Thoughts on big trends in technology, media, politics, and society. Oh, and kind of a diary except more public.

Thursday, October 27, 2011

Psychiatry = Pharmacology, Nothing More

This hits close to home, but hopefully readers will not expect me to divulge details on how close to home.

I just saw another example of "The answer is a prescribed pill." The doctor has offered behavior modification techniques, but not in a heartfelt way. And not with the doctor being involved hands-on with the patient. Instead, the recommendation was a treatment of daily drugs. There's clearly a higher return-on-effort-expended for the psychiatrist to dole out "meds" to patients than to be more active in therapy. It's the easier route, for sure.

In my opinion, a large part of the problem is the field of psychiatry itself has major "coping" issues. The field hasn't kept up with modern Western culture and typical behaviors. Major forces like social media (Facebook, Twitter) usage, cyber-bullying, etc. haven't been studied closely enough by the psychiatric profession. There are coping methodologies and practices out there, but few if any have been updated for relevance in today's hyper-connected, information-overload Western society. The average person's affiliations and beliefs are radically different than those of twenty years ago, for example ZERO twenty-somethings expect tenure with specific workplaces to be longer than a couple years and trust in institutions is lower than even in the 1960s.

The sad irony is that many of the technologies creating the newest stresses, the smartphones and Facebook accounts and Google searches, could themselves be harnessed to allow psychiatrists to handle more patients more intensively, with better information, better interactions, and better monitoring. Regarding psychological and spiritual well-being, there should certainly be "an app for that." Why isn't this happening?

Maybe I'm influenced here a little bit by the current "Occupy Wall Street" movement putting such a spotlight on corporate greed. But I think an overwhelming bias in spending and attention favors pills over practices. The big pharma companies spend billions on R&D, lobbying Washington, marketing directly to consumers via big prime-time advertising campaigns, and wooing doctors aggressively. Who is going to fund the innovation in non-pill solutions? Who is motivated to do anything like that? The answer, unfortunately, is NOBODY. You have a few "guru" types, Tony Robbins perhaps the most famous, who earn enough to spend some of the earnings on research and marketing. But this is peanuts compared to the activities of Big Pharma.

Unfortunately there's been no big philanthropic activity around mental illness, other than the Special Olympics movement (which is a very good thing, and sports are a great antidote for psychological problems, but it doesn't do the trick). There's too much of a stigma about mental illness, it's the dirty little secret families don't want out there for others to see. And it's not as "marketable" as cancer, heart disease, or AIDS (readers, PLEASE do not take this as an argument against continuing strong fundraising to fight those diseases or raise awareness about treatment and prevention; maybe there can be some room for more activity on mental health, too?).

It could be argued that, in the past, organized religions were sort of in-the-business of behavioral modification practices and treatments for psychiatric problems, and they could