Bipolar disease and ADHD is becoming increasingly diagnosed in the United States, but isn’t an issue in the rest of the world.
Investigative journalist Philip Dowdy has some strong reasons for that, and lays the blame squarely at the drug companies, along with child psychiatrists at Harvard.
“The pharma companies and the Harvard crew worked hand-in-hand to bring America a generation of ADHD kids and bipolar children,” Mr Dowdy says, “and their profound influence can be seen in the millions of children and teens who now carry lifetime diagnoses and take gobs of psychotropic drugs each day, often to their detriment . . . The bipolar child is a purely American phenomenon, as big a metaphor of our times as credit swaps, subprime loans, and government bailouts.”
I really don’t have anything to add to that. The whole interview, which includes Mr. Dowdy’s takes on parenting, whether psychosis can be prevented, and the pressure to silence male aggressiveness, is quite fascinating.
(via Schwitzer)
Related posts:
- "The market for ADHD is almost entirely American"
- Should ADHD be re-branded as a blessing?
- Rebecca Riley’s psychiatrist under the spotlight
- Ten top medical blog posts, April 2009
- Growing up with ADHD
- When should you keep your sick child away from school?
- 6 top medical comments, May 3rd, 2009
{ 7 comments }
Dr Kevin:
I have a difficult time listening to a “journalist” discuss epidemiology of psychiatric disorders here in the US and abroad. I lost attention when he said that these children didn’t have bipolar disorder, but a personality disorder.
Maybe he should talk with a psychiatrist who can help him understand that children aren’t diagnosed with personality disorders.
When one is making enormous claims about a profession, I would think that person should get an underlying knowledge in the profession before doing so.
This guy sounded like a fraud just trying to increase his readership.
I have no disclosures to report. I have no ties to any drug companies or child psych research institutions.
The scandalous over-diagnosis of bipolar disorder, across all ages, has a specific origin.
In the 1980’s, a father sued his insurance company in Ohio. His daughter had true bipolar disorder. The insurance company applied a $25,000 lifetime limit on psychiatric care. It refused to pay for this latest hospitalization.
The father argued, it was a neurological disorder, subject to the $1 million lifetime limit on medical conditions. He provided physical evidence and expert testimony. The judge agreed, and applied the $1 million limit, making the insurance company pay for her hospitalization.
The next month, the diagnosis exploded in frequency across the country.
As someone from London with bipolar disorder, who was diagnosed as an adult, I take issue with the fact that making the diagnosis in children is an “American phenomenon.” I clearly had signs of this terrible problem when I was a child, and especially as a teenager. But instead of getting actual help, which I would have were I an American, I got labeled “delinquent” and “lazy” and all sorts of nasty things which have followed me to this day. Once I did receive a proper diagnosis, and proper help (a combination of therapy and medication), my life has finally been a lot more stable, and I don’t have to feel ashamed of my depression or manic highs anymore. Bipolar disorder isn’t something that magically appears when you turn 20, like doctors seem to think in England. It starts much, much earlier, but we’re still too caught up in our biases to even broach that question. I appreciate that at least in America, people are asking the right questions!
Great post Dr. Kevin! Sorry I don’t always take the time to leave a comment!
Although the title of this made me snicker a bit….I do have to agree with the commenter above me about “labeling” ….first of all I am sorry that you were labeled as “lazy” as a child when your parents didn’t know you were really depressed. Second of all, are the rates of Bipolar and ADHD reported as high in Uganda and Zimbabwe? Not likely because no one is their to diagnosis and “label” them. A double edged sword perhaps.
Western medicine focuses on labels while Asian and Ayurvedic medicine focuses on symptoms and bringing balance to the system. So for that reason we would naturally have less labels of depression in Chinese medicine for instance as depression my instead be diagnosed as “liver chi stagnation.”
While labels may be restricting they do in fact address the condition that likely exists in other countries at the same prevalence, yet for cultural reasons non-Americans may not be as open with their clinician.
