READINGS

Lifetime Prevalence of DSM-III-R Psychiatric Disorders Among Urban and Rural Mexican Americans in California
(William A. Vega et al., Archives of General Psychiatry, vol. 55, 1999)

As discussed in Adbusters #36, this study shows the negative impact that the American way of life can have on one's psychological well being. Examining the prevalence of psychological disorders in Mexican-Americans, Vega and colleagues found that the longer Mexican immigrants lived in the US, the greater their likelihood of experiencing psychological problems. After 13 years, whatever cultural protection a Mexican heritage could offer had worn off, with Mexican immigrants approaching the same incidence of depression, anxiety, and drug problems as those in the US population generally. In some cases the effect was quite dramatic. The lifetime prevalence of any disorder was 18 percent for Mexican immigrants with less than 13 years in the US, 32 percent for those with more than 13 years, and 49 percent for Mexican-Americans born in the US. Also, Mexican men born in the US were five times as likely to experience a "major depressive episode" as were Mexican men who had recently immigrated. Similarly, for women, drug misuse was seven times greater for those Mexican women born in the US.

(abstract)

The Changing Rate of Major Depression
(The Cross-National Collaborative Group, JAMA, vol. 268, 1992)

Also summarized in Adbusters #36, this is the most intensive study of the changing rates of depression ever conducted, looking at 39,000 people across nine epidemiological surveys. Myrna Weissman and the Cross-National Collaborative Group found that depression is being experienced more often in the US and elsewhere; depression is being experienced at younger ages; episodes are becoming more severe; and episodes are more frequent throughout individuals' lifetimes. The rate of depression has doubled in the US since WWII, with each generation showing greater rates of the depression than the last. Before 1905, about one percent of Americans experienced depression by age 75. By 1950, six percent experienced depression by age 24.

Psychiatry's Global Challenge
(Arthur Kleinman & Alex Cohen, Scientific American, March, 1997)

This article in Scientific American reviews recent findings by the World Heath Organization (WHO), noting that "An evolving crisis in the developing world signals the need for a better understanding of the links between culture and mental disorders." Kleinman and Cohen are professors in the Department of Social Medicine at Harvard Medical School, a program that studies the impact of "modernization" on mental health http://www.hms.harvard.edu. The article describes how, in the wake of globalization, the human ecological conditions that cultivate strong mental health are being destroyed. The WHO estimates that depression will become one of the most common disabling disorders in the world by 2020, second only to heart disease. Kleinman and Cohen conclude: "Behind this rise in the prevalence of mental illness [in countries such as India and China] is an array of demographic and social factors. Rapid urbanization, chaotic modernization and economic restructuring have left many developing countries reeling."

Cross-National Epidemiology of Major Depression and Bipolar Disorder
(Myrna M. Weissman et al., JAMA, vol. 276, 1996)

The link between culture and mental health is made clear in this study, which reports on the rates of depression and manic-depression in ten countries. The lifetime rates of depression were found to vary by more 1,200 percent, from 1.5 percent in Taiwan to 19 percent in Beirut, Lebanon. This finding suggests that the highest rates of depression are often linked with cultural instability, which Beirut has experienced sporadically for several decades.

(absract)

The Roots of Addiction in Free Market Society
(Bruce K. Alexander, Canadian Centre for Policy Alternatives, April, 2001)

This policy paper is based on an earlier essay entitled "The Globalization of Addiction" (Addiction Research, 2000). In it, Alexander argues that addiction is chief among the mental health problems that result from the rapid expansion of free-market values. For Alexander, addiction does not only refer to drug compulsions. The cultural dislocation produced by the rise of corporate culture–and the decline of community-based culture–results in addictions to money, image, sex, and other pursuits of happiness. Alexander summarizes, "This paper argues that dislocation is the necessary precursor of addiction, and uses examples from Canadian and Scottish history to show that free markets inevitably produce widespread dislocation among the poor and the rich. As free market globalization speeds up, so does the spread of dislocation and addiction."

(To read a pdf version of the study go to: http://www.policyalternatives.ca.)

The Evolution of Despair
(Robert Wright, Time, August 28, 1995)

This well-crafted essay by best-selling writer Robert Wright explores the idea that there is a mismatch between what people need (as social animals) and what they are receiving (from contemporary society). Rising levels of malaise, angst, and despair are the result. Wright's main argument is that the evolution of culture in modern times has created a human ecological space that differs radically from the one in which humans evolved. When this difference becomes too great, as it has in advanced society today, psychological dysfunction and despair increase. Questioning our technological society, Wright notes that "the problem is that too little of our 'social' contact is social in the natural, intimate sense of the word."

(read a text version of the study)

Related Articles

Malignant Sadness
(Kalle Lasn & Bruce Grierson, Adbusters #30, June/July 2000)

A precursor to "Toxic Culture USA," this article explores the question of why psychological distress is on the rise. "A very postmodern mood disorder has settled over the most prosperous nation there ever was. On the crest of the boom, there is sadness. In a time of peace, there is anxiety. Amidst unprecedented stimulation, there is boredom. Just what's going on?"

Melancholy Nation
(Joannie M. Schrof & Stacey Schultz, US News and World Report, March 8, 1999)

This article provides an example of how the popular press responds to the idea that depression is on the rise–by advocating that people take more, or stronger, drugs. In the discussion of "treatment-resistant depression," the article states: "All but lost in the clamor are some dispiriting facts: Prozac has not turned out to be a magic bullet against depression, and the problem is now worse than ever. In fact, many who study depression say that we are entering an ‘Age of Melancholy,’ where people are getting depressed at younger and younger ages, with episodes that are severe and frequent."

