July 23, 2008

Psychiatry is the pressure valve of society

In case you doubted, here is today's front page of USAToday: Economy's stuck, but business is booming at therapists' offices.

If that was the end of the story-- if people had social troubles and turned to psychiatry for help because of those troubles, it would be a good thing.  Get help where you can.

But the larger problem is that in going to psychiatry, their socioeconomic issues get demoted to "factors" and the feelings become pathologized.  Psychiatry doesn't explain, it identifies.  You're not depressed because you lost your house; you have depression, and one of the triggers is losing your house.  See the difference?

You'll say this doesn't happen all the time, maybe not even the majority of the time.  But even if it doesn't happen to a specific individual, it still happens to enough people that it bolsters  psychiatry's role as the necessary player in managing suffering of any kind.

A 20% increase in therapy visits will be interpreted by psychiatry as a 20% increase in depression and anxiety.  It will say depression has a prevalence of X, it will say it is underdiagnosed and undertreated, etc. And it will creep into the social consciousness that these are pre-existing diseases with triggers, not the consequences of external events.

Society needs that illusion, it needs that lie, because it has created unrealistic expectations in people and no way of fulfilling them.   Here's what a society looks like under the similar economic conditions, but without psychiatry:

The absence of hope

Today's popular frustrations over flat-lining living standards have been building for years. The recent boom, felt only by the already well-off, has done little to change that discontent. Labor unrest has been growing for months; violent protests erupted... corporate taxes will be raised and gasoline subsidies cut... The move was designed to take the steam out of boiling anti-government sentiment.

The above article, also from USAToday, has a slightly different title: Egypt's economy soars; so does misery.