Why people who value their psychiatric diagnosis, and/or their medication, should be more Pharma-sceptical (draft #3)
When a ‘condition’ becomes a meaningful part of identity, attacks on ‘diagnosis’ are often experienced as personal. I know this partly because I have had an anxiety disorder, also depression, and see myself as having mild-to-moderate ADD.
People the whole range of diagnoses are affected, but I will just mention ‘bipolar’ and ADD / ADHD as examples, because I think the language involved supports what I have just said about identity.
‘Bipolar’ here is in scare quotes not to suggest that it doesn’t exist, but to draw attention to the many people who ‘drop the disorder’ from the name of the condition. Some of those will have tried medications and not found any helpful, while others will have reduced the dose to a low level, and perhaps would not object very much to the suggestion that they may be getting more of a placebo effect than a direct brain effect. Some who are on higher doses, within the ‘therapeutic range’, and believe it to be largely non-placebo, may still prefer ‘bipolar’ to ‘bipolar disorder’.
Many people with ADD / ADHD are in a similar position: although both acronyms contain D for disorder, that word is disguised most of the time. There is a similar range of positions with medication.
To get to my main point: why are the so-called ‘critical’ psychologists and psychiatrists so successful in getting attention for their attacks on diagnosis? There are, I believe, several reasons: one is that it reduces pressure on taxpayer-funded mental health services to provide expensive support and psychotherapy in the form of real people being paid for their work.
But another is that the diagnosis-attackers skilfully exaggerate the links between diagnosis and the pharmaceutical industry. I have challenged several of them to concede that no drug has ever been licenced for autism, learning disability, or personality disorder. The point is always avoided.
It is easy to avoid because it is so easy to switch to the real wrongdoings of the pharmaceutical industry in recent decades. There has been so much of it that the diagnosis-attackers can constantly give the impression that they are virtuously bringing new cases to light, or reminding us of old ones in danger of being forgotten.
People who value their diagnosis and/or medication have nothing to fear from pro-diagnosis Pharma-sceptics such as myself. In fact it is in their interest to promote real Pharma-scepticism, rather than the selective version used by the ‘criticals’, who tend to say very little about exactly what kind of improved regulation of the pharmaceutical industry there should be, or the precise nature of a compulsory system of financial disclosure. They also do not want a discussion about who is more or less corrupted within academic psychopharmacology, because that would lead to the less corrupted research regaining some credibility.
I suspect some of them genuinely believe they can overthrow ‘diagnosis’. Let’s try to disarm those few extremists of what is perhaps their most powerful weapon, before they cause even more damage.