American women are ready with their laundry list of complaints to frankly discuss with me….but after studying Japanese for five years I learned that Asian women are more hesitant and that the culture in general frowns upon talking about “personal problems” which would lead me to theorize that the prevalence of bipolar/adhd is likely the same across the board country to country (okay maybe we are a bit worse because we are on the SAD diet….Standard American Diet) but Big Pharma and their motivations aside….American physicians are likely diagnosis and recognizing symptoms at a faster rate, because doctors are more “trained” by drug reps *shudder* to recognize the symptom set, meanwhile patients have access to multi-media educational materials unavailable in other countries that likely prompts earlier intervention. Plus bipolar is advertised in a commercial every five minutes. Now everyone thinks they are bipolar and need Abilify. So they go to their doc and get diagnosed. Again a double edged sword.
As a health care person, I find the authors comments to be extremely outrageous. I think it is sad that in the year 2009 people have a problem understanding that the brain is part of the body and it too can have illnesses. Maybe these disorders are diagnosed in America more often do to better research. Better research leads to better abilities to diagnose and recognize mental illness. We must learn to stop thinking of mental illness as a short coming. ADHD and bipolar disorders are physiological. These things should be thought of just like one might think of diabetes or any other “medical” problem. We wouldn’t be having this debate if the children had diabetes or cystic fibrosis and took “gobs” of drugs each day for their ailments. Yet, it is a huge issue simply because it is a “mental” illness. I have been in the medical field for 18 years and I’ve seen many people who started out with a psychological disorder, that was not treated properly or was all together ignored, and subsequently they ended up suffering from all sorts of physical problems.
I think this journalist makes a relevant point in revealing that disease is not just a physiological diagnosis but includes a dysfunctional component which is determined in its relative relationship to societal expectations. The Snetches by Dr Seuss is a good example (http://en.wikipedia.org/wiki/The_Sneetches_and_Other_Stories)
The physical-physiological presentation of having a star or not only becomes relevant in social standing. so too has bipolar II and ADHD become disorder of social dysfunction and failure to meet arbitrary standards of behavior so that teachers, parents are not bothered by the greater needs of these children. A good deal could be discussed about neglect of caregivers leading to bipolar and ADHD. It is a very reasonable hypothesis that American culture uniquely will have greater incidence of bipolar II and ADHD, sometimes it takes someone who isn’t starting down a microscope at neurons to see where all of the pathology is coming from.
My answer:
This Makes Me Sick
When I was a child, I heard the phrase ‘war-monger’, I had to find out its definition, as I had no idea what that phrase meant.
I knew others could, and were, labeled with this phrase, as I had heard it in the past directed at others whoever said these two words.
So I felt a need to know what these words meant, and how they affected others who heard them.
Finally, I found the answer: a warmonger is one who promotes war, which is undesirable or discreditable.
In this case, one labeled this would have an affinity for what others are reasonably opposed to share the same topic, which is war:
Today, it is quite clear that others promote other things besides war.
Disease mongering is when a large pharmaceutical corporation implements various unethical if not illegal activities in order to sell more of their products by either creating or expanding a particular illness.
They do this by creating the perception that others are likely ill in some way when, in fact, they are not.
Drug companies do this by seeking more of those who should be patients in need of treatment with the drug maker’s promoted medications, regardless if they are in need of such treatment or not, clinically.
How this is done by these companies will be described soon.
The drug makers clearly place the needs for their drugs to be for medical conditions whose treatment regimens are to be viewed by others as incomplete or unmet.
The companies want to let the public know of the progressive increase for the disease states and how their products treat this illness better than what is available now or has been used in the past.
How ironic it seems that drug companies, who make drugs to delay the progression of, or cure diseases with these drugs, wish for others to become as sick as possible to profit from their suffering that they create with disease mongering and sell more pills.
This disease-mongering in fact does occur often to widen the diagnostic boundaries of an illness, disorder, or syndrome by creating awareness of such medical conditions to the public.
