Once upon a time, anxiety was anxiety. Maybe you were going for a root canal, taking a flight when you were a nervous flier, or meeting your in-laws for the first time, so you had “nerves.”
That was then. Sensing an untapped market, drugmakers who funded writers of the Diagnostic and Statistical Manual of Mental Disorders or “DSM” (the Bible for mental conditions) recast anxiety as “really depression,” and suddenly everyone was depressed. Significantly, since your anxiety was “really” depression, you needed to replace a medicine taken sporadically, as needed, with an antidepressant taken every day.
The discovery that people with real-life problems or occasional bad moods or days would willingly call themselves “depressed” made drugmakers Wall Street darlings. Stocks soared. No matter the sexual side effects from antidepressants, usually SSRIs, and their weight gain.
But there was more to come. Drugmakers then debuted the concept of “treatment-resistant depression.” If you weren’t deliriously happy on your new antidepressant, per a new mental “normal” defined by drugmakers, it wasn’t that you didn’t have depression in the first place; you had “treatment-resistant depression.”
Your first expensive drug needed to be coupled with more expensive drugs because monotherapy, one drug alone, wasn’t doing the trick. Enter the era of drug cocktails.
Then drugmakers and their DSM writers declared that depression was “progressive” and “chronic,” locking in patient customers for life and sometimes using fear marketing. Did anyone remember that before direct-to-consumer drug ads, depression was considered self-limiting, sometimes not even requiring medication? Apparently not.
The selling of depression was abetted by “patient” groups that declared anxiety and depression to be “mental illness.” Yes, mental illness! Suddenly, everyone was mentally ill. A tsunami of “behavioral” clinics, doctors who specialized in psych drugs, and even online platforms and apps urging you to love your mind (after you take your meds) ensued.
Today, a full fourth of U.S. women are on antidepressants. The full effect of such medication on the population’s collective mood and IQ is still unknown.
Today, with new drugs in the pipeline, legions of people on antidepressants are now told that they may really have “bipolar disorder,” which requires new expensive drugs. Or that they have “adult ADHD” (if they are restless or impulsive—and who isn’t?). If your child has ADHD, you also have an “ADHD family,” drugmakers now say.
Selling disease fears to sell drugs is unconscionable. But it has also convinced millions of healthy people they have and “want” a mental diagnosis. Yes, advertising works.
Martha Rosenberg is a health reporter and the author of Big Food, Big Pharma, Big Lies and Born With a Junk Food Deficiency.