(Thanks to the corporatization of health care, Americans pay double what other countries pay for health care but have much worse health. The recent Obamacare roll-out has heightened public awareness about the role of private insurance companies in sucking billions of health dollars out of the health care system. There is far less scrutiny of the role of Big Pharma in driving up health care costs.
This is the first of several posts on “disease mongering” by pharmaceutic companies – i.e. the invention of fictitious diseases to market drugs that supposedly treat them.)
Marketing Serotonin Deficiency
With the release of Prozac back in 1987, the pharmaceutical industry began systematically indoctrinating doctors with the theory that depression is caused by a genetic deficiency in a brain neurotransmitter called serotonin. Big Pharma then spent the next 25 years reaping billions of dollars from marketing high-priced SSRIs to treat this so-called deficiency.
There are several obvious flaws in the theory that depression is a genetic brain disorder. The first is the skyrocketing increase in depression and suicide triggered by the 2008 meltdown. The prevalence of a genetic illness should follow the same predictable growth curve as population. The second is the total absence of so-called “serotonin deficiency” in lower mammals. The third and most obvious is the extremely low response rate to SSRIs and other antidepressants. Only 50% of patients who take them ever achieve full recovery.
The Learned Helplessness Model of Depression
The absence of “serotonin deficiency” in lower animals means that depression has to be artificially created to research prospective antidepressants. Most of this animal research is based on the “learned helplessness” model. In a common experiment, mice are dropped into a large vat of water and the researcher times how long they keep swimming before they give up. After taking a dose of Prozac, they swim longer before giving up.
There is something incredibly sad about the drug companies’ persistence in torturing small animals. If the medical profession is serious about addressing the immense suffering caused by the costly and disabling condition, surely they need to start addressing some of the other known causes – for example, nutritional deficiency, derangements in intestinal bacteria and the total degradation of family and community life.
Depression Caused by Poverty and Malnutrition
Doctors have known for half a century that specific nutritional deficiencies can cause depression. Western countries are particularly known for depression-linked deficiencies in omega 3 and Vitamin D. Cross-cultural research shows that Asian and Scandinavian countries consuming quantities of fish (which contains both omega 3 and Vitamin D) have extremely low rates of depression. The phytonutrients found in fresh fruits and vegetables also seem important in preventing depression, though the evidence is less strong.
Owing to recent skyrocketing food costs, I feel a little silly advising low income patients to eat more oily fish and fresh vegetables. I also feel angry and disgusted about a corporate-driven health policy whereby Medicaid, Medicare and Obamacare happily pay for a Prozac prescription (to help their friends at Big Pharma) but not to subsidize fresh, organically grown food for low income patients with obvious nutritional deficiencies.
Depression Caused by Unhealthy Gut Bacteria
Pioneering gastroenterology research suggests that the microbiome (the resident bacteria in our intestines) also plays a major role in brain function. The overuse of antibiotics, in medicine and factory farming, has killed off normal bowel flora in a large segment of the industrialized world. This, in turn, has led to a near epidemic levels of irritable bowel syndrome and inflammatory bowel disease. Surprisingly both conditions have links to arthritis, obesity, autoimmune diseases, and so-called “brain” diseases, such as depression, anxiety, migraines, and even autism.
Recent studies suggest that treating this type of depression can be as simple as taking probiotics or eating fermented foods, such as yoghurt and sauerkraut. Yet because these treatments aren’t medication-based, they aren’t covered by health insurance, Medicare or Medicaid.
Human Misery, Stress and Social Isolation
Obviously the worsening depression, along with epidemic levels of foreclosures, bankruptcies and evictions, is a far bigger culprit than nutritional deficiencies or gut bacteria in the recent exponential increase in depression and suicide. The best way to trigger depression in higher mammals is through massive, unrelenting environmental stress. Surely the pharmaceutical companies know this, or they wouldn’t be using learned helplessness in their animal research, would they?
It’s also striking that the current economic depression has hit people a lot people harder than the Great Depression of the 1930s. This seems to relate to the overall breakdown of family and community life. Prior to World War II, the family and social networks people belonged to exerted a protective effect during stressful times. Human beings, like other primates, such as apes, monkeys and gorillas, are fundamentally social beings. We are all hard wired to have strong social needs and function very poorly when they go unmet.
Recent neurophysiologic research shows that the human brain produces specific “feel good” neurochemicals (e.g. oxytocin, endorphins, and dopamine) to reward people for social activity. Social isolation appears to produce a deficit in these chemicals.
The Absence of Social Needs Research
Research into non-pharmaceutical treatments for depression is unlikely to occur in the US, where Big Pharma oversees the vast majority of medical research. For obvious reasons, drug companies have no incentive to investigate treatments that don’t involve a product they can sell for profit. It hasn’t helped that Obama has slashed research budgets for National Institutes of Health and National Institutes of Mental Health.
photo credit: Tidewater Muse via photopin cc
You certainly know what you are talking about. I agree on every single point. I have long pointed out the fact that back in my early days, we didn’t hear of mental diagnoses that really make no sense at all. People were able to rely on each other for support and social life. That is not the case today as we are more isolated than ever. And just because we are on Facebook and Twitter, that does not take the place of eye-to-eye contact and body language and actually taking the time to sit down with one another, one on one. That is practically unheard of now.
In my opinion, the business of psychiatry is to bring more patients into the “you need to be heavily medicated” fold. “Here, take these ‘happy’ pills.” When I lived in Baltimore, MD, the government monitored methadone program that was to aid recovering heroin addicts, they would be given such a high dose of methadone that those people would just stand in the middle of the sidewalk and weeble and wobble and bend almost down to their ankles because they were so out of it. So, they weren’t being ‘cured’, they were just changed from one addiction to another. I used to just look at them in complete bewilderment because I expected them to just fall right on over, but they never did. When I moved to Minnesota, the people who are participants in the methadone program were not as heavily medicated. This led me to believe that those people in Baltimore, MD were giving too high of a dose of methadone and this I think is done deliberately. Just as I think that every time we turn around, a new mental diagnosis is popping up from seemingly out of nowhere.
I do not think that it bodes well for us when we hear that we should take ‘Cymbalta’, an antidepressant because it will cure those aches and pains that come with depression. Could that not have the potential for patients to not be listened to when they complain of pain and it gets no attention because it is attributed to their so-called, ‘depression’? It just amazes me what we put up with and what we will accept and not question what makes no sense at all. If I have a pain, I am not attributing it to depression, I am going to see what the heck is causing it.
StuartBramhall, thank you for posting this. It needs a wider audience, that’s for sure because America is the pill popping capital of the world. We feel down, we take a pill. If a child is rambunctious, the child is given a diagnosis and a pill or several. This is all way past ridiculous!
Again, thank you!
Thank you, Shelby, for your very thoughtful comment. In my clinical experience, lots of medical problems can masquerade as depression. Usually severe pain triggers depression – not the other way around.In my opinion, the intrusion of Big Pharma into the practice of medicine has destroyed the art (and science) of diagnosis.
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