Big Pharma and your healthcare

Psychology is a popular topic — and college major — for a lot of people who really haven’t got a clue what to make of humanity. People may sometimes be bothersome, but they’re interesting! Whether you’re wondering why you keep dating jerks, why your boss with an engineering degree still doesn’t seem to have any common sense, or what possessed your neighbors to willingly adopt a blind, two-legged Pomeranian whose larynx is (conveniently) the only thing that works, it’s natural to stop and ask yourself, “Why do people do what they do?”

Unfortunately, this can also be pretty futile, and the modern pop psychology infiltrating our talk shows, social media, and conversations does little to shed light on the subject. If anything, the extra task of sorting through all the unverifiable, cockamamie theories further convolutes the whole process.

So what can we do to avoid simply buying every personality test peddled to us or wondering if we qualify for that medication we’ve seen eighteen commercials for in the last hour? For one thing, we can sort through the muck. Behold some of the affronts to real progress in modern psychology:

Affront #1: The dangerous relationship between psychiatrists, the Diagnostic Statistical Manual (DSM) and Pharmaceutical Companies.

Quite frankly, the proof is in the Prozac. While Big Pharma can deny that the latest edition of the DSM seemed to bode well for over-diagnosis in psychiatric offices and therefore an uptick in pharmaceutical company profits, anyone can see evidence of the harm caused by their over-reaching, direct to consumer advertising, and constant price inflations. Just this month, Pfizer raised the prices of many of their most popular drugs. In some cases, existing customers can expect price increases up to 20 percent. If you’re wondering, Pfizer has long been under scrutiny for anyone who is truly concerned about health.

The World Health Organization actually confronted them in 2003 for launching misleading ads regarding Neurotonin. Of course, Pfizer not only continued to run the ads, but after paying off the government ($430 million), continued to make nearly $3 billion in profit through off-label marketing of that very drug (Murray, 2009).

As for the problems with the drugs themselves, I’ve written about this at length in a previous two-part article entitled: “The Business of Medicating What Ails You.” For one thing, advertising prescription drugs is a practice we’ve upheld since 1997 in the United States, with very little FDA regulation, allowing the drug companies to spend nearly $60 billion annually in marketing to physicians alone (Murray, 2009).

A study from the same year by Canadian researchers Gagnon and Lexchin revealed that drug companies spent more on marketing than research and development of their products. How much more? Try at least double the amount. Meanwhile, a 2009 report from the Journal of American Medical Association found false and misleading statistics in many medical studies evaluating antidepressants, and an increasing number of people report learning of their medication from advertising rather than from their doctor (Landers, 2001).

We have essentially come to a place in history where marketing has trumped scientific knowledge in this area, perhaps because it is still such a low priority. Many insurance companies still categorize substance abuse as a physical problem, making it difficult to coordinate mental health and substance abuse treatment (referred to as dual diagnosis). Furthermore, while it is technically legal for pharmaceutical companies to assist in funding for medical grants and education, this seems a blatant conflict of interests, increasing the possibility of a dangerous bias in research, not to mention unreliable diagnostic tools.

In 2010, a Vermont study cited by Chimonas, et al, uncovered pharmaceutical companies giving large financial gifts to psychiatry specialists at rates of nearly 70 percent of total funding. How is this legal? It’s covered under disclosure laws. They’re a little bit like campaign funding with the wiggle room for special interests, lobbying and corruption, but the catch here is that they at least “disclose” the amount. As it turns out, the love of money is perhaps the root of some disorders.

If you close your eyes, open the DSM-V, and put your finger somewhere on the page, you have a pretty good chance of finding a few familiar sounding “symptoms.” Because being human has practically become a diagnosis, the newest Diagnostic Statistical Manual included disorders such as Disruptive Mood Dysregulation Disorder (temper tantrums), Binge Eating Disorder (eating too much 12 times minimum in 3 months), and Major Depressive Disorder (now including bereavement following the loss of a loved one, formerly known as…grieving). By some of the loose definitions included, a label can be reached in no time, with a drug to match.

Affront #2: Pseudo-science, Pseudo-psychology and the Quacks that Preach It.

Despite our mockery of television doctors and unqualified authors in the “Self-Help” section, we take in more of their advice than we’d like to admit. For instance, have you ever heard someone use the term “co-dependent?” That’s outdated.

• Fun fact: If you graduate with a Chemical Dependency/Addiction Studies minor, you’ll find that most educated and qualified Chemical Dependency Professionals not only scoff at the assertion that someone is “co-dependent” or has an “addictive personality,” but consider the idea to be harmful in theory and application.]

Nobody is codependent because (nearly) everybody is codependent. Wendy Kaminer, author of Chances Are You’re Codependent Too, put the number around 96 percent of the population. If she’s right, we don’t need “Codependents Anonymous,” we need “Codependents Unanimous!” It’s not a special trait because the warning signs of codependence and the factors that are used to define and differentiate the “condition” of being codependent can apply to anyone.

