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Is This What We Want?

© John McManamy

"Gone are the profession's proud boasts that depression and schizophrenia and manic depression could be rooted out and destroyed ... "

Following is an expanded version of an article that first appeared in my depression and bipolar weekly:

"In my view," says the writer, "psychiatry has been almost completely bought out by the drug companies. The APA could not continue without the pharmaceutical company support of meetings, symposia, workshops, journal advertising, grand rounds luncheons, unrestricted educational grants etc etc. Psychiatrists have become the minions of drug company promotions."

Strong stuff, but what makes the accusation so singular is that it comes from within the ranks of the psychiatric profession, itself. In December 1998, Dr Loren Mosher, a prominent psychiatrist, sent his letter of resignation to the American Psychiatric Association.

"These psychopharmacological limitations on our abilities to be complete physicians also limit our intellectual horizons," he writes. "No longer do we seek to understand whole persons in their social contexts; rather we are there to realign our patients' neurotransmitters. The problem is that it is very difficult to have a relationship with a neurotransmitter whatever its configuration."

He goes on to say: "Anyone with the least bit of common sense attending the annual meeting would observe how the drug company exhibits and industry sponsored symposia draw crowds with their various enticements while the serious scientific sessions are barely attended. Psychiatric training reflects their influence as well; ie the most important part of a resident curriculum is the art and quasi-science of dealing drugs, ie prescription writing."

And, of course, we have managed care coming from the other direction, virtually boxing the profession in.

Is this all we want from our mind doctors? To perform as learned and disinterested dispensers of pills? Perhaps we do. Gone are the profession's proud boasts of old that depression and schizophrenia and manic depression could be rooted out and destroyed through the simple and expedient process of talking with the meter running. Bad potty training may not have been the answer, after all. Instead, the neurotransmitters serotonin, dopamine, and norepinephrine offer the discredited children of Freud a new lease on life.

And there are enough of us desperate people to line up outside their doors. Without these drugs, after all, I might have wound up as one of those crazy uncles the family never talks about.

Then there is the small matter of the public, all those so-called normal people out there. Gradually, they are buying into the idea that the root of our respective conditions is physically-based and easily treated by drugs. It's as if we have diabetes of the brain, which is different than being crazy, which is what we want them to think, thus ensuring our rehabilitation back into

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