(read the article)

Surgeon General Report Is Laudable but Misleading
(Richard DeGrandpre, Los Angeles Times, December 30, 1999)

This op-ed essay, originally published in the LA Times, discusses the 1999 Surgeon General report on mental health in America. The essay criticizes the report for ignoring the social and cultural causes of our declining mental health.

(read)

Beyond the Pharmaceutical Fix

Beyond Serotonin
(Hara Estroff Marano, Psychology Today, March/April, 1999)

An editor at Psychology Today, Hara Estroff Marano looks at the myth that depression is nothing but a chemical imbalance in the brain.

(read)

Prozac.org
(Ken Silverstein, Mother Jones, November/December, 1999)

This is one of several excellent articles on the pharmaceutical industry by journalist Ken Silverstein. Here he shows how "an influential mental health nonprofit [NAMI] finds its 'grassroots' watered by pharmaceutical millions." Donors from 1996 to 1999 include Eli Lilly ($2.87 million), Pfizer ($1.3 million), Abbott Laboratories ($1.24 million), Wyeth-Ayerst Pharmaceuticals ($658,000), and Bristol-Myers Squibb ($613,505).

(To read the article go to: http://www.motherjones.com.)

Shopping Can Make You Depressed
(Ben Summerskill, The Guardian, Sunday May 6, 2001)

The lead-in to this article sums it up: "For a generation, 'retail therapy' has offered the salvation from the stresses of modern living. But a major new study now suggests that for millions of people, binge shopping is no longer an emotional cure-all. If anything, it may make you feel worse."

(To read the article go to: http://www.guardian.co.uk.)

Selling the Cure for Shopaholism
(Chris Berdik, Mother Jones, May 23, 2000)

If shopping makes you sick, the pharmaceutical industry has just the solution. As reported here, shopaholism is now claimed to be a legitimate medial disorder in need of pharmacological management. Note that the Stanford study that "proved" this was funded by a pharmaceutical company.

(To read the article go to: http://www.motherjones.com.)

Selling Happiness
(David D. Kirkpatrick, New York, May 15, 2000)

This is an excellent article on the influence of drug companies on the prescribing habits of doctors. The article focuses on the antidepressant drug Celexa: "Before a drug like Celexa can ease the minds of patients, marketers must capture the minds of doctors–using free gifts, dinners, propaganda, and research funds."

(To read the article go to: http://www.newyorkmag.com.)

Classic studies from the Archives of General Psychiatry
(The Archives of General Psychiatry can be found in most university libraries)

Life Events and Depression
(Eugene S. Paykel et al., Archives of General Psychiatry, vol. 21, 1969)

While the onset of depression often appears to occur "out of the blue," this 1969 study showed a clear relationship between "life events and depression." The study concludes: "On the average, depressed patients reported nearly three times as many important life events in the six months prior to the onset of the depressive episode as were reported by controls in a comparable six-month period." Such studies are rare today, with the prevailing assumption being that depression is a biological disorders that results from a chemical imbalance of the brain. In fact, as the following study shows, there is a clear link between everyday experience and brain biochemistry.

Caudate Glucose Metabolic Rate Changes with Both Drug and Behavior Therapy for Obsessive-Compulsive Disorder
(Lewis Baxter et al., Archives of General Psychiatry, vol. 49, 1992)

The title of this 1992 study is a mouthful, but the implications are clear. The study treated obsessive-compulsive individuals using either drug therapy (Prozac) or psychotherapy (behavior therapy), and found that both treatments were similarly effective. More important, the researchers found that both treatments had comparable effects on the brain, as measured by PET scans. This clearly suggests that psychosocial interventions can impact on the very same neurobiological processes as do pharmacological ones. The implication: just because a drug is effective in making you feel better, this does not mean the problem could not also have been improved with a non-drug treatment. It also does not mean the problem is a biological one. This study might also help explain why drugs like Prozac often quit working after some time (called the "Prozac poop-out" effect). Because the drug does nothing to change the "toxic culture" around you, perhaps it's no surprise that the drug effect eventually collapses.

Nonblind Placebo Trail
(L. Park & L. Covi, Archives of General Psychiatry, vol. 12, 1965)

Just as it is difficult to identify the factors in the mental environment that impact mental health, it is also difficult to know, when taking a psychiatric drug, whether the drug is effective. This study is perhaps the most compelling study of placebo effects ever conducted. Although a journal article, it is brief and highly readable, especially the first-person accounts provided. The specifics: after being told they were being prescribed a "sugar pill"–and that sugar pills have been found to be effective despite their lack of pharmacological ingredients–14 of the 15 individuals in the study completed it, and all 14 reported relief from their psychological symptoms. The average initial "distress score" was reduced 43 percent by the sugar pills, from "quite a bit" of distress to "just a little." One individual who had not benefited from psychotropic medications previously and who had complained "of severe insomnia, loss of appetite and weight, restlessness, feelings of despair, death wishes, and various somatic symptoms," argued that "It wasn't a sugar pill, it was medicine!" Another declared, "They're not sugar pills... because they worked." Also described as notably depressed, she stated she was "...very satisfied with the idea of continuing with the same doctor and pills."