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Managing High Anxiety Without the Drugs - The myth of magic cure

Sunday, 22 August 2010 20:51

Written by Joseph Hart

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Article Index
Managing High Anxiety Without the Drugs
The myth of magic cure
Mind Body Connections
Mix your own cure
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The Myth of the Magic Cure
Mental disorders are categorized and described in the Diagnostic and Statistical Manual of Mental Disorders (DSM), a book written by a committee of doctors to codify psychiatric conditions. Psychiatrists use the DSM to diagnose patients and prescribe medication; insurance companies typically require a DSM diagnosis before they approve payment for services.


The DSM, however, is a flawed document, says Christopher Lane, author of Shyness: How Normal Behavior Became a Sickness (Yale University Press, 2007). In researching the book, Lane conducted an exhaustive study of correspondence and interviews with doctors involved in compiling the 1980 DSM-III. “What I found was, frankly, very disturbing,” he says. “Some of the definitions lack a rigorous scientific rationale….Some of the criteria are nodrugsastonishing in terms of their carelessness and the absence of empirical justification from field studies.”

This carelessness, says Lane, opened the door to drug manufacturers to exploit the DSM categories in marketing their products. The United States and New Zealand are the only two countries in which direct-to-consumer advertising of drugs is legal, and pharmaceutical corporations spend millions to press their competitive advantage.

“GlaxoSmithKline spent almost $100 million promoting social anxiety disorder in what they called a public awareness campaign just two or three months after they got FDA approval for Paxil- then, the only pharmaceutical treatment available,” Lane explains. “Meanwhile, the psychiatric community went straight for medication and largely overlooked other forms of viable treatment.”

While medication can provide immediate relief from anxiety (although at the risk of side effects), long-term pharmaceutical treatment rests on the controversial 1950s-era theory that mental illness is caused by a “chemical imbalance” that can be corrected with medications. When the brain functions normally, it sends what can be thought of as a chemical code from one cell to the next using substances called neurotransmitters. When a person is depressed or anxious, levels of some of these neurotransmitters drop; thus, the notion that correcting the chemical balance corrects the condition.

Although the metaphor of an imbalanced brain persists, we now know that it’s a biological oversimplification. Neurotransmitters like serotonin and dopamine may be present in higher or lower levels during various emotional states- but that doesn’t necessarily mean they are the primary cause of those states. In fact, they can just as easily be seen as the result or biochemical product of emotional experiences.

Moreover, depression and anxiety are normal, predictable responses to certain life events, so any change in brain chemistry during these states can’t accurately or always be described as an “imbalance.” Neurotransmitters often play more than just one role in the brain and can act broadly to influence all sorts of body functions (serotonin, for example, has been shown to play a role in both mood and appetite), so interfering with their transmission can affect more than just mood sometimes in unpredictable ways.

Drug interactions with brain chemistry are similarly broad: Any drug, whether cocaine or Prozac, affects our mental state by broadly repressing or enhancing our ability to manufacture, release or transfer certain neurotransmitters. Which is to say that increasing or suppressing the transmission of a selected neurotransmitter increases or suppresses all the roles that neurotransmitter plays in the brain, not just its one role in, say, anxiety. (For a look at how nutrition affects neurotransmitters and moods, see Comfort Food for Your Brain.)

But perhaps the most damaging aspect of the chemical imbalance theory is that it treats the brain in isolation from the rest of the body. In fact, they’re one highly integrated system.

Next: Mind-Body Connections

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