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Distorted Packaging: Marketing Depression as Illness, Drugs as Cure

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Abstract

Prominent consumer depression manuals issued in recent years circulate a standard depression script as scientific knowledge. The script, asserting that a broad spectrum of depressions are brain illnesses that require antidepressant treatment, is in fact highly contested among researchers. This paper reviews the logical problematics of these manuals, and how such discourse promotes the diagnosis and pharmaceutical treatment of behaviors ranging from mild symptoms to severe depression. In keeping with the trends of pharmaceutical advertising and State health policy, these manuals encourage consumers to self-scrutinize risky behavior, and to treat common behavioral and mood distresses with antidepressants. Ultimately, these activities of self-management function to produce a more productive citizen population.

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References

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

    Google Scholar 

  • Andrusenko, M. P., Sheshenin, V. S., & Iankovleva, O. B. (1999). Use of Tianeptine in the treatment of late-life depression. Zh-Nevrol-Psikhiatr-Im-S-S-Korsakova, 99(2), 25–30.

    Google Scholar 

  • Birmaher, B. (1998). Should we use antidepressant medications for children and adolescents with depressive disorders? Psychopharmacology Bulletin 34(1), 35–39.

    PubMed  Google Scholar 

  • Birmaher, B., Ryan, N. D., Williamson, D. E., Brent, D. A., & Kaufman, J. (1996). Childhood and adolescent depression: A review of the past ten years. Journal of the American Academy of Child and Adolescent Psychiatry, 35(12), 1575–1583.

    Article  PubMed  Google Scholar 

  • Boyce, P., & Hadzi-Pavlovic, D. (1996). Some historical aspects. In G. Parker & D. Hadzi-Pavlovic (Eds.), Melancholia, disorder of movement and mood: A phenomenological and neurobiological review (pp. 9–19). Cambridge: Cambridge University Press.

    Google Scholar 

  • Breggin, P. B, & Breggin, G. R. (1991). Toxic psychiatry: Why therapy, empathy and love must replace the drugs, electroshock and biochemical theories of the “New Psychiatry.” New York: St. Martin's Press.

    Google Scholar 

  • Breggin, P. B, & Breggin, G. R. (1994). Talking back to prozac: What doctors won't tell you about today's most controversial drug. New York: St. Martin's Press.

    Google Scholar 

  • Brody, J. (1997, February 4). Quirks, oddities may be illnesses. New York Times, pp. B9, B11.

  • Brophy, B. (2000, January 10). Kindergartners in the prozac nation. US News On-Line. Retrieved January 10, 2000 from http://www.usnews.com/usnews/issue/prozac.htm

  • Brown, L. (1992). A feminist critique of personality disorders. In L. Brown & M. Ballou (Eds.), Personality and psychopathology: Feminist reappraisals (pp. 206–208). New York: Guilford Press.

    Google Scholar 

  • Browne, A., & Finkelhorn, D. (1986). Impact of child sexual abuse: A review of the research. Psychological Bulletin, 99(1), 66–77.

    Article  PubMed  Google Scholar 

  • Chesler, P. (1972). Women and madness. New York: Avon.

    Google Scholar 

  • Cole, M. G., Elie, L. M., McCuster, J., Bellavance, F., & Mansour, A. (2000). Feasibility and effectiveness of treatments for depression in elderly medical inpatients: A systematic review. International Psychogeriatrics, 12(4), 453–461.

    Article  PubMed  Google Scholar 

  • Cruikshank, B. (1999). The will to empower: Democratic citizens and other subjects. Ithaca, NY: Cornell University Press.

    Google Scholar 

  • DeJong, H. F., Kool, S., van Aalst, G., Dekker, J., & Peen, J. (2001). Combining psychotherapy and antidepressants in the treatment of depression. Journal of Affective Disorders, 64 (2–3), 217–229.

    Article  PubMed  Google Scholar 

  • Elkin, I., Shea, M. T., Watkins, J. T., Imber, S. D., Sotsky, S. M., Collins J. F., et al. (1989). National Institute Of Mental Health Treatment Of Depression Collaborative Research Program. General effectiveness of treatments. Archives of General Psychiatry, 46(11), 971–982.

    PubMed  Google Scholar 

  • Erni, J. N. (1994). Unstable frontiers: Technomedicine and the cultural politics of “curing” AIDS. Minneapolis, MN: University of Minnesota Press.

