DEPRESSION AND ANXIETYmakes her nervous, her heart races (biological); she forgets what she
was saying, and she leaves the scene feeling that she made a fool of
herself, vowing to avoid such situations ever again (behavioural). And,
of course, complementing this triangle of factors are the combined
influences of a person’s upbringing, social situation and genetic
inheritance.
mental-health diagnoses that they can claim to have treatments for.
These suspicions have been kindled by the number of disorders listed
by psychiatry’s diagnostic bible – the Diagnostic and Statistical Manual
of Mental Disorders – which has spiralled with each successive edition
(182 in the second edition published in 1968, 297 in the fourth edition
published in 1997).
Drugs companies have also been known to re-brand old drugs
as a treatment for a different mental disorder from the one they
were originally intended for, thus opening their products up to new
markets. Famous antidepressants like Prozac and Paxil have since been
marketed as effective treatments for social anxiety. “You’re not shy,
you’re sick!” was the catchphrase of one associated marketing drive.
Work is currently underway on the fifth edition of the Diagnostic
and Statistical Manual, and there have already been noisy claims that
board members have conflicts of interest by virtue of their ties with
the pharmaceutical industry. Drug companies and critics alike will be
watching keenly to see if new diagnostic categories such as “hyper-
sexuality” and “binge-eating disorder” make the final cut.
A related area of controversy concerns whether mental illnesses
should be seen as akin to “real” physical illnesses. It’s not just drug
companies that have championed the idea that mental illnesses have
physical causes. Charities like the National Alliance for The Mentally
Ill have campaigned for mental illnesses to be seen as brain diseases,
because they feel that this will help reduce stigma and get people
the treatment they need. In fact, there’s evidence suggesting that the
“medical model” approach increases stigma by encouraging the belief
that a patient is stuck with their problems for good.