America the Pharmaceutical

Give us this day our daily meds...



Once upon a time, not so very long ago, being an American was considered the best card one could hold from fate's deal. And perhaps it's still true, which makes our national dependence on psychotropic drugs that much more perplexing. What the hell is wrong with us?

This isn't to attack those who suffer with depression or any other medical mental-health issue. My grandfather and father suffered — with an emphasis on suffered — with depression long before anyone knew what it was, how to treat it effectively, or how to engage males in something as emasculating as a discussion about feelings without a compromise of integrity. I have no doubt that their lives would have been improved and lengthened in today's mental-health-care climate. Instead, they treated what is now the most diagnosed psychiatric disorder with alcohol, the cause of the second most diagnosed psychiatric disorder. They may not have done anything differently today, but they would have had more treatment options and been able to explore them in a world that's more articulate about their problems.

The side effects, though, of Americans' expanding awareness of mental-health issues and the pharmaceutical treatments for those issues haven't all been positive. After the killers depression and alcoholism, the third most common psychiatric diagnosis is something called "social anxiety disorder." Past generations referred to its symptoms as "shyness." Quaint, huh? This, friends, is the New Coke of the mental-health industry. The business of treating legitimate mental-health issues found such wide and enthusiastic consumption that it went too far. It gave us something that we didn't need and, unlike New Coke, effectively convinced us that we are all much better off for it.

A book published last year by North-western University English professor Christopher Lane, Shyness: How Normal Behavior Became a Sickness, details the recent remaking of the psychiatric industry and its ties to pharmaceutical companies. Lane's book centers specifically on social anxiety disorder, exposing it as a construction of big pharmaceutical companies and the American Psychiatric Association. Some-thing other than scholarship, however, should tell us that it's misguided to medicate the shy. That is common sense. (The APA will soon release ground-breaking research that diagnoses this as self-assuredness disorder, defined as the delusional state some patients experience when they think they understand how the world fits together.)

The idea that we should strive to be gregarious extroverts is ridiculous. Social anxiety is a fact of life. Who hasn't felt awkward or nervous about the prospect of making conversation at your in-laws' Thanksgiving, or networking during a job search, or breaking the ice with strangers at a party? (Thus the popularity of my ancestors' drug of choice, I suppose.) My point, and it applies to physical as well as mental health issues, is that to be uncomfortable is not only normal, but a guaranteed and essential aspect of the human experience. We are playing with something that's more powerful and important than our little lives if we spend precious time, energy, and money on relieving ourselves of inconvenience.

As Americans, we often assume it's our birthright for things to come easy. Don't wait for a drug company to tell you the difference between healthy and unhealthy. Remember common sense? Use it. Nervous about the professional convention you have to attend? Take a couple of deep breaths and remember that everyone else there feels just like you — it's normal. Can't get out of bed in the morning? That's a problem, but thankfully we have a number of therapeutic options to help.

Still, we should never hesitate to question the solutions to the problems that are placed before us. Because despite the identification of the scourge known as social anxiety disorder, and the breakthrough discovery of medicinal treatments for it, I'm still waiting for party chitchat to brighten. 

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