Breeding mental illness in the US

Rampant over-prescribing of drugs contributes to a system that is better at producing disorders than rectifying them.

Pills line the shelves in the pharmacy at Venice Family Clinic in Los Angeles
"Standard psychiatric diagnoses… do not correspond to meaningful clusters of symptoms in the real world" and can counter-productively result in "further stigma, discrimination and social exclusion" for their recipients [Reuters]

In a recent article on the BBC News website, Professor Peter Kinderman – head of the Institute of Psychology, Health and Society at the University of Liverpool – warns that the forthcoming edition of the American Psychiatric Association’s Diagnostic and Statistical Manual “will lower many diagnostic thresholds and increase the number of people in the general population seen as having a mental illness”. 

According to Kinderman, the manual – scheduled for publication in May 2013 – constitutes a dangerous effort to pathologise emotions and other symptoms of human existence and will exacerbate the rampant over-prescribing of drugs that already occurs “despite significant side-effects and poor evidence of their effectiveness”. 

The practice of attributing emotional distress and other phenomena to alleged cerebral/biological abnormalities rather than to social and psychological causes, writes Kinderman, is particularly problematic: “Standard psychiatric diagnoses… do not correspond to meaningful clusters of symptoms in the real world” and can counter-productively result in “further stigma, discrimination and social exclusion” for their recipients. 

Regarding the impending updates to the psychiatric manual, Kinderman notes that “[t]he new diagnosis of ‘disruptive mood dysregulation disorder’ will turn childhood temper tantrums into symptoms of a mental illness”, while relaxed criteria for “generalised anxiety disorder” will turn “the worries of everyday life into targets for medical treatment”. Normal grief will undergo conversion into “major depressive disorder”. Additional cutting-edge maladies will include “internet addiction” and “sex addiction”. 

No guidelines are apparently provided as to how to go about diagnosing societies that obsessively pathologise routine aspects of individual life. 

Societal diagnostics 

Incidentally, the tendency toward over-diagnosis and over-prescription that dominates the mental health care scene in the US contributes to a system that is better at producing disorders than rectifying them. 

For example, it is not difficult to see how anxiety that otherwise would not be present can be generated by inculcating persons with the fear that something is always wrong with them and that it requires purchase of a substance, service, or gadget to fix – a process aided by ubiquitous advertising for antidepressants. 

The profitable endurance of the depression industry in particular is presumably ensured by the very nature of contemporary society – not least by the isolation of the individual who has been conditioned to believe that self-made success and material gains trump inter-human bonds in importance. 

To be sure, neoliberal policies dependent on the obstruction of communal solidarity facilitate a mass alienation from human reality and deprive individuals of psychological support networks enjoyed in certain other cultures. 

It could be argued that alienation in the US begins at birth, an event too often characterised by scheduled Caesarean sections, the immediate removal of newborns from the vicinity of their mothers in defiance of natural bonding needs, and hospital distribution of infant formula encouraging mothers to simplify their lives by administering expensive and potentially toxic material to their offspring rather than the free nutrition that is generally located in their own breasts. 

And it is pretty much downhill from there.

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The “socialisation” process of children increasingly involves fundamentally anti-socialising activities such as video games and other technological distractions, the all-pervasiveness of which renders the proliferation of attention deficit disorder somewhat less than surprising. Of course, this does not stop ADD from being treated by and large as an individual mental defect rather than a societally induced condition. 

Energetic children are reformed into automatons via the fanatical prescription of pharmaceuticals with side effects ranging from depression to sudden death, while a cultural insistence on individual triumph and competition over collaboration likely contributes to such manifestations of emotional insecurity as the institutionalised practice of bullying at US schools. 

Luckily for drug companies and other entities that profit from mental disturbance, the New York Times reported in February with regard to victims of bullying and bullies themselves that “researchers have found that [an] elevated risk of psychiatric trouble extends into adulthood, sometimes even a decade after the intimidation has ended”. 

Disconnecting from the human condition 

My own personal experience with mental health issues in the US includes a prolonged panic attack I suffered in high school in the late 90s. Convinced for a period of six months that I was on the verge of spontaneous death, I would hyperventilate, unceasingly check my pulse, and hide in bathroom stalls. 

After later living abroad for many years in locations less estranged from reality, I concluded that the attacks had been hypochondriac fallout of extreme anxiety over the possibility of stigmatisation by society for exhibiting any indication of physical or psychological weakness – such as anxiety itself. 

Of course, the structure and habits of other societies and cultures can also have adverse effects on the human nervous system; however, the position of the US as global superpower means that its acute unhinging from humanity contains worldwide ramifications. 

For example, the mass production of isolated persons lacking empathy naturally facilitates the frequent military devastation of populations abroad – a hobby that has been deemed more lucrative than, say, providing health care to US children

The agricultural imperialism of US-based corporations like Monsanto, patron saint of the genetic modification of food, has also proved an effective means of global population control, facilitating the suicide of hundreds of thousands of farmers in India

Obviously, a nutritional reliance on modified and artificial ingredients and other materials that do not technically qualify as food does not bode well for biological – and therefore also psychological – processes. The quest for profit at the expense of the functioning of the body is further evidence of the US disconnect from the human condition, which is reinforced by schizophrenic electronic multi-tasking and the general reduction of interpersonal relations to a barrage of mobile phone beeps and Facebook notifications. 

In my interview last year with renowned Indian essayist Pankaj Mishra, he commented on the contemporary deterioration of the human essence: 

“Our capacity for uncritical love has been expended recklessly in recent years on the free market… This was the false god we were instructed to worship during the era of globalisation and most of us duly obliged, even the least resourceful and economically underprivileged peoples, dazzled by our new goods and gadgets, the routinely updated models of mobile phones… [Now] we can see more clearly how a tiny minority has enriched itself, leaving many others feeling cheated, and exposed to deprivation and suffering.” 

Professor Kinderman notes in his BBC News article on mental illness that therapy constitutes a “humane and effective alternative… to traditional psychiatric diagnoses”. 

Any truly effective therapeutic approach, however, would require a thorough examination of the inhumane context in which minds function – and, presumably, a comprehensive systemic rewiring.

Belen Fernandez is the author of The Imperial Messenger: Thomas Friedman at Work, released by Verso in 2011. She is a member of the Jacobin Magazine editorial board, and her articles have appeared in the London Review of Books blogThe BafflerAl Akhbar English and many other publications. 

Follow her on Twitter: @MariaBelen_Fdez