Has a Disease for Your Problems Been Marketed Yet?
Mental and physical illness is a real and increasing problem in today’s society. But there is also another problem: an escalating trend to highlight a rare disease, proclaim that it affects large numbers of the population, and then prescribe medication to treat it.
Call it disease-mongering.
In the last few decades, advertising has made the public aware of such afflictions as social anxiety disorder, panic disorder, attention deficit hyperactivity disorder, conduct disorder, oppositional defiant disorder, premenstrual dysphoric disorder, menopausal disorder, erectile dysfunction and obesity disorder. Other ailments that have been found in recent years include irritable bowel disorder, restless legs disorder and hypertension. Researchers have now even identified as a disorder “pre-hypertension,” the condition of being in danger of developing hypertension (New England Journal of Medicine, April 20).
Many people now readily accept these conditions, originally unheard of or thought of as extremely rare, as being mainstream.
Disease-mongering is a successful money-making strategy and is “being increasingly refined by the pharmaceutical industry and its colleagues in the advertising industry,” says Peter Lurie, deputy director of Public Citizen’s Health Research Group (United Press International, April 10). Drug advertisements constantly bombard people with, “One in five have this illness …” or, “If someone you know or love is suffering from these symptoms …” (followed, of course, by a pitch for the miracle cure). Advertisers propose solutions to conditions you may not have even realized were problems!
According to Ray Moynihan, author of the book Selling Sickness, a classic example of disease-mongering is how pharmaceutical company GlaxoSmithKline turned the formerly little-known “social anxiety disorder” into a huge market for its anti-depressant drug Paxil. He credits Paxil’s marketing slogan, “Imagine being allergic to people,” for expanding the drug’s sales. The Paxil website actually claims that “more than 12 million Americans suffer from this disorder in any given year” and consoles prospective clients by telling them that “some people find comfort just by learning that social anxiety disorder is a medical condition.”
In the case of bipolar disorder, a looser definition has resulted in some experts claiming that up to 10 percent of the population is affected—as opposed to the past estimation of 0.1 percent. U.S. children as young as 2 years old are being started on two or three treatment medicines, even though the classic definition of the illness says that symptoms “don’t usually show up until the teens”—not to mention that, according to Dr. Jon McClellen at the University of Washington in Seattle, “there isn’t even any evidence that any of them work in children” (Business Week, May 8).
In this diagnosis-happy climate, every complaint or tendency one might possibly have becomes a symptom of a disease.
Some physicians and health-care professionals are now speaking out against this mass-marketing of ailments. However, in terms of public awareness, their criticisms are drowned out by the infomercials equating mild or loosely related problems to symptoms associated with rare and serious disorders.
One Example: IED
A blatant example of disease-mongering has recently been publicized across America. Some medical specialists say Americans are commonly afflicted by an ailment called Intermittent Explosive Disorder (ied). They declare that it “is not the rare occurrence that psychiatrists had previously thought” (Chicago Tribune, June 6). Dr. Emil Coccaro, the University of Chicago’s chief of psychiatry, says, “Our new study suggests ied is really out there and that a lot of people have it.”
Those who agree with Dr. Coccaro claim that a recent nationwide study shows 1 in 20 (or 16 million) Americans have symptoms of ied, characterized by recurring outbursts of extreme anger and violence as seen in cases involving road-rage or spousal abuse. Their study asserts that approximately 5 percent of Americans have “physically assaulted someone, threatened bodily harm or destroyed property in a rage an average of five times a year” (ibid.). The average monetary damage resulting from these super tantrums, the study purports, averaged $1,359 per person, or about $21.7 billion nationwide—annually!
Interestingly, the ied study also showed that while diagnoses are rising among teenagers, they are much more rare among people in their 40s, and even more so among individuals over 60. “[O]lder people tell us they’ve never had it,” said Ronald Kessler, a professor of health-care policy at Harvard. It is young adults, teens and children who most often exhibit the “symptoms” of outbursts of verbal and physical violence.
