I’ve long been sceptical of the big drug corporations and their hold on our understanding of mental illnesses. While I don’t deny the usefulness of medications in treatment, I don’t think that they are necessarily the best choice or the only choice. Additionally, there is come compelling evidence that major pharmaceutical companies are going into other countries and exporting the Western/North American conception of mental illness, essentially redrawing the line between normal and abnormal in these cultures so that they can enlarge their market.
I recently heard a discussion on CBC “Q” where journalist Ethan Watters was talking about his new book, “Crazy Like Us: The Globalization of the American Psyche.” I haven’t read the book yet, though I have it on hold at the public library. From the interview, he talks about this very thing. [For the interview with Jian on Q, you can find it here (first 20 minutes of the program “Q the Podcast 2010-04-05 Regina Spektor”). For a video of an interview at Berkley, go here (the first half is interview, the second half is Q&A).]
Last month in my course, we were asked the question “Why is medication considered the mainstay in the treatment of psychotic disorders?” I had difficulty with this question, not because I have little to say on that topic (the opposite would appear to be the case) but because of the assumption it seems to make in that medications should be the mainstay treatment.
My immediate and cynical response to that question was “Because they are a relatively easy treatment that rapidly deals with psychosis and ‘fixes’ the thing that makes an individual stand out from the masses. We don’t like strangeness and difference.” Our society seems to have a preoccupation with medication and using it to control everything, including psychosis. The big pharmaceuticals are okay with that because that is how they make money. Because we are unable to cure something like schizophrenia, we concentrate on keeping it under control so that the individual can have a “normal” life. But what is a “normal” life? I’ve read some research by social psychologists working cross-culturally stating that recovery rates for schizophrenia prior to the advent of antipsychotics were closer to 60%, and that they are still around that rate in developing countries without access to antipsychotics. In North America, recovery rates for schizophrenia are basically 0%. A WHO report studying schizophrenia internationally, suggests that individuals with schizophrenia have a much better outcome in developing countries where access to antipsychotic medications are less readily available. Additionally, there is some research suggesting that medications actually do some damage to the brain, making recovery impossibly.
So after doing a lot of research, I am still wrestling with the problem of “why medication?” and how it became such a mainstay of treatment. Is it merely a money grab by the big corporations? I dunno.
After visiting a number of developing countries and spending time with regular people, I’ve seen the differences in the way people interact with each other (or don’t) and help each other. I am led to wonder, then, if medications are perhaps a “band aid” solution (because I do not deny that medications work for treating symptoms) for a deeper, societal problem.
All of this to say that I am growing disillusioned with the accepted ways of dealing with mental illness in North America and horrified that we would export our ineffective methods to other countries merely because we are the experts and we want their money. The pride and arrogance of that is astounding. My challenge now, as someone pursuing counselling and interested in cross-cultural experiences is finding a way to lose that hubris associated with my profession and approach people in a meaningful way without transferring my preconceived notions to them.