In his book, Anatomy of an Epidemic (hurricane reading....), Robert Whitaker (the author mentioned in the NYRB article on the epidemic of mental illness Joanna linked to) documents the rise of the notion that mental disorders such as anxiety, depression, mania, schizophrenia, etc. are "chemical imbalances in the brain" - an idea that has been thoroughly debunked. He also shows us how Big Pharma co-opted the AMA which had once been a sort of watch dog for the pharmaceutical industry but then became big pharma's lap dog in the 1940s and 50s. This is a great history in so far as most people think this relationship was only sinister very recently. Not so, says Whitaker.
Thorazine and miltown launched the "psychopharmacology revolution", creating drugs that said to be "like insulin for diabetics" and "potent regulator(s) of unbalanced cerebral metabolism" from one of several fascinating Time articles of the era. With the co-optation of doctors by big pharma, by 1967, Whitaker writes, "one in three American adults filled a prescription for a "psychoactive" medication, with total sales of such drugs reaching $692 million."
I'm looking forward to further development of his thesis in which he points out something that runs contrary to a claim Carrol has made. He spends time doing ethnographic work with members of a bipolar support group, doing case studies on them. Half of these folks feel they were helped by the drugs, the other half feel they were not and have gotten off them. The people on drugs are all on disability, unable to work. The people who got off the drugs are living ordinary lives and aren't on disability. (I think this is an important thing people have overlooked: getting a mental disability diagnosis is a way to supplement family income.... I learned about this from a guy at work and wonder how much of this is being fueled by that...)
Anyway, Carrol says that, while incorrect, the chemical imbalance theory of mental health has the virtue of destigmatizing mental illness. But this isn't a uniform opinion among those who have been diagnosed with mental illnesses/spectrum disorders. A strand of people he talks with, including supporters and members of the Depressive and Manic Depressives Association, argue that the chemical imbalance approach is also stigmatizing. The chemical imbalance theory just changes the nature of the stigma. In this case, they label themselves as disabled in one or several ways: unable to get along with co-workers, unable to work, incapable of normal relationships, etc. In other words, they are stigmatized as people who cannot live normal lives and/or as people who can't help misbehaving with co-workers, neighbors, friends, family, etc. I'm born this way or the drugs make me this way; I can't help it. For others, it's a self image and belief that they are incapable of being productive members of their household and/or unable to hold down a job. *
The people he interviewed say that they now have to fight this stigma - their own debilitating self understandings according to some. In other words, in the words of David Rudy - they learn how to *become* mentally ill -- which means that, regardless as to the origin of their condition (biological, genetic, whatever), mental illness is socially constituted and people come to see themselves certain ways once they are labeled mentally ill. In this case, critiqes of the medical model are saying that there are drawbacks to this approach as well. Though foucault isn't mentioned, the point is: there's no progress here.
To those who see the medical/chemistry model of mental illness as a problem, the answer was to get off the drugs and stop seeing themselves as people who needed to be treated with drugs to handle their problems. Instead, the learned to cope in other ways, including a guy diagnosed as schizophrenic who is no longer on meds for it.
The one thing that is annoying me so far, though, is that Whitaker seems to be using the "productive member of society" trope to subtly persuade. In other words, he's saying that rise in the number of people collecting SSI/SSDI payments is alarming because there are so many unproductive members of society who aren't holding down jobs. I mean, I happen to think that people need to be productive members of society - something they do that contributes to the betterment of their and others' lives. But he's using it in a way to sort of say, at least so far, "See, there are all these people sitting around on the dole when they could be holding down regular jobs." One woman, from an elite background, even calls her monthly check from SSDI being "on welfare."
-- http://cleandraws.com Wear Clean Draws ('coz there's 5 million ways to kill a CEO)