I have been saving news items and blog posts that have caught my eye over the last few weeks so now that In Treatment is over, it's time to begin to catch up.
First is this op-ed by Christoher Lane from a couple of weeks ago. I have mentioned him before because I like the approach he has taken to the medicalization of ordinary life and I plan to read his book, Shyness: How Normal Behavior Became a Sickness. He begins --
"America has reached a point where almost half its population is described as being in some way mentally ill, and nearly a quarter of its citizens - 67.5 million - have taken antidepressants.
These statistics have sparked a widespread, sometimes rancorous debate about whether people are taking far more medication than is needed for problems that may not even be mental disorders. Studies indicate that 40% of all patients fall short of the diagnoses that doctors and psychiatrists give them, yet 200 million prescriptions are written annually in America to treat depression and anxiety. Those who defend such widespread use of prescription drugs insist that a significant part of the population is under-treated and, by inference, under-medicated. Those opposed to such rampant use of drugs note that diagnostic rates for bipolar disorder, in particular, have skyrocketed by 4,000% and that overmedication is impossible without over-diagnosis."
How can anyone not be at least a little disturbed by the statistics on percentage of the population taking psychotropic drugs? And why does it take someone from outside the field to raise the alarm about this as a problem?
"Failure to reform psychiatry will be disastrous for public health. Consider that apathy, excessive shopping, and overuse of the Internet are all serious contenders for inclusion in the next edition of the DSM, due to appear in 2012. If the history of psychiatry is any guide, a new class of medication will soon be touted to treat them. Sanity must prevail: if everyone is mentally ill, then no one is."
I have argued before that very few people who seek psychotherapy are actually what we might consider "ill"; most people have what might better be described as problems in living, but not an acute illness requiring psychiatric treatment. Most of the people I see in my practice fall into this category, which doesn't mean they do not suffer or struggle, only that they are not ill.
What does it mean to take on the label of being ill rather than having problems in living? I suspect that part of it is a factor of where one wants to place responsibility. If I have an illness then it's not really my fault; instead it is my faulty neurochemsitry or something like that but not a matter of choices I make or have made or defenses I employ to fend off painful or uncomfortable feelings. In the instance of illness, I depend upon the medication to maintain my emotional balance. Absent illness, I am called upon to look at myself and work to change the things I am unhappy about.
Of course that is a gross oversimplification, but I do suspect that these are issues embedded in the vogue for pills over therapy, for illness over personal responsibility.