Designer Disease : “I am Wrong”.

NPR news of 10th November 2010 cited the findings of Centre for Disease Control (CDC) survey : “1 In 10 Kids Has ADHD (Attention Deficit Hyperactivity Disorder)”. The numbers are startling to say the least. They amount to 23% increase over the numbers released in a 2003 survey and add about 1 million children into the ranks of those diagnosed with ADHD. While scientists are not clear about the underlying causes of the rise, partly they hold – greater awareness and stepped-up screening efforts – as responsible. “More parents than before are saying their children have ADHD” – reports the same survey. This agrees with earlier statement. Greater awareness means more parents reporting, and more parents reporting means greater awareness. But this is tautology. It neither explains nor suggests the way forward. Director of ADH & Behaviour Disorders, NYU, weighed in that there is “no blood test or brain-imaging exam for the condition” & cited other reports, which put the rate of ADHD prevalence at about 5%. Diagnosis is a matter therefore of expert opinion, and experts seem to differ here widely. Since “Opinion” is also informed by “Awareness”, it may explain the highly significant divergence among experts. It would be interesting to investigate what instigates this awareness. Remarkably, two-thirds of those diagnosed with ADHD are on drugs. Now Drugs are made by pharmaceutical companies, and more positive diagnoses simply imply more revenues and more profits.

 

Awareness is a function of information availability, and though the readership of printed material and newspapers may have dropped significantly, that of TV and internet has shot up. Developmental, behavioural or most other psychological disorders are what they call spectrum disorders. That means there is a wide variability in the intensity with which the behavioural responses of such people are altered from what is judged as the norm. Another difficulty is that norms are prescriptive and therefore subjective. What would be considered a perfectly normative behaviour in one culture may be treated as an unacceptable aberration in another. One has to recognize that both the yardstick and the deviations that are measured against it have a significant element of “subjective judgement”, which goes under the name of “Opinion”. Such being the case, the usual marketing and advertising tools could easily be used to shape the opinion of both the laity and the learned. This is the sense one gets when one sees the high powered advertising by pharmaceutical majors targeted unabashedly at “Consumers” and “Practitioners” alike. Is such targeted advertising shaping the outcomes of expert opinions & parental expectations? Only a sweeping study would be able to assess the exact impact of various methods (e.g. Controversial celebrity endorsements) mega corporations use to drive up revenues, but some intuitive conclusions are not beyond our reach. Incidentally, USA & New Zealand are the only two countries where advertising of prescription drugs is permitted.

 

To begin with US-FDA takes a very ambivalent attitude towards highly aggressive and targeted advertising. Its guide for consumers (see the irony, even patients – often with serious conditions – are looked upon as “consumers of drugs”) says this on the website : “Your healthcare provider is the best source of information about the right medicines for you. Prescription drug advertisements can provide useful information for consumers to work with their health care providers to make wise decisions about treatment”. Once the healthcare provider is proclaimed as the best source of information, the FDA is free to assert that advertisements can provide useful information to consumers. Isn’t this a classic case of running with the hares and hunting with the hounds. Camouflaged by the laudable objective of “informed decision” by the “consumer” lies the insidious asymmetry of information, influence, and power between the consumers and producers. A consumer-patient, already compromised by his health issues, is a soft target of advertisements that are out there to sell, not to educate. Selling “novel drugs”, not unlike selling “sophisticated investment instruments”, very subtly exaggerates the advantages while diminishing the risks – the risks are often there in small print added as an after thought. Like the cigarette adverts of the yesteryears, drug ads focus on lifestyle enhancements that evoke the feel good factor, which makes the drugs a desirable commodity. The following advert of drug Ritalin for example emphasises convenience (& desirable obscurity of the medical condition which medicating in school would likely compromise).

 

 

 

 

 

 

 

 

Among the benefits of adverts, one argument claims how they help generate acceptance, “Prescription drug advertisements lessen the stigma associated with many health conditions and thus make it easier for patients to acknowledge their potential health issues”. While this may have some substance, the flip side is they may make it fashionable – any disease is nothing to be ashamed about, but nor is it anything to be proud of. There is an interesting chart of Pros & Cons of prescription drugs advertising that is worth perusing. It says that every dollar spent on adverts fetches dollars four in profits, and among the pros lists an argument that drug companies like any other must legitimately pursue profits (even super profits). When health of most becomes the business of others (see these adverts) the interests of both groups could hardly be convergent. Often, these adverts tempt the consumer-patients by incentivising them with freebies, like in this Abilify advert.

