Dorothy Rowe

Saga Magazine January 2007

New Illnesses for Sale

Have you bought a new illness lately? We're being told about them all the time, and what we have to do to keep well. I'm taking fish oil, though I'm not too clear whether it's to keep my heart healthy, my memory functioning, or my lungs working. It's nice to think that one small capsule is doing me so much good. However, the fact that a number of people like me ingests some substance regularly and go on to have healthy hearts, brains and lungs doesn't mean that this substance caused them to be healthy. We're complex organisms living in complex environments, and so it could be something else that brought about a beneficial result.

In good scientific research there is always a control group made up of people who don't take the drug being tested, but instead some inert substance known as a placebo. If the experimental group do significantly better than the control group we can be reasonably confident that the substance taken does have a beneficial effect. However, some of the people in the control group will show benefit from the placebo they've taken. These people believed that what they were taking would do them good, and it did.

The placebo effect shows that what is important is not what happens to us but how we interpret what happens to us. People who want to sell us something will work very hard to get us to change how we interpret that thing. Over recent years various health campaigns have tried to persuade us that that some aspect of our behaviour isn't just something that we do, a habit, but is, in fact, an illness. We've always known that some of our habits aren't good for us. We know that tucking into cream cakes or relaxing over a second gin and tonic could lead to some physical discomfort in the future, but life is always a matter of balancing immediate pleasure against future pain. However, over recent years, the medical profession has managed to turn every aspect of our lives into a medical or psychiatric problem. Fat people used to be just fat people, but now they're evidence that an epidemic of obesity is sweeping the country. A young woman cannot emerge from being held hostage on her own for eight years and show herself to be courageous and intelligent. The experts on these matters know that at some point in her captivity she was struck down by the dreaded Stockholm Syndrome.

We allow ourselves to be persuaded that we have some new medical or psychiatric illness, syndrome or disorder because thinking about ourselves in this way allows us to avoid taking responsibility for ourselves. If your scales tell you that for your weight you need to be five inches taller, instead of saying to yourself, 'I'd better cut down the amount I eat,' you can say, 'It's my metabolism. My body just doesn't burn up the calories as it should.' If you find that you're getting increasingly afraid of attending social functions, instead of saying to yourself, 'I must face up to this and do the commonsense things necessary to get over this,' you can tell family and friends, 'I can't go to social functions. I have Social Phobia Disorder.'

Thus you play into the hands of those people who gain enormously from the medicalisation of our lives. Doctors are now experts on an immense range of new diseases. Psychiatrists create mental disorders out of the usual trials and tribulations of life. All these disorders are listed in the Diagnostic and Statistical Manual (DSM). You're in it. Mourn the death of a loved one, and you have Bereavement Disorder. Worry about your exams, and you have Academic Disorder. In the list of Personality Disorders you'll find everyone you know, including yourself, probably under 'Personality Disorder Not Yet Specified'.

The emergence of every new disease or disorder brings joy to the heart of the pharmaceutical industry because they can now create a new drug for each new disease, or simply re-brand an old drug and say it cures this new disease. Thus that tired, irritable, bloated feeling before a period starts has become Premenstrual Dysphoric Disorder (PDD). The pharmaceutical company Eli-Lilly offers a cure, a drug called Sarafem, which is simply the widely used anti-depressant drug Prozac. Eli-Lilly and the manufacturers of the other selective serotonin reuptake inhibitor drugs (SSRIs ) have been forced to admit that these drugs have some unpleasant and sometimes dangerous side-effects. You mustn't assume that your doctor will be sure to give you this kind of information.

In the creation and medication of new diseases the alliance of the medical profession and the pharmaceutical industry has been joined by public relations companies, government departments, the media and patient advocate groups, though not the groups of patients and the relatives of patients who have been harmed by the treatment they have received. This is big business, and, as we all know, big business is not always at its most scrupulously moral. Its critics call what this alliance does 'disease mongering', defined as, 'the selling of sickness that widens the boundaries of illness and grows the markets for those who sell and deliver treatments.' Of course there are many doctors who know that some of the drugs available won't actually help their patients and may in fact injure them. These doctors know that not prescribing a drug is often the best treatment for particular patients. However, not prescribing can be very difficult to do. Some of my psychiatrist colleagues have told me how they have been reprimanded or, in one case, sacked, because they wouldn't prescribe drugs which they knew would harm their patients. Often it's the patients who demand their prescription. They're seen television programmes and reports in the media about some wonderful new drug tailor-made for their disease. They believe the 'experts' in the media rather than their doctor who might, perhaps, know them quite well.

Even when we have a physical illness whose existence can be demonstrated by physical tests we have to continue to take responsibility for ourselves by making sure we understand the nature of the disease and the treatment programme we have been advised to follow. If no organic basis for our symptoms can be found and we are told we are suffering from 'stress', or if we have been told that the particular misery we are suffering is a mental disorder, we shouldn't pass responsibility for ourselves over to the experts. Something is amiss in the way we are living our life, and we have to be prepared to change. Fish oil might not be the answer.