Hello Sir, Could I sell you some Anxiety?

You would be hard pressed to find a psychologist in the 21st century that isn’t thankful the Freudian era is over. With the creation of the Diagnostic Statistics Manual (DSM) III in 1980 came the death of armchair theory as a ruling monarch over the field. The shift away from the era of dynamic psychiatry, built upon the theories of Freud and his disciples, to the cognitive era and the medical model had a profound impact on the fields of psychiatry and psychology. It moved the field into a far more rigorous epoch, one predicated on our understanding of scientific method.

This change in the dominant school of psychiatry has had many positive ramifications as the field entered modernity. But there have been negative consequences often unaccounted for as well. The implementation of a medical model, and this drastic change in the way we identify mental illness, inadvertently enabled the pharmaceutical industry to more effectively market and sell mental illness to the population.

The dynamic model - which predicates itself on the principles that symptoms were symbols, illness was continuous, and treatment required deep intrapsychic interrogation – was phased out of the field when it’s precepts became incompatible with the biomedical model for treatment that emerged in the late 60s and early 70s. A model principally defined by the notion that symptoms were indicators of a disease entity, illness was discrete, and treatment required well defined and developed criteria. The principles of dynamic psychiatry were unsuitable for the biomedicine model of science, and consequently psychiatry evolved, adopting the medical model for diagnosis in the DSM III in 1980. This shift in the field satisfied many of the scientific principles of the time, such as the falsifiability principle, which further assisted the field in its establishment as a hard science. The marriage with the medical model allowed psychiatry to do this because it migrated the field away from hypotheticals, postulations and unknown constructs, and toward observation and method. The days of diagnosing someone through talk therapy were over, the process for diagnosis now consisted of the identification of visible symptomology.

But the unforeseen ramifications still linger today, perhaps stronger than ever. Namely, the ability for pharmaceutical companies to more effectively market and sell diseases and cures. The medical model makes it far easier for consumers to understand a mental illness, subsequently self-diagnose, and then go on to demand pharmaceutical treatment. In the medical model a clear set of criteria are set out that define the underlying ailment. Under this model, anyone can pick up a DSM and understand the mental illnesses it describes. Such an act was not possible in the dynamic psychiatry period. It took an expert with a depth of understanding of Freudian theory to ‘pinpoint’ the causation of one’s psychopathology. Freudian theory can be justly brought into questions around validity, but the complexity of his suppositions guaranteed that only experts could ‘understand’ mental illness. Now, in modern day psychiatry, anyone willing enough to read the mundane literature on psychopathology can gain insight into mental suffering. Diagnoses have skyrocketed since the 70s. Unequivocally, one thing has become clear; big pharma has had its part to play.

As our understanding of mental afflictions morphed so did our treatment. And the recalibration of mental ailment meant a firmer grasp by the layman. Consumers, lacking expertise and a full understanding of diagnostic criteria, fell subject to the marketing ploys of the pharmaceutical industry. 

A good example of is when Roche was promoting its antidepressant Aurorix (moclobemide) as a treatment for social anxiety. Roche had their PR department publish a study that claimed that roughly a million people in Australia had undiagnosed social anxiety. Compared to other estimates published at the time the number was a gross over exaggeration. The study pointed to antidepressants as treatment, specifically theirs. By overstating the prevalence of the mental disorder Roche prompted a social anxiety epidemic, spurring thousands of people to seek pharmacological solutions.

Combine the ease at which a layman can pick up a DSM and with the advertising of the pharmaceutical industry and the result becomes self-evident. A growing population of diagnosable people with a demand for treatment. An industry with the capacity to ‘sell sickness’ is not scientific, it is capitalist, big corporate interest. And to this end, the current course of mental illness must be brought into question.  It is worth noting that no one individual may be ‘faking’ a psychopathological suffering. It may be the case that this type of marketing has brought to surface suppressed mental illness issues in the populace. That people previously unknowing about how to seek help are being moved to take action. But it should be agreed that in seeking treatment, pharmacological solutions should be relegated behind other treatments.

Naturally, this ramification does not void the progress made in the field. A lot of good has come from the progress made in psychiatry over the last half century. Many more people suffering mental afflictions have been able to find treatment, and treatment techniques have improved immensely. This fact, however, does not detract from a confronting reality. That it is likely that our current system has allowed corporate interest to exaggerate the prevalence of mental disorder, pushing people to seek a pill to solve their issues, instead of a helping hand.