 

 

 

 

 

Inventiveness of drug companies doesn’t end with peddling formulations for known diseases, but spreads over into characterizing new diseases like RLS. Everyone needs legs to take them around, but what happens when legs refuse to stop – Boom!, then one has Restless Legs Syndrome (wait, what’s that?). But, don’t worry, there is a cure – taaraa laaraa lee….

As if all this propaganda is not enough, a well regarded magazine Time in its 1st November issue carried an extensive article on “Kids & Mental Health”.

 

 

 

 

 

 

 

 

 

 

It had some good observations.

  • Parents worried about the most common childhood-onset disorders — phobias, generalized anxiety, OCD, depression, bipolar disorder, attention-deficit/hyperactivity disorder, autism—rarely know exactly what to look for or what to do if they spot something. Is a child obsessive or just fastidious? Depressed or ruminative? Hyperactive or high-spirited? ”.
  • American parents are scared out of their wits about autism these days — partly with cause, partly because of media hysteria and myths about the perils of vaccines”.
  • In psychiatry, if you don’t ask the questions, you’re not going to get the diagnosis. A lot of things that were labelled as conduct problems may be bipolar. But once doctors and parents began looking for bipolar disorder, they started finding it everywhereeven when it wasn’t there. In 2002 researchers reported that within a single generation, the average age of onset of the disorder had fallen from the early 30s to the late teens. Few conditions change their nature so suddenly, and many of those bipolar cases were surely misdiagnoses“.

But it also had this to say.

  • All of us, in many ways, are born insane. Our emotions are unregulated; our moods are explosive; we are consumed by irrational fears, erupt into manic happiness, dissolve into inexplicable tears. It takes years — decades really — for an internal emotional governor to come fully online, and in that time, young minds can be prey to all manner of disorders and pathologies”.
  • About one in five children in the U.S. suffers from some sort of emotional or behavioral condition, according to a new study led by the National Academy of Sciences (NAS)”.
  • Childhood is a canary-in-the-coal-mine time. If early signs of mental-health problems aren’t correctly managed, they may stay with kids for life“.

On the balance, the tone of the article generates a fear psychosis in readers, who are numbed into meekly accepting the clever sales-pitch unleahsed by the drug companies (the article was generously interspersed with drug adverts). Situation is not unlike the WMD hysteria unleashed by Bush administration prior to attacking Iraq. The power & clout of the coprorations is so huge that most doctors, scientists, & researchers either actively serve or fall in line with the “official position”; and often emerging evidence, such as the possible ill effects of vaccines, is simply brushed aside or trashed as “mythical” or “delusional”. Defeat Autism Now (DAN/ ARI) is a movement of mainstream modern medicine practitioners/ doctors, who largely were drawn into its fold when someone they loved were diagnosed with the condition. They were thus compelled to take a close look at the disorder out of personal reasons. Apart from overload of vaccinations, DAN doctors have identified heavy metal poisoning, immune system disorders, food allergies, etc. as other significant causes. The solutions they advocate do not necessarily add profits to the coffers of pharmaceutical industry, and may in fact adversely affect their bottom line. Therein lies the rub. The whole sphere of health issues is so fundamentally shaped and controlled that drugs become the first & sole choice of treatment to the complete exclusion of even considering other available options & alternative therapies.

Post second world war the US industry faced the problem of what to do with the huge production capacity that was built to service the massive war effort. Mass production required mass consumption. Consumption not only had to grow fast and reach a critical mass to keep the wheels of industry moving incessantly, but had to keep growing ceaselessly. Consumption was turned into the Creed of US citizens, and Growth, the Mantra of its military-industrial complex. That was the birth of Consumerism. But for all this to happen, the traditional values of thrift & living within one’s means had to be broken and moderation in lifestyles had to be severed permanently. That is where advancements in psychology informed and aided the fields of marketing and advertising. Clever messages are delivered to make people unhappy with what they have or the way they are. The way out of this unsatisfactory situation, these messages then suggest, is to buy this, buy that, and buy whenever one can or even can’t – the latter led to massive household debt – to match the humongous public debt – over the years (but that is another story). After 9/11, the president of USA urged citizens, not to grieve or pray or reflect or volunteer to help, but to go out and shop. Drug industry too wants people to go out and shop. That’s why it is telling people – “You are wrong”.

