mental “disorders”
[hat tip to Lou Proyect for tagging this one]
There is suspicion that the pharmaceutical industry is cooking the studies that prove that antidepressant drugs are safe and effective, and that the industry’s direct-to-consumer advertising is encouraging people to demand pills to cure conditions that are not diseases (like shyness) or to get through ordinary life problems (like being laid off).
Jenny:
Actually, the whole article is simply an overview of different opinions on psychitray, Way to take it out of context.
22 February 2010, 11:33 pmStan:
Huh?
23 February 2010, 11:09 amJenny:
Sorry for my condescending tone last night,but if you read the whole article- it touches on all the views about psychiatric treatment,not just the one you mentioned.
24 February 2010, 12:18 amStan:
It does. But what is unusual is that the critique of psychiatry in general is given equal credence in a mainstream publication. Few will pull the tail of Big Pharma these days, or challenge the widely accepted medicalization of the human condition.
It opens a conversation that needs having outside the ususal suspects.
De’s comment on another thread today relates to this, re the radical monopolies (a la Illich) of medicine et al in a culture where we have been so thoroughly alienated from direct experience of our own enfleshed existence, from pop-genes to the gym-perspective of body as scupture (“I’m working on my glutes today”).
24 February 2010, 8:28 amMichael Anderson:
If a profit can be made from the relatively inexpensive procedure of writing medical reports, re-defining mental “health” within the auspices of a “peer-review” organization like the WHO (and what about the acculturation of peer review as an instrument of power??), and “merchandising, merchandising, merchandising”, then I’m absolutely sure Capitalism will go after it….especially if it meshes with another goal of THAT system (or any other authoritarian centralized system), control of the population.
And, what is money if not numbers on paper backed up with a Hellfire rocket?
24 February 2010, 3:04 pmJenny:
For the record, I take zoloft for anxiety and to be frank, it works for me. I’m just uncomfortable with the “mental illness is a lie” theory. I understand indeed that there are incompotent people in psychaitry and that unfortunately, big pharmacuticals love lobbying,but I don’t think that’s a reason to dismiss the medical field or psychology altogether.I was a bit miffed that aspect of your “progressive” rant if you want to know the truth.
25 February 2010, 12:45 amRichard:
The point, Jenny, is that modern society effectively creates certain conditions which it then medicates. The very wiring of our brain is affected by the chemicals we are exposed to, along with countless other environmental factors. Gene expression is affected by the same things. My wife takes prozac for depression, a lot of it. It works, more or less, for her too. That doesn’t change things.
25 February 2010, 12:02 pmStan:
Moreover, we are left with the ‘naturalization’ of the medical model of experience. Freud played a part in this, along with other lights of enlightenment… removing us from our bodies and making us outsiders looking in. Treating ourselves as if we are egos, machines, immune systems, sculpture projects, putting us constantly on watch against any anomolies, self-monitoring and terminally self-conscious… in a state of either diagnosing or performing, never just being in our skins the way small children are (whether joyfully or painfully or otherwise). Our capacity for authenticity has been excised (medical pun intended). I think we pay a terrible price for this, and not just as individuals (cut off from having a people, belonging), but collectively.
25 February 2010, 1:26 pmRichard:
Check out this article, on the link between environmental toxins and autism:
http://www.nytimes.com/2010/02/25/opinion/25kristof.html?ref=opinion
My favorite line: “Concern about toxins in the environment used to be a fringe view.” Dude, they’re CALLED toxins!
25 February 2010, 7:33 pmRichard:
Also, on a related not, I liked this quote from SF writer Kim Stanley Robinson (swiped from here: http://6thor7th.blogspot.com/2010/02/kim-stanley-robinson-beats-me-to-punch.html):
25 February 2010, 7:35 pmRichard:
um…. related note….
25 February 2010, 8:02 pmDeAnander:
How the Brain Responds to Inequality
Rather interesting, partly for its unintentional humour (watch the neolib economic orthodoxy desperately trying to make the brain’s egalitarian reflex into a selfish reaction)… partly for its implications. If a part of our brain is disturbed by inequality and wants greater equality, then (a) how is it that we humans keep forming grossly inequitable hierarchies, and (b) what does it do to us to be trapped w/in these structures for a lifetime?
Confronted with this text
I found myself wondering whether the Powers that Be will next move to describe the “inequality aversion” as a mental dysfunction and start looking for a pharmaceutical “cure”
26 February 2010, 3:55 pmJenny:
Richard: depression is a chemical imbalance in the brain and the toxic thing is nonsense- that’s just an opinion column.