Most individuals diagnosed with Intermittent Explosive Disorder report that anger episodes first occurred during childhood or adolescence, and increased rapidly in their teenage years. “In most situations, he is relatively affable, calm and very responsible,” says Jennifer Hartstein, a psychologist at Montefiore Medical Center in New York, of a newly diagnosed 16-year-old. But when in stressful situations at home, he “explodes and tears apart his room, throws things at other people”—to the point that his parents have called the police (Connecticut Post Online, June 6).
A generation ago, people would have considered this a case of a rebellious teenager throwing a temper tantrum after being punished for disobeying his parents. Today, the medical establishment labels it a “disorder” and believes it has found a biomedical fix.
Dr. Daniel Deutschmann, a psychiatrist and clinical professor at Case Western Reserve University, says he has found medicating aggressive ied patients with anti-epileptic drugs to be successful (Plain Dealer, Cleveland, June 6). Meanwhile, Coccaro believes medicines such as selective serotonin reuptake inhibitors (ssris) and mood stabilizers should be included in treatment to “increase the threshold at which people will explode” (Ascribe Newswire, May 31).
Such treatments are recommended despite study results showing that among people classified as having this disorder, 81.8 percent were also diagnosed with depression, anxiety, and alcohol or drug abuse disorders—“disorders” that are strongly or entirely related to lifestyle choices.
Treating the ied symptoms with medication will not treat the sources of these disorders; in fact, it will probably impede the lifestyle changes that would truly improve health and well-being. By classifying temper tantrums and other supposed conditions as diseases, medical specialists are telling an affected individual that without medication, nothing can change: he or she is fated to have impulse control disorders and health problems indefinitely. What a discouraging and hopeless message!
And where does that leave people who, as in the case of ied, cannot afford the ssris, mood stabilizers or other medicines that are supposedly needed?
Denying Responsibility
Overall, this characterization of emotional outbursts and lack of self-control as symptoms of pharmaceutically treatable disease represents another major shift in thinking regarding what defines behavioral and lifestyle choices, and what defines biomedical proclivities. It also revolutionizes our ideas on what our responsibilities are to society.
Instead of teaching and training our children to control their emotions and impulses, and spending time making sure our children become stable, productive members of society, drug companies have found that people will pay for the seemingly easy, responsibility-free solution: medicating our kids. Moreover, adults are readily embracing that remedy for themselves as well.
In our society, it is acceptable to have a “disorder.” The prevailing attitude is, no one can be blamed for being sick. After all, biological problems can’t be helped.
Or can they? In reality, although much illness is caused by factors outside our control, it is our own choices that generally affect our health the most. The human body and mind was not designed by our Creator to be sick or uncontrolled.
As society searches for biomedical solutions for all its problems, it increasingly sends the message that it is all right to have symptoms of disorders—even violent impulse control problems—with the catchall excuse, “It’s because I am sick.”
That is the crux of the problem with disease-mongering: It promotes the idea that everybody has a biomedical excuse for the consequences of poor health and lifestyle choices. It absolves people of guilt for their actions and of responsibility to change the underlying cause of their problems by just taking a pill. Consequently, bad behavior gains legitimacy.
What other impulses that we do not feel like controlling will become diseases? What about crime? After all, crime has long been called an epidemic! Now, because of disorders like ied, criminal expression is actually being classified as a disease.
Americans love their quick-fix, labor-free culture—which is why they embrace pharmaceuticals. But people aren’t looking at the causes of problems—their family relationships, work habits, mental outlook, diet and so on. Changing is hard. It’s inconvenient. It is much easier to believe a pill will make everything better.
Let’s face it: New drugs are not a solution, but a mask. They will not mend the shattered lives of young children whose parents fight or separate, fill the void of a missing father or mother, teach parents how to properly rear their children, teach people the value of healthful living, or end man’s hatred toward his neighbor. Drugs will never remove the cause that has brought about the effect of physical or mental disease.
The question we should be asking is: What is causing our ills? Then the challenge is to really accept the hard answer that we are not living our lives the way God designed us to, and set our minds to fix that. That can truly give suffering individuals and their families hope.
For more reading related to this topic, request a free copy of our two booklets What Science Can’t Discover About the Human Mind, and Human Nature: What Is It?