls’ View of Body By Erica Goode, May 20, 1999

Oddly enough the idea of viral mental illness set me to thinking about some unusual toys I played with as a child. My father was a psychologist who administered psychological tests for schools, government agencies and mental institutions before he gave that up to go into military and aerospace research.

He had a cupboard full of old psychological tests that he never used, and when I got old enough not to mess them up, he would let me take them out and play with them. I think by then his worldview was that these tests were indeed games, so why shouldn’t I play with them.

It’s been nearly 50 years since I last picked these up but I still remember how beautiful the Rorschach ink blots were. They were large, thick cardboard about six by nine inches and not just black and white, but with almost three-dimensional gray shadings, and colorful red, blue, green orange and pink swirls.

Another test was the TAT or Thematic Apperception Test, again pictures on even larger cards. Each drawing showed a little scene that you were supposed to tell a story about–good training for a novelist, although that was hardly anyone’s plan for me at the time.

The creepiest test was the Szondi test–no, not Zombie test, it was named after Hungarian psychiatrist Lipot Szondi (1893-1986). This test consisted of four sheets of mug shots, 48 pictures of mental patients taken in the late 1800s to early 1900s. As my father explained it, if you got on a bus and there was an empty seat next to each of these people, who would you sit next to?

Szondi lived into the 1980s and I don’t know if he ever changed his diagnostic definitions, but the eight diagnoses the Szondi test used were: homosexual, sadistic, epileptic, hysteric, catatonic, paranoiac, schizophrenic, depressive and manic.

Just that list gives you an idea of how ideas about what constitutes mental illness have changed just in America.

The Watters New York Times article that started my whole trip down memory lane talks about mental illnesses that once were common and now are rarely if ever seen, such as hysterical paralysis. He reports a contagious anorexia phenomenon in Hong Kong, and goes into a fascinating digression on how one culture’s treatment of schizophrenia as spirit possession actually leads to fewer relapses than the Western diagnosis and drug treatment

An internet search away from the Watters article was an equally absorbing commentary by Greg Downey at Neuronthropology.net. Downey suggests that export of mental health can also be motivated by:

[P]ure mercenary impulses, as drug companies try to persuade new markets that the individuals need their products, suffering as they do from disorders of which they were previously unaware. Here, the idea that it’s just the beliefs about illness held by therapists and authorities obscures the naked greed that goes into public relations campaigns designed to produce disorder.

He cites the case of GlaxoSmithKline’s fostering of depression in Japan, where the concept of depression (and thus treatment with their product) was unknown until 1999. The manufacturer of Paxil was forbidden by Japanese law to advertise directly to customers, so they embarked on a series of “educational” ads telling consumers: “Depression is a disease that anyone can get. It can be cured by medicine. Early detection is important.”

So, as Dr. Phil would say, “How’s that working for GlaxoSmithKline?”

Pretty well, alas! A 2007 Boston Globe article reports that depression and the drugs to treat it have taken solid root in Japan.

Our Daily Meds

Debbie says:

I finished Our Daily Meds, by Melody Peterson, last week. Sometimes, I think I understand the scope of a social problem, until I read a detailed and well-researched account and realize that what I knew was just the tip of the iceberg. Usually, that’s because I just can’t be cynical enough to take in what’s actually happening.

book cover

This book is a perfect example: Peterson is writing about how the American pharmaceutical industry has intentionally transformed not just the country’s prescription drug habits, but our national health, our attitudes towards our health, and our real income levels.

Basically, Peterson convinced me that it isn’t possible to be cynical enough. Her basic premise is that, while the benefits of prescription medications are obvious and crucial, the concept of marketing them like toys or candy has done an incomprehensible amount of harm. Drug marketing is not only pretty advertisements in public media, it’s also hundreds of millions of dollars spent paying medical doctors and movie stars to convince other medical doctors to prescribe drugs without any scientific evidence for their use–and sometimes with significant scientific evidence that those drugs do harm. It’s taking over the medical journals with articles actually written by the drug companies and their affiliates, lying eloquently about what the drugs do. It’s packaging strong narcotics in berry-flavored lollipops, and writing “children’s books” about how a particular drug transformed an unhappy child’s life.

Peterson details how drug companies have literally (and consciously) invented “diseases,” (such as “overactive bladder”) because they had a drug (in this case for incontinence) that not enough people needed. She has a chapter on Neurontin: an epilepsy drug so ineffective that the FDA approved only as a second drug to supplement some other seizure drug. (Why was the approval so limited? Because it “had not reduced the number of seizures in most volunteers in the company’s clinical trials” and “5 to 10 percent of the epilepsy patients taking [it] actually got worse.”)

The small-time approved use didn’t fit the company’s bottom line. And the law says once a drug has been approved for any single use, doctors can prescribe it “off label” for other uses. So the company decided to sell Neurontin for profitable uses, “from children with attention deficit disorder to adults with sexual dysfunction,” as well as migraines and uncontrolled hiccups. This would be bad enough, if the company had not then gone on to mount a wide-ranging illegal campaign to bribe doctors to prescribe it for these uses … and to pay doctors to convince other doctors to prescribe it. They spent tens of millions of dollars on upscale events at expensive restaurants and country clubs, where paid doctors spoke about nonexistent benefits and drug company salespeople got huge commissions based on number of prescriptions written.

Peterson comes off as a sensible researcher, not a starry-eyed crusader. She never forgets that most of the drugs she is discussing actually do some good. One thing I thought the book might be when I bought it was a deep critique of “brain meds,” but instead she writes about psychoactive drugs as part of the greater pharmaceutical picture, which is much more useful.

She also discusses some hidden social issues: she estimates the number of drug-related deaths in the U.S. at more than 250 per day (!) and shows how these deaths are hidden in the statistics. (I understand that, because anorexia and bulimia deaths are hidden the same way; the cause is “pneumonia” or “heart failure,” and the underlying issues disappear.) She talks about the measurable presence of trace pharmaceuticals in urban water supply (a 2002 study found prescription drugs, fragrances, insect repellents, disinfectants, and other household chemicals in 80% of the streams sampled in 30 states). She discusses the thriving high-school and street-corner market in pretty pills, and the highway and military deaths caused by prescription drug misuse or overuse. She talks about the marketing of drugs to children and the elderly, despite no studies regarding those groups: this results in particular in overprescribing for the elderly, whose body systems often process drugs less efficiently.

I’m a critical reader: I always look for how the author might be slanting her data to make her points. I saw that occasionally in this book, but the vast bulk of the time, Peterson was either giving me statistics on something I already basically believed, or convincing me it was worse than I thought.

Why is this a body image issue? Because body image isn’t just about how we look; it’s also about how we feel. And one of the nastiest aspects of the whole slimy mess is that by promoting sweetness and light, the drug companies have made Americans perceive ourselves as sicker, more in need of help, and less powerful than people anywhere else in the world. (And America’s government and citizens have supported the effort.)

The U.S. is the only country that has let this madness run unchecked. Peterson’s last chapter is a prescription for how to fix this on a personal level and a social level. If your stomach is strong enough, this book is well worth your time.