O O O O O O O O O O O O

Tags: , , , , ,

10 Responses to “Designer Disease : “I am Wrong”.”

  1. Donna Says:

    RLS is NOT a “new disease”, and was not invented by drug companies
    to sell drugs. It was first named by Dr Karl Ekbom in 1940, and I am quite SURE there were no drug ads in the 40’s. The US is one of very few countries that allow direct to consunmer drug advertising, but that does not mean that the diseases that they are advertising drugs for are do not exist. Know your material and read up on it. I have several online support groups that I moderate for RLS and sleep disorders, with many members coming from countries who do not have drug advertising on TV. One group is 14 yrs old with more than 1200 members from 12 countries. NOT a new disease by any stretch of the imagination.

    • satark Says:

      Thanks Donna for bringing to my notice the antiquity of RLS. Often some people experience inexplicable sensations, which are seized upon by drug companies to characterize into a “disease” with a “label” that is at once suppose to inform and explain the phenomenon. Such characterization commonly precludes non-drug approaches to resolve the discomfort experienced and exclusively focuses on drug-treatment approaches. I am currently visiting USA and the lady at one of the houses I stayed said she had sensations in the legs that were aggravated at night when sleeping & relieved by motion. Though, her condition was characterized and labelled as RLS, she consciously chose to desist from starting the recommended drug therapy and sought alternate options. In her case eating iron rich organic foods like beetroot and prunes and practising Yoga ceased her discomfort completely. Later when her daughter complained of similar symptoms, her alertness helped her to identify the excessive muscular fatigue brought on by hard training for cross country running competition as the cause. Easing training schedule coupled with soaking lower part of body in warm water & salts gave her daughter complete relief. Treating underlying causes is better than symptom targeting. Having said that, drug therapy may be unavoidable in some individuals facing such symptoms, but it will be a need based approach, not a blanket cure for the “labelling” & “Characterization”. The word “new” was really directed at the tendency of drug companies to claim such sensations under the umbrella of a “label” and then unleash an aggressive campaign to seek “consumers” for the “drugs invented” to treat them. The place where I come from, India, this “disease” is unknown or at least not widely known at the moment, but with many of the same drug companies operating there it won’t be long before we too have a surfeit of RLS patients. Even the “consumers” that we all have become are blameworthy for invariably choosing soft options of popping pills rather than make life style changes that alternate drug-free approaches entail because they are more demanding.

  2. lynn Says:

    After seeing your piece, my homepage had an ad for HSDD and a Bloom Study that can’t find anything. Why all the viagra,etc. too?

  3. lynn Says:

    PS. Remember Premarin?

  4. Lynn Says:

    Thought to send this- why do the keep making people feel so self-consious ?

    http://www.answers.com/topic/hypoactive-sexual-desire-disorder?sms_ss=email&at_xt=4ceadb5aec9db1c5,0


    This message was sent by lchadderdon@sbcglobal.net via http://addthis.com. Please note that AddThis does not verify email addresses.

    Make sharing easier with the AddThis Toolbar: http://www.addthis.com/go/toolbar-em

    • satark Says:

      I guess if people feel self-conscious, they would experience there is something wrong with them or deficient. Then they would seek help and would be prompted to consume this or that to make them feel good. Isn’t it the purpose of all advertising any way?

      Your commented : “After seeing your piece, my homepage had an ad for HSDD and a Bloom Study that can’t find anything. Why all the viagra,etc. too?”.

      What did you mean? Its strange though that you should get all those adverts.