    Google Scholar 

  • Fischer, S., & Greenberg, R. (1989). The limits of biological treatments for psychological distress: Comparisons with psychotherapy and placebo. Hillsdale, NJ: L. Erlbaum Associates.

    Google Scholar 

  • Foucault, M. (1961). Madness and civilization: A history of insanity in the age of reason. New York: Vintage.

    Google Scholar 

  • Foucault, M. (1966). Order of things: An archaeology of the human sciences. New York: Vintage.

    Google Scholar 

  • Foucault, M. (1973). The birth of the clinic. New York: Vintage.

    Google Scholar 

  • Foucault, M. (1975). Discipline and punish: The birth of the prison. New York: Vintage Press.

    Google Scholar 

  • Foucault, M. (1976). The history of sexuality: An introduction. (Vol. 1). New York: Vintage.

    Google Scholar 

  • Foucault, M. (1988). Technologies of the self. In L. Martin, H. Gutman, & P. H Hutton (Eds.), Technologies of the self: A seminar with Michel Foucault (pp. 16–49). Amherst, MA: University of Amherst Press.

    Google Scholar 

  • Gardner, P. (2000). Memory and personality disorders. Unpublished manuscript. Northeastern University.

  • Glenmullen, J. (2000). Prozac backlash: Overcoming the dangers of Prozac, Zoloft, Paxil and other antidepressants with safe, effective alternatives. New York: Touchstone.

    Google Scholar 

  • Hales, D. R., & Hales, R. E. (1995). Caring for the mind: The comprehensive guide to mental health. New York: Bantam Books.

    Google Scholar 

  • Healy, D. (1997). The anti-depressant era. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Kaufman, J., & Charney, D. (2001). Effects of early stress on brain structure and function: implications for understanding the relationship between child maltreatment and depression. Developmental Psychopathology, 13(3), 451–471.

    Article  Google Scholar 

  • King, R. A., Riddle, M. A., Chappell, P. B., Hardin, M. T., Anderson, G. M., Lombroso, P., et al. (1991). Emergence of self-destructive phenomena in children and adolescents during fluoxetine treatment. Journal of the American Academy of Childhood and Adolescent Psychiatry, 30(2):179–186.

    Google Scholar 

  • Kirk, S. A., & Kutchins, H. (1992). The selling of the DSM: The rhetoric of science in psychiatry. New York: Aldine De Gruyter.

    Google Scholar 

  • Kleinman, A. (1995). Writing at the margin: Discourse between anthropology and medicine. Berkeley, CA: University of California Press.

    Google Scholar 

  • Koverola, C., Pound, J., Heger, A., & Lytle, D. (1993). Relationship of child sexual abuse to depression. Child Abuse and Neglect, 17(3), 393–400.

    Article  PubMed  Google Scholar 

  • Kramer, P.D. (1993). Listening to Prozac: A psychiatrist explores antidepressant drugs and the remaking of the self. New York: Viking.

    Google Scholar 

  • Kutchins, H., & Kirk, S. A. (1997). Making us crazy: DSM: The psychiatric bible and the creation of mental disorders. New York: The Free Press.

    Google Scholar 

  • Long, P. W. (1998, May). Major depressive disorder [Electronic version]. Mental Health. Retrieved May 6, 1998 from http://www.mentalhealth.com/dis/p20-md01.html

  • Meiselman, K. C. (1990). Resolving the trauma of incest: Reintegration therapy with survivors. San Francisco: Jossey-Bass Publishers.

    Google Scholar 

  • Meyer, S. E, Chrousos, G. P, & Gold, P. W. (2001). Major depression and the stress system: A life span perspective. Developmental Psychopathology 13(3), 565–580.

    Article  Google Scholar 

  • Miller, T. (1993). The well-tempered self: Citizenship, culture and the postmodern subject. Baltimore: The John Hopkins University Press.

    Google Scholar 

  • Molnar, B. E., Buka, S. L., & Kessler, R. C. (2001). Child sexual abuse and subsequent psychopathology: Results from the National Comorbidity Survey. American Journal of Public Health, 91(5), 753–760.

    PubMed  Google Scholar 

  • National Alliance of the Mentally Ill. (1999), November–July 2000). Email alerts [Email messages]. Received between November 1999 and July 2000.