It’s the same for that old phrase, “I have an addictive personality.” No, you don’t. Everyone does. Everyone has mechanisms in their brain that respond positively to pleasurable experiences and strive to avoid negative experiences. If chocolate or alcohol or cocaine increases pleasure and nothing else measures up neurologically/chemically speaking, then your chances of becoming “addicted” are equal to the next guy. You know, the one who “doesn’t” have an addictive personality.

But it’s not the terms, or even the usage, that’s important. It’s the fact that we blatantly accept a checklist of general traits or symptoms and apply them without realizing that we’re essentially reading a psychological horoscope. Often, these terms are thrown around and used by well-meaning family members and friends as an attempt to get their loved one to honestly assess their problems when those problems are fairly universal, and any serious issues ought to be addressed by a professional when that individual decides to seek help.

On that note, ill-conceived practices like familial interventions can be just as harmful as exorcisms. They’re confrontational, personalized, and they feel an awful lot like an attack (because they kind of are). NIDA, the National Intervention for Drugs and Alcohol, obviously supports interventions, yet even they warn against planning one without professional help and guidance.

Another area in which people slip up is their inherent misunderstanding of personality test results. First of all, many of the tests you find online — in spite of their length and supposed depth — are unreliable or invalid. Test reliability refers to the degree of consistent, repeated results. If the results differ significantly depending on what mood you’re in when you take the test, if you had your morning coffee, or if your hormones are out of whack that week, then the test is not reliable.

Validity refers to the construct, criteria and content of the test. In a rather silly example, the test claims to measure your personality but actually puts forth questions that determine your ability to recall information from elementary school, it is unreliable. In other words, a truly scientific psychological test ought to test the domain it claims to test, and the results should remain reasonably similar upon any repeated efforts. Even extremely popular tests like the Myer-Briggs, commonly used for some occupational fit assessments, have come under scrutiny for being invalid (perhaps measuring transient rather than stable traits) and unreliable (someone may get INTJ one day and INFP the next, depending on their mood and resulting outlook).

Tests like these aren’t harmful, but they should be used as a tool for further inquiry, or even just for a lively discussion, rather than the basis for whether or not you should apply for that job as a foreman or date a fellow ENTP.

Affront #3: Examples of psychological disorders in movies and television.

Sometimes, Hollywood gets it right. However, inaccurate portrayals based on loose understandings and definitions of many disorders are commonplace in the movies, often due to the necessity of contrived storylines and linear character development.

Take the story of real mathematical genius John Nash in A Beautiful Mind. The movie certainly portrayed his delusions and paranoia with a high degree of detail and sensitivity, despite dressing up his disorder by neglecting to clarify the nature of his hallucinations (auditory and voices rather than visual hallucinations) and skimming over the vast scope of his symptoms (infantile behavior, bizarre manner of dress, and disorganized speech). Schizophrenic is a complex disorder with subtypes that include: Paranoid, Disorganized, Catatonic, Undifferentiated and Residual.

We tend to picture the first subtype, almost as a rule, because it’s the most commonly seen in entertainment mediums. However, Catatonic states are also common, characterized by (you guessed it) motionless, catatonic behavior and blank stares. Disorganized schizophrenia, another common subtype, can be recognized by extremely bizarre speech and behavior, coupled with inappropriate or flat emotions. In movies, schizophrenia is often the “one size fits all” explanation for true insanity, and those who have the disorder are portrayed as violent and unstable.

Additionally, many films show mental illness as a sudden reaction to a traumatic event. For example, most of the “demented” villains have tragic pasts to which we can pinpoint one major event and say, “Ah ha! That’s what did it!” In reality, a parent’s murder or being witness to horrific events might be a catalyst for traumatic stress disorder, but only in films does it tend to result in a sudden psychosis in the category of mood or personality disorders.

As usual, there’s no easy, streamlined solution to the myths surrounding psychological study, but is a way to build up a defense against the harebrained ideas dragging a noble aspiration through the mud: Education.

The great thing about all the knowledge out there is that it’s readily available; the terrible thing about all the knowledge out there is that it’s readily available. It’s the sorting process that takes some time.

For the chronically depressed, pharmaceutical drugs can provide a chance to live without feeling like they’re hopping on one foot uphill with an REI backpack, but the reality of the medical industrial complex must be taken seriously. For the casual online test takers and avid self-help readers, there is wisdom to be gleamed from personality tests and the New Age section, but it should be weighed against the evidence. For enthusiastic moviegoers, major Hollywood films like Silver Linings Playbook or A Beautiful Mind can provide a starting place to talk about mental health, but not all films can even boast that.

And if reading all that digression didn’t make you just a little nutty, perhaps you’re halfway there already.