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Medicalising discontent

v01ce5

v01ce5

Well-known member
Joined
Dec 11, 2007
Messages
160
The article in the BBC Is depression good for you? points out that depression is part of what it is to be human

An article from 1997 was brought to my attention recently, entitled "Psychiatric Imperialism: The Medicalisation of Modern Living" by Joanna Moncrieff, M.D. also considersthis issue. I heard her speak at a conference a couple of years ago and she has a refreshingly sceptical view of the scientificity of psychiatric research.

Here is an extract about depression and psychiatry

"In psychiatric hospital practise in the 1950s depression was a relatively rare disorder and there was no concept of a specifically antidepressant drug as opposed to a general stimulant. When antidepressant action of certain compounds was first proposed drug companies were initially reluctant to develop and launch such drugs. In an unconscious alliance of interests, influential psychiatrists developed and popularised the view of depression as a common biologically based disorder, amenable to drug treatment and as yet frequently unrecognised. This concept had the dual benefits of vastly expanding the market for psychiatric drugs and extending the boundaries of psychiatry outside the asylum. Since this time the psychiatric profession and the drug industry have continued to try and inculcate this idea into the consciousness of both the general public and other doctors. The DDC is the latest offensive.

Numerous biochemical mechanisms responsible for depressive illness have been proposed implicating a variety of biochemical and hormonal mechanisms, partly determined by fashion. The evidence for all these theories has been inconsistent and the consensus about the efficacy of antidepressant drugs remains the strongest support for the thesis that depression is a physiological condition. Perusing the psychiatric literature indicates that this consensus developed in the mid 1970s based on evidence from randomised controlled trials of the original and still widely used antidepressants, the tricyclics. However, early reviews of this evidence portray an ambiguous situation with a large proportion of trials failing to find a positive effect. In addition, more recently some researchers have suggested that antidepressants are not specifically active against depression but merely exert a placebo effect in a receptive condition. They appear to perform better than an inert placebo because their side effects increase their suggestive power and may admit bias into the assessment procedure by enabling investigators to guess whether patients are on the active drug or the placebo. A recent meta-analysis of placebo controlled trials of prozac found that the likelihood of recovery was indeed associated with experiencing side effects . A review of seven studies which used an active substance as a placebo to mimic antidepressant side effects found that only one showed the drug to be superior.

Variation in mood is a characteristically human way of responding to circumstances but unhappiness has become taboo in the late 20th century, perhaps because it undermines the image that society wishes to project. Medicalisation diminishes the legitimacy of grief and discontent and therefore reduces the repertoire of acceptable human responses to events and denies people the opportunity to indulge their feelings. At the same time it diverts attention away from the political and environmental factors that can make modern life so difficult and distressing. It may be no co-incidence that the concept of depression has reached its present peak of popularity in western societies reeling from two decades of economic events and political policies which have been blamed for increased unemployment and marginalisation of a substantial section of the population.

However, it is also important to acknowledge that people have different propensities to experience intense moods and that, for those at the extremes of this spectrum, such as those with manic depressive disorder, life can be very difficult. Prophylactic medication is promoted by psychiatrists for long-term use in this condition primarily in the form of lithium. However, in a similar way to antidepressants, claims of the efficacy of lithium seem to have been based on insubstantial evidence and follow up studies of people with manic depression do not indicate that it has improved the outlook of the condition. It is possible therefore that prophylactic drug treatment constitutes a false hope held out to people who feel desperate, by a profession that feels helpless. But it may only further undermine the self assurance of people who are already vulnerable. Instead of aspiring to complete cure, natural remission of episodes should be encouraged by providing care and security, and attempts should be made to enhance people's confidence in their own ability to manage or survive their condition."
 
D

Dollit

Guest
I read an article in New Scientist some time ago on a similar theme. It was the deciding factor in whether or not I should take a medication break. I did, it was disastrous and back on lithium, with a better attitude, it works for me now.

We do seem to be over fond of labelling people and then medicating the life out of them. How many people are labelled depressed when all they are suffering from is the modern trend to move from place to place and live away from their extended families so that when times get hard the families we have traditionally depended upon are no longer there on hand?
 
midnight

midnight

Well-known member
Founding Member
Joined
Dec 24, 2007
Messages
219
Location
cumbria
to be honest the whole institution needs to take a good hard look at itself.

People are different, people react different, people cope different. By reducing their locus of control i.e. that they themselves are in a position to deal with the situation rather than a chemical compound in a bubble strip makes people feel unable to help themselves.
WRONG

It aint easy when the worlds crumbling around you

but sometimes give the man the food he can feed himself for a week, give the man the tools to grow his own food he can feed himself for a life time. Same principle don't mask the syptoms teach people to recover from them
 
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