  • National Alliance of the Mentally Ill. (1999a). Understanding major depression: What you need to know about this medical illness [Brochure]. Arlington, VA: NAMI.

    Google Scholar 

  • National Alliance of the Mentally Ill. (1999b). Women and depression [Brochure]. Washington, DC: NAMI.

    Google Scholar 

  • National Alliance of the Mentally Ill (2000, June 15). Women and depression [Brochure]. Retrieved June 15, 2000 from www.nami.org/helpline/women.html

  • National Institute of Mental Health. (1999). Depression awareness, recognition and treatment Program (D/ART) [Program papers]. Retrieved October 10, 2000 from www.yearbooknews.com/html/DART.html

  • National Institute of Mental Health. (2000a). Depression fact sheet [Factsheet]. Retrieved October 10, 2000 from http://www.nimh.nih.gov/publicat/depresfact.cfm

  • National Institute of Mental Health. (2000b). Depression—What every woman should know [Brochure]. Retrieved October 10, 2000 from the World Wide Web: www.nimh.nih.gov/publicat/depwomenknows.cfm#ptdep1.

  • National Institute of Mental Health. (2000c). The invisible disease–Depression [Brochure]. Retrieved October 10, 2000 from www.nimh.nih.gov/publicat/invisible.cfm

  • National Mental Illness Screening Project. (1999, October 10). Retrieved October 10, 1999 from http://www.nmisp.org/depression.htm

  • Nowakowska, E., Kus, K., Chodera, A., & Rybakowski, J. (2000). Behavioural effects of fluoxetine and tianeptine: Two antidepressants with opposite action mechanisms in rats. Arzneimmittel Forschung, 50(1), 5–10.

    Google Scholar 

  • Oppenheim, J. (1991). Shattered nerves: Doctors, patients and depression in Victorian England. New York: Oxford University Press.

    Google Scholar 

  • Oppenheimer, G. (1992). Causes, cases, and cohorts. In E. Fee & D. M. Fox (Eds.), AIDS: The making of a chronic disease model (pp. 49–83). Berkeley, CA: University of California Press.

    Google Scholar 

  • Papolos, D., & Papolos, J. (1997). Overcoming depression: The definitive resource for patients and families who live with depression and manic-depression. New York: HarperPerennial.

    Google Scholar 

  • Parker, G., & Hadzi-Pavlovic, D. (Eds.). (1996). Melancholia, disorder of movement and mood: A phenomenological and neurobiological review. Cambridge: Cambridge University Press.

    Google Scholar 

  • Pasquino, P. (1991). Theatrum politicum: Geneology of capital—Police and the state of prosperity. In G. Burchell, C. Gordon, & P. Miller (Eds.), The Foucault effect: Studies in governmentality (pp. 105–118). Chicago: University of Chicago Press.

    Google Scholar 

  • Porter, R. (1987). A social history of madness: The world through the eyes of the insane. New York: Weidenfield & Nicholson.

    Google Scholar 

  • Rose, N. (1990). Governing the soul: The shaping of the private self. London: Routledge.

    Google Scholar 

  • Rothschild, A. J., & Locke, C. A. (1991). Reexposure to fluoxetine after serious suicide attempts by three patients: The role of akathisia. Journal of Clinical Psychiatry, 52(12), 491–493.

    PubMed  Google Scholar 

  • Russell, D. (1995). Women, madness and medicine. Cambridge, UK: Polity Press.

    Google Scholar 

  • Showalter, E. (1985). The female malady: Women, madness and English culture, 1830–1980. New York: Pantheon Books.

    Google Scholar 

  • Showalter, E. (1993). Hysteria, feminism and gender. In S. Gilman, H. King, R. Porter, G. S. Rousseau, & E. Showalter (Eds.), Hysteria beyond Freud (pp. 286–344). Berkeley, CA: University of California Press.

    Google Scholar 

  • Showalter, E. (1997). Hystories: Hysterical epidemics and modern media. New York: Columbia University Press.

    Google Scholar 

  • Smith-Rosenberg, C. (1985). Disorderly conduct: Visions of gender in Victorian America. New York: Albert A. Knopf.

    Google Scholar 

  • Teicher, M., Glod, H. C., & Cole, J. O. (1990). Emergence of intense suicidal preoccupation during fluoxetine treatment. American Journal of Psychiatry, 147(2), 207–210.

    PubMed  Google Scholar 

  • Thase, M. (1999). When are psychotherapy and pharmacotherapy combinations the treatment of choice for major depressive disorder? Psychiatry Quarterly, 70(4), 333–346.

    Article  Google Scholar 

  • Treichler, P. (1987). AIDS, homophobia and biomedical discourse: An epidemic of signification. October, 43, 31–70.

    Google Scholar 

  • Treichler, P. (1988). AIDS, gender and biomedical discourse: Current contests for meaning. In E. Fee & D. Fox (Eds.), AIDS: The burden of history (pp. 190–266). Berkeley, CA: University of California Press.

    Google Scholar 

  • Treichler, P. (1992a). AIDS, HIV and the cultural construction of reality. In G. Herdt & S. Linderman (Eds.), The time of AIDS: Social analysis, theory and method (pp. 65–98). Newbury Park, CA: Sage.

    Google Scholar 

  • Treichler, P. (1992b). AIDS and HIV infection in the third world: A first world chronicle. In E. Fee & D. Fox (Eds.), AIDS & the making of a chronic disease model (pp. 377–412). Berkeley, CA: University of California Press.

    Google Scholar 

  • United States Center for Disease Control. (1998). 1995 Behavioral Risk Surveillance System [Health policy document]. Retrieved February 19, 1998 from www.cdc.gov/nccdphp/brfss/about.htm.

  • United States Center for Disease Control. (1998). 1995 Youth risk behavior surveillance system [Health policy document]. Retrieved February 19, 1998 from www.cdc.gov/nccdphp/dash/yrbs/sudi.htm

  • United States Department of Health and Human Services, Public Health Service. (1996–2000). Healthy people 2000 and 2010 [Health policy document]. Retrieved February 19, 1998 from http://odphp.osophs.dhhs.gov/pubs/hp2000

  • United States Department of Health and Human Services, Public Health Service. (1996, June). Healthy people progress review: Mental health and mental disorders [Health policy document]. Retrieved February 19, 1998 from http://odphp.osophs.dhhs.gov/pubs/hp2000/progrvw/mentalprog.htm

  • Ussher, J. (1991). Women's madness: Mental illness or misogyny. Amherst, MA: University of Amherst Press.

    Google Scholar 

  • Ussher, J. (Ed.). (1997). Body talk: The material and discursive regulation of sexuality, madness and reproduction. New York: Routledge

    Google Scholar 

  • van West, D., & Maes, M. (1999). Activation of the inflammatory response system: A new look at the etiopathogenesis of major depression. Neuroendocrinology Letter, 20(1–2), 11–17.

    Google Scholar 

  • Vein, A. M., & Vorob'eva, O. V. (2000). Neurological masks of depression. Zh Nevrol Psikhiatr In-S-S-Korskava, 100 (5), 21–23.

    Google Scholar 

  • Wagstaff A. J., Ormrod, D., & Spencer, C. M. (2001). Tianeptine: A review of its use in depressive disorders. CNS drugs, 15(3), 231–259.

    PubMed  Google Scholar 

  • Wallace, E. R. (1994). Psychiatry and its nosology: A historico-philosophical overview. In J. Z. Sadler, O. Wiggins, & M. Swartz (Eds.), Philosophical perspectives on psychiatric diagnostic classification (pp. 16–86). Baltimore: John Hopkins University Press.

    Google Scholar 

  • Walsh, B. T., Siedman, S. N., Sysko, R., & Gould, M. (2002). Placebo response studies of major depression: Variable, substantial, and growing. Journal of the American Medical Association, 287, 1840–1847.

    Article  PubMed  Google Scholar 

  • White, H. (1978). Tropics of discourse. Baltimore: John's Hopkins University Press.

    Google Scholar 

  • Wirshing, W. C., Van Putten, T., Rosenberg, J., Marder, S., Ames, D., & Hicks-Gray, T. (1992). Fluoxetine, akathisia, and suicidality: Is there a causal connection? Archives of General Psychiatry, 49(7), 580–581.

    PubMed  Google Scholar 

  • Zuckoff, M. (2000, June 8). Prozac data was kept from trial, suit says. Boston Globe, p. A1.

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Gardner, P. Distorted Packaging: Marketing Depression as Illness, Drugs as Cure. Journal of Medical Humanities 24, 105–130 (2003). https://doi.org/10.1023/A:1021314017235

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