  5. Lynn Says:

    HEY MR. P!!
    Look what gets rewarded by society- blonde something 20y! If one is not acceptable then you can’t participate. And add to that the faux disorders the drug companies create! So many problems in the world and the only urgent problem for males is needing viagra!
    The adverts are on my homepage and can’t contact them to get it off.
    May I say, India women are most beautifull!
    Ever hear of the drug Premarin? On: http://www.answers.com they have the breakdown of it- horses urine for ‘hot flashes’! Hate to tell them- think it’s normal to stop menstraration after a certain age- hate to tell them, ageing is a part of life and they do more damage by not accepting it,non?
    Thanks ever for your time!
    lynn 🙂

  6. Donna Says:

    I feel that I still must explain a few things to you, satark.
    YOU will most likely see a big rise in RLS cases in India, since several recnet studies show that it ois mostly people of “northern European decent” that have RLS. Having said that, I DO have one member from India in one of my support group that was loooking for help for his brother who has severe RLS. There are two different kinds of RLS, and several levels of severity occur. The milder cases can be controlled sometimes by a change of diet, exercise and cognitive behavior. But, to insinuate that if someone is taking drugs to help control their severe and unrelenting RLS that can occur 24/7, that is extremely insulting. Most people with RLS that I know, and that number is HIGH, start out trying to avoid meds at all costs. But, even these people usually have to try something so that they have some quality of life. RLS causes severe sleep deprivation in lots of people (5-12% of the population oin the U.S)
    and sleep deprivation can cause all kinds of deadly and life changes. We work our butts off to try and get a handle on this, and there comes a point where you have to choose meds, or you will lose your mind just trying to make it to work, or take care of your kids, or just to make it to the mailbox. Seriously, this is no joke, and sleep deprivation NEEDS to be emphasized here. It is impossible to function without sleep. Period. So, you may be right about drug companies pushing their ads on us, but that has dropped off immensely since the generics for the RLS drugs have come out. TO suggest that people with RLS who take meds for it are “soft” implies that you think we are too lazy to do anything else about it, and that is WRONG. Half, or more, of our discussions cover things we can do that do not include drugs. That is sooooo wrong, and I have a couple of thousand people who will tell you so. I have RLS since I broke my back at the age of 14. I did not ask for it, it can be inherited, and also be caused by underlying conditions (secondary RLS) If you had ever suffered from the severe from of rLS, you would know that we would do anything to make it go away. The thing that drives me absolutely nuts are the “scam ads” that are all over the internet trying to sell us a “cure” when there is, in fact NO cure, just treatments that we can try. NOt all people are helped by these drugs that were advertised heavily up until last year for about 2 yrs. Yes, drugs are a big business, but it is obvious that you do not understand how bad RLS can get. Can you imagine having to walk the floor all night, no matter how exhausted you are, not able to lay down or sit down, because your legs will not allow you to? A warm bath does help temporarily; some peopel like cold water to stop iot for a few minutes, but this is not a desirable thing to do every half hr all night long. Falling asleep in the bath tub is not a good idea either. Sleeping only 15 mins at a time every night for years will make you reach for that medicine bottle, trust me.

  7. satark Says:

    I have my full sympathies for anybody suffering from any malady. Medicines do help in many such cases, not just in RLS I suppose; so do change in lifestyles, which are often responsible for many modern day maladies like Hyper Tesion. But no one wants to give up or can’t give up eating non-vegetarian food to lower cholesterol, smoking or drinking, reduce weight if overweight, or exercise, follow meditation practices to reduce stress, etc, that have caused the condition in first place. Instead, we follow the simple expedient of popping up drugs – a habit in which we are actively and successfully encouraged by Drug companies and Health Care professionals. My focus was on the system which has brought us to this impasse and not on individual ailments and their victims.

    BTW, since you have so obviously studied RLS well, it would be interesting to know if this malady affected the North European extraction populations say in 19th or 18 the century. Perusing medical or even literary sources would be quite educative. Or is RLS a modern malady or has it achieved pandemic (you mentioned : “RLS causes severe sleep deprivation in lots of people – 5-12% of the population oin the U.S”.) proportions in last few decades? Lastly, is 5 to 12% of the entire US population or 5 to 12% of those suffering from RLS in USA? I think such historical perspective would restore lot of balance in our understanding of any issue including RLS.

    regards

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s


%d bloggers like this: