Medicalisering van sociaal lijden

The medicalization of deviance is more Todd Krohn’s turf. However, this was widely reported and should probably raise any sociologist’s antennas and I fully agree with this:

“A new survey from the European College of Psychopharmacology, a meta-analysis of a gathered mass of earlier research, reports that a staggering 164.8 million Europeans – 38.2% of the population – suffer from a mental disorder in any year. As well as depression, this includes neural disorders such as dementia and Parkinson’s; childhood problems from ADHD to “conduct disorder”; and the leading anxiety disorders – everything from panic attacks to obsessive-compulsive disorder to shyness. Depression and anxiety, they tell us, are disproportionately women’s ailments. Men, it seems, become alcoholics (another illness category) rather than depressives, particularly in eastern Europe.

Such reports are worrying. They may draw attention to a rising toll of human suffering, but they pinpoint the imperialising tendency of the mental health sector. Our ills and unhappiness are squeezed into a package labelled “disorder” and an ever-proliferating assortment of supposedly objective diagnostic categories. A cure is somehow promised, though it rarely seems to come, certainly not for everyone or for ever.

In talking to the press or drafting press releases, researchers often extrapolate from their material in order to create good copy. The notion that women are somehow more prone to mental illness often emerges – as it did in the Daily Telegraph’s headline on this survey.

According to Hans-Ulrich Wittchen, one of the report’s authors, the reason women suffer nearly twice as much depression and anxiety disorders as men lies in the changing social pattern in which women take on work on top of marriage and children. So stay home, ladies, and you’ll be as happy as apple pie; though in the 50s when we stayed home to bake it, the doctors gave us Miltown and Valium to help us take pain-free care of hubby and the young ones

On the subject of women’s greater susceptibility, it’s just as well to remember that women go to doctors far more than men, for all kinds of ills: indeed the way the stats add up, women’s greater incidence of mental ills just about equals their greater number of visits to the doctors. If men went to doctors as often as they go to the pub, it’s a fair guess that their unhappiness would be represented as depression or anxiety as well.”

What this highlights is how much medical disorders are socially constructed. For instance, see this post by Todd Krohn on the new edition of the DSM. Oftentimes, new medical designations reflect the social anxieties of our time and provide new ways of disciplining deviant without the guilt; after all, treating a disorder is a humane thing to do.

These classifications also reflect power relations between various institutions such as the criminal justice system, the psychiatric establishment and the pharmaceutical industry. At the other end of the spectrum, to whom these designations get applied is also a matter of social power and socially more or less acceptable and stigmatized populations.

But to put a medical label and to create a new mental health disorder does a few things: it reduces the space of normality. It also depoliticizes and desocializes social suffering. After all, considering the level of increasing social insecurity, how can one not feel anxious, or depressed (losing one’s job or home will do that people) and hearing morons on TV repeating over and over that the lousy unemployment benefit you get is too much and that you are just a lazy bum is not exactly cheering. And it would not be surprising either to find that those who suffer the most from such social suffering are the most socially vulnerable categories, such as women.

Once a condition is defined as medical disorder, then, the solution is a medical treatment, individualized and chemical. Social policy has been pushed out of the picture. The issue involved, anxiety or depression, no longer is perceived as a rational response to social conditions and social suffering, but rather a pathology unrelated to public policy.

And there is nothing new in defining women as permanent carriers of womanly pathologies. The medical establishment has long been a major bastion of patriarchal control.