26 February 2010, 6:59 pmStan:
Describing “depression” as a chemical imbalance in the brain seems to be fairly tautological, since the term depression arises as a medicalized term alongside its own definition – chemical imbalance.
I have to wonder if experience hasn’t been shunted off into some parallel universe, a secondary concern to a disembodied self that is monitoring the body from the outside.
De’s point about circumstance and experience mirrors my own critique of the notion of PTSD, which I have been told I suffer from… by well-meaning friends and relatives. One of the “symptoms” of PTSD is “the patient loses her/his sense that the world is a safe place.” It’s just that I don’t buy that there is some natural entitlement to this sense of safety; and what combat veterans and rape victims (two of the major ‘PTSD suffering’ categories) go through does not delude them out of the entitlement; the experience demonstrates to them that, in fact, the world is not a safe place. So I don’t get why this is ‘disordered.’ It seems rational.
Women ‘suffer from anxiety.’ Well, anxiety is the experience of vigilance in the face of perceived dangers. Many, I would guess most, women in male-dominant and misogynist cultures have very good reason to be afraid… and vigilant.
Is there some chemical change in the brain when we experience anxiety? I suppose there is, from this out-of-body perspective; but this reminds me of someone trying to explain the experience of music using the anatomy and physiology of the inner ear (and maybe the brain with all those chemicals washing around, all those charge gradients and concentration gradients and molecular pumps).
The classification of these experiences as medical “disorders,” however, does two things at once. (1) It pathologizes the experience by setting experience against one of those norms, and (2) it places the “pathology” in the hands of credentialed experts, in other words, it legtimates the social power of cadres of experts who have determined what the norms are.
So we ‘treat’ the disorder of anxiety or depression (sadness?) with Paxil or whatever new drug, and we get relief from the discomforts of our experiential state.
I did that for a long time before these new drugs, using alcohol to overcome anxiety, and marijuana to overcome boredom (Uninterested Restlessness Disorder – URD – common disorder of students in mandatory public schools).
I’m not dissin’ this alcohol dependence or others’ use of the newer drugs. If I was still in the army, I’d probably take up drinking again. Booze is a great conscience anesthetic, too. The point is not to judge people who use what there is to cope in the world-as-it-is, but to raise some critical questions about the epistemology of the medical.
The concern behind this questioning is whether the medical episteme isn’t more than a specious claim on some totalizing principle (the speciousness of which which we can deomnstrate fairly easily), ie, whether the dependencies created therein aren’t more than chemical dependencies, but dependencies on technocrats and bureuacracies.
Here’s a quote from theologian Stanley Hauerwas (quoting Bishop James Edward Lesslie Newbigin), on bureaucracy:
27 February 2010, 9:07 amRichard:
I’d love to know in what manner the toxins thing is “nonsense”, or what it being an opinion piece might have to do with that.
The short version is this, supported by recent discoveries in brain science (in the way that science has of discovering things which previously only seemed impossible because science had said they were): environmental toxins contribute to the ongoing chemical make-up of the brain. These “imbalances” of which you speak are not “innate”.
27 February 2010, 10:59 amcabdriver:
I am convinced that there is such a medical disorder as severe chronic depression.
But without a doubt, many a “chemical imbalance” has been rectified through the means of finding new employment; relocating to a more socially and/or naturally hospitable environment; making a new friend; making breakthrough progress in a difficult task. Etc.
I think it’s even quite possible that an optimistic societal Zeitgeist can reduce the incidence of negative mental states in the population.
27 February 2010, 1:11 pmJenny:
So you believe depression and PTSD are actually defense mechanisms? You agree with Thomas Schnaz then?
And as a 21 year old woman, I was diagnosed with anxiety after 9/11 so there goes your theory
27 February 2010, 1:18 pmJenny:
And there is a biology of depression: http://en.wikipedia.org/wiki/Biology_of_depression
27 February 2010, 1:18 pmStan:
Not sure you’re hearing what I said, Jenny. Who has articulated a theory? This is a critique.
9/11 no doubt caused a great deal of anxiety, enough to gain the government widespread support for a foreign war.
And I would expect Wikipedia to elaborate a medical description of a condition that is being described as a medical condition.
My point is, and has been, there are other ways to understand this – outside the purview of the radical monopoly of medicine -that raise critical questions about the claims of institutionalized medicine, and the implicit claim that a medical episteme is the only correct way to understand it.
There is a power dynamic at work here, that is demonstrable, both in the monopoly of so-called experts and in the hegemony of their perspective; and looking at that power is not an indictment of anyone who take medications. In my own piece on ‘progress,’ I talked about taking sleeping pills so I could go to work without killing myself or my colleagues by being underslept on hazardous worksites.
It seems to me that our participation – which can hardly be called voluntary, except by the most abject libertarian sophistry – makes this critique even more urgent.
Let me state this as explicitly as possible: I am not indicting, blaming, or making suggestions of personal failure or moral weakness, with regard to people who use the medical system, who have been schooled in the medical episteme, or who take drugs.
I am asking us to reclaim some agency by stepping out of that way-of-knowing and back into the realm of direct experience as a first step to breaking away from the tyranny of experts and specialists.
One of the symptoms of an age where the (deracinated, alienated, dependent) individual is the last word is the reflexive tendency to take general critiques too personally.
27 February 2010, 1:55 pmJenny:
Yes and it sounds to me like you’re saying “disorders”(putting it in quotes for your sake) are actually coping mechanisms as opposed to medical problems.
27 February 2010, 2:30 pmcabdriver:
The neurochemistry of living organisms is to a large degree mutable, and this is an indisputable fact, confirmed by many scientific studies.
Neurochemical status is dependent on factors such as nutrition, exercise, and various environmental stresses- including, in humans, factors as grossly material as whether one finds oneself newly in possession of a windfall of cash- or, conversely, the occasion of finding oneself victimized by a burglary.
27 February 2010, 2:54 pmcabdriver:
It’s possible for someone to maintain equanimity of temperament regardless of the whims of fortunes as far as their own personal material circumstance- but as a rule, that’s an acquired ability, and the result of a lot of spiritual practice and self-discipline.
Most people find themselves euphoric from obtaining a boost in their material status- or prone to lethargy and and apathy, from a setback along those lines. And if they lose even more traction as a result, it’s quite possible to slip into a marked and sustained state of depression.
There are other, more subtle environmental influences that have also been found to affect human neurochemistry.
(“touchy-feely” alert!)
http://www.nytimes.com/2010/02/23/health/23mind.html
NY Times, 2/23/2010
Mind
Evidence That Little Touches Do Mean So Much
By BENEDICT CAREY
Published: February 22, 2010
Psychologists have long studied the grunts and winks of nonverbal communication, the vocal tones and facial expressions that carry emotion. A warm tone of voice, a hostile stare — both have the same meaning in Terre Haute or Timbuktu, and are among dozens of signals that form a universal human vocabulary.
But in recent years some researchers have begun to focus on a different, often more subtle kind of wordless communication: physical contact. Momentary touches, they say — whether an exuberant high five, a warm hand on the shoulder, or a creepy touch to the arm — can communicate an even wider range of emotion than gestures or expressions, and sometimes do so more quickly and accurately than words…
…If a high five or an equivalent can in fact enhance performance, on the field or in the office, that may be because it reduces stress. A warm touch seems to set off the release of oxytocin, a hormone that helps create a sensation of trust, and to reduce levels of the stress hormone cortisol.
In the brain, prefrontal areas, which help regulate emotion, can relax, freeing them for another of their primary purposes: problem solving. In effect, the body interprets a supportive touch as “I’ll share the load.”…
27 February 2010, 3:06 pmxenia:
As a traumatized war refugee, i have gone through year long periods of depression, and I expect them to reoccur seasonally. I know other people who lost most of their families, their houses, or parts of their body, and many of them were or are depressed as well. Calling some of those reactions merely “depressed” or “traumatized” is of course trivial and insulting.
Medications are not a solution for any of those. They merely make you “functional” so that you can go to work, smile, act like a plastic person from a commercial. A doctor who gives you frigging pills does not help you — he is just there to sell the product and to charge you for his services.
This is what helps depressed and traumatized people, but the system will NEVER give them this:
-a lot of free time — A LOT. possibly years off work.
-physical and emotional tenderness coming from people around you. -joyous physical activity, including hiking, running, swimming, biking, dancing.
-creative activities, including painting, weaving, writing, playing music.
That helps. That heals, and as a human being you should be entitled to it. But no, it is much easier to put a tag on you as having a medical condition which can only be healed with a drug, and let you carry on like a robot.
27 February 2010, 3:15 pmaskod:
DeAnander,
that reminds me of a russian female early psychologist about whom I saw a film. Unfortunately I have forgotten her name.
Anyway, her first contact with psychology was when she was sent as a patient to the famous doctor Freud in Austria so she would be cured from her hysteric outburst that happened ever so often. Apparently, they happened every time her father was beating her brothers…
27 February 2010, 3:45 pmJim:
Re: “One of the symptoms of an age where the (deracinated, alienated, dependent) individual is the last word is the reflexive tendency to take general critiques too personally.”
Exactly right! This knee-jerk reaction is almost universal. It clouds almost all discussion of important questions.
Another symptom of a hyper-rationalism and individualism is the alternativism in thinking: vantage points are presented as irreducible alternatives, as always either-or. They can be both or neither, depending on the standpoint taken, on the level of the vantage point, and so on.
27 February 2010, 4:07 pmlatte lenya:
…to say nothing of the way gender is used in marketing these pills…sad women looking through rain-streaked windows, victims of their own chemistry…
27 February 2010, 9:45 pmprozac is what happened to feminism.
if there were no profit in it, there would be no ‘mental illness.’
the soviets liked locking up their dissidents in psych wards, too: criticism of the system was proof of insanity.
young people are being drugged wholesale, for things like ‘oppositional-defiance disorder.’ if you drug one-third, you can scare the rest into compliance.
maybe that’s why there’s no antiwar movement.
Stan:
I want to re-recommend Barbara Duden’s Canadian Broadcasting System inteview on the pop-gene. She is simultaneously more conversational and eloquent than me. Her preoccupation is apparent in the title of her book, which I haven’t had the opportunity to read yet, Disembodying Women. In the interview, she points out the ways in which the introduction of scientific concepts, like immune system and gene, originally categories that were peculiar to science, and thereby confined by the admirable (in my view) self-limitations of scientific practice, have been altered by popularization. So when a scientist, for whom certainties are limited to tested and re-tested obvservations, talks about genes, they have a very specific meaning determined within the established certainties of molecular biology.
When the general public gets hold of these concepts, they become fuzzier, and are understood through various familiar analogs. So the popular gene is different than the scientific term “gene.” Or immune system. Or – even where science gets rocked on its heels by the prejudices of scientists – hysteria, neurosis, mathematics disorder, et al.
Self-help literature – worthy at some point of its own thread – has propogated the popularization of quasi-medical notions as cultural epistemes.
Consumer capitalism, as a self-organized and self-reinforcing, and self-expanding (medically, “metastatic” [smile]) system, lays the material foundation for this kind of propagation – both in its relentless acquisitive invidualism (self-involvement) and by demand production (advertizing using manufactured insecurities, envy, etc).
Jumping from there to our old friend Alf Hornborg: AH talks about a triad of recursion – environment, culture, personhood. Each of these evolves, or emerges, in relation to the other. Without getting sidetracked by this equally interesting idea, I’ll highlight the idea of personhood.
That’s precisely the concern underlying this whole provocation… this unified sense of self and other, prior to the disarticulations of self and other into various objectified systems, chemical reactions, even “organisms.” Personhood. Our sense of dwelling in the world before we take ourselves and others apart with these disembodying ideas.
As an aside, my old references to the dehumanization of the Other as part of warfare, msogyny, racism, etc, ought to be amended to “de-personizing.” Anyone who owns a beloved pet has recognized and been recognized by the animal as a fellow-dweller in the world – a person, joined in the “bonds of love” (the title of Jessica Benjamin’s worthy tome on intersubjective psychology). When we withdraw personhood – by reducing another to something unworthy of that fellow-dweller recognition – we clear the way to dismiss, ignore, abuse, even kill that other.
The problem I see with the medicalization of cultural understanding is that we not only do that to others, we now do it to ourselves. The problem being, we can commit to this self-alienation in our minds, but we can’t escape experience, which embodies us whether we like it or not. And so we become fragmented… there is a disconnect between our mind and body, that then becomes self-reinforcing.
Something in us yearns for that integrated sense of simply being, a person, a being dwelling in the world. I know I’m not saying this well, and language itself is frustrating me because its symbolic and abstract nature make it a pretty blunt instrument.
This sense that we can’t quite get back to direct experience of ourselves, each other, and the world, is the price of the male-dominant “enlightenment,” in my opinion, and it is painful. People use anesthetics for pain.
Socially, power has learned to make and monopolize anesthesia… even for itself.
I’ve wandered way out into the woods here, so I’lll stop. Maybe only poets and songwriters can put language to it.
28 February 2010, 7:22 amDeAnander:
Re: coping vs disorder — random thought:
Many prostitutes — at the street level certainly, probably in the higher ranks as well — are habitual drug users medically diagnosable as “addicts.” It’s generally acknowledged that addiction is a medical problem; it’s also generally acknowledged that prostitutes take psychoactives in order to make the stress, indignity, risk and alienation of their livelihood more bearable. So — is the addiction a medical problem (a disorder) or a coping mechanism? Is the “disorder” in the individual, who “just” needs to get rid of her drug habit — or is it in the larger structure of power and abuse that alienates that individual and narrows her choices to a no-win scenario?
There is much about the world that industry and capitalism (and human greed and folly) have built that is — and should be — unbearable. I wonder whether we should really expect people to adapt to it and whistle “Don’t Worry Be Happy” while their planet burns and they are either implicated in crimes of terrible proportion, or victimised by same (sometimes both).
28 February 2010, 10:50 amStan:
Interesting, addiction – in the more tolerant view – is seen as a disease-model. In the harsher view, it’s seen as personal failure. In neither model is an account of circumstance factored in.
In your account, De, there is the anesthetic that takes over, heirarhical dependencies wrapped in heirarchical dependencies… from the John to the pusher to the John to the pusher (sometimes one guy, no?).
Consumerism can be seen as addiction, certainly, but then we’re back at the impasse of locked-out personhood… the analogy we use to unmask one thing itself masking another.
Makes my head hurt.
28 February 2010, 1:25 pmMark:
I had not before heard of the term “pharmacological Calvinism” but I think it applies the the anti-drug crowd in relation to depression. As someone who suffered for years I whole heartedly agree with William Styron that “his experience in talk therapy was a damaging waste of time, and that he wishes he had gone straight to the hospital when his depression became severe.”
The brain is no different from the heart, liver, or any other organ. I need my heart to keep pumping at a steady lub-dub. Of course it should increase in rate when I exercise or when I’m in a dangerous situation and need to either fight of flee. However, if it starts behaving in an erratic manner, functioning outside acceptable parameters, I’m going to seek medical attention to get it corrected (if that is at all possible). It took me many years to understand that my brain is no different.
1 March 2010, 2:32 pmStan:
Critiquing ‘radical monopoly’ and technocratic control is not being ‘anti-drug.’ I think we’ve pointed that out several times now.
1 March 2010, 7:03 pmxenia:
i do not see how one could set up a juxtaposition between anti-depressant drugs and therapy. surely they are both points along the same rotten continuum, and they serve the same purpose for capitalism and the medical establishment.
i went to about 4 therapy sessions in my entire life before i abandoned them as laughable and inadequate.
i have never taken an anti-depressant, and i took ONE sleeping pill 12 years ago. i still remember the horrible sleep which was too deep to be natural, and it did not have the texture of my sleep. as for covert calvinism, well, you can certainly count that out in my case. i was 23 when i first entered a protestant church, and i attended perhaps three services total, being somewhat appalled that they used electric guitars.
the reason why i do not connect with most americans has to do with socialization, and drugs are a large part of it. people rattle down names of pharmaceuticals like it’s nothing. i agree with latte lenya that they are one of the main reasons for the absence of an anti-war movement. the constant hideous compulsion to smile!!!
2 March 2010, 9:37 amRichard:
Check out this article on the harmful effects of even low levels of lead:
Our daughter tested positive for just such a low level last Fall, all too common in Baltimore City especially. Who knows what kinds of ill effects she’ll encounter?
8 March 2010, 3:12 pmCurt:
I am watching this program which has been discussing the danger of prescription medicenes ending up in the drinking water. Switzerland has already added another step to its sewage treatment plants to clean meidcations from the sewage. A person who was reccomending that this happen in Germany said that to add this extra step would only cost 10 Euro per person per year. I do not believe that. It may be true in the long run but I can not believe that the initial capital investment would only cost 10 euros per person. The most important thing is that medications should not be flushed down the toilet. You would think that people could be informed of this and they would follow the instructions. You would think.
22 March 2010, 12:57 pm(Boer) Tom:
@Curt
23 March 2010, 11:39 amWhat of medications that remain chemically intact in urine?
DeAnander:
Actually I think you will find that people are not necessarily flushing their meds directly down the loo; but the body excretes excess chemicals and toxic compounds via the kidneys and urinal system, and thus the pharma products end up in the loo w/o deliberate “littering” by the user, in the course of normal urination.
This re-opens the whole paradoxical nightmare of “sanitation” and the unwisdom of collecting, concentrating, and dumping human wastes into our water system… backyard composting with fungi would probably be doing a far better job at far less cost, but of course that is not “high tech” or “civilised” so it is never a serious option for Serious (industrial) People.
23 March 2010, 12:01 pmCurt:
Yes that was mentioned in the program too. It gave examples of several different types of medications and percents of the medications that were typically excreted by human bodies.
23 March 2010, 2:57 pm