The drug companies do this by utilizing in several ways the delivery of fabricated if not baseless information during this process.
Usually, the pharmaceutical either creates or expands a disease state by deception directly to consumers, often.
Then the consumer, who now believes that they are ill, go see their health care provider.
The health care provider, due largely to the unfamiliarity of the patient’s symptoms expressed by the patient, if not the drug the patient is requesting, usually writes a prescription for the drug requested by the patient.
First, let’s take a look at this label of disease mongering. It is inappropriate in that, unlike diseases and illnesses, mongering occurs with medical disorders and syndromes as well.
It is accurate and factual, however, that disease mongering does happen with deliberate intent and reckless disregard for the well-being of others by drug companies.
There was a book written by Ray Moynihan and Allan Cassels called, “Selling Sickness” in 2005. The book thoroughly described how big pharmaceutical corporations are turning all of us into patients, and into a over-medicated society.
Disease mongering progressively continues to create patients with illnesses, disorders, or syndromes that in fact may not exist without any intervention to discontinue this behavior.
What the drug company implements to make sure this happens includes the following:
1. Paying medical journals to publish fabricated clinical trials involving their promoted medications after paying those involved with such a clinical trial to create such fabricated data. That is disease mongering to the health care provider.
2. Subjective screenings, such as those for various mood disorders.
These screenings, as well as the affective disorders, which were rare until about 1995, involve leading questions often- created by the drug company.
It was around this time that the United States was becoming more of a psychotropic nation with the amount of these drugs being prescribed to the citizens in large quantities.
These screenings that involve the leading questions responded by select groups of people.
They are asked these questions by certain disease state support groups who have been converted into front groups after being funded by those big pharma companies who produce drugs for particular mood disorders.
A- Disease creations I: Social Anxiety Disorder, or social phobia:
This condition is in the DSM IV which was published in 1994, and some were forced to delete the statement regarding this disorder that said, “Social Anxiety Disorder is not well-established, and requires further study.”
Aside from what may be simply amplified introversion, social phobias are likely due to societal dysfunctions and certainly should not be labeled as a pathological condition requiring pharmacological treatment.
B- Disease creations II: Premenstrual dysphoric disorder.
I call this a mid-life crisis, yet it was entered by instruction by the APA (American Psychiatric Association) into the DSM (the psychiatrist’s bible) in 1993. Anxiety about the inevitable does not require pharmacological treatment.
C- Direct to Consumer Advertising:.
Most memorable were those commercials for erectile dysfunction. Their absurdness in creating these commercials appears to have multiple psychotic components:
A healthy man who could probably run a marathon is having a decent time with his wife at some upper- middle class location.
He is smiling all the time. Because now, his marriage is secure due to his ability to copulate- which was apparently absent before this wonder drug entered his system.
Of course, it is not possible to have a happy marriage without intercourse, right?
Then there are other conditions which are entirely natural in the human lifespan, yet have been determined to be diseases by those who can profit off of these lifespan events.
Examples include osteoporosis and menopause, as well as erectile dysfunction, which was known as impotence before Pfizer coined the ‘disease’ erectile dysfunction as it prepared to launch Viagra.
It’s insane the FDA approves pharmaceuticals for these natural events that occur normally in a human being.
Finally, there are the required medical guidelines for various disease states, such as dyslipidemia.
Drug companies that make medications to treat this disease are more than happy to support the financial needs involved in creating these guidelines.
Dyslipidemia, for example:
Publications such as the Lipid Letter, and Lipid Management, both offered more aggressive management of the lipid profiles of the patients of the readers.
And both publications were funded completely by those big pharma companies that promote statins.
Same with cholesterol screenings that occur often that are implemented by those drug companies with drugs that treat the disorder of dyslipidemia.
A myth is something unproven. A false belief, or invented story.
Disease Mongering is not a myth. Large pharmaceutical corporations promote illness and disease- not desired by anyone and discredited by many, and these companies do this for profit and profit only.
Dan Abshear
Comments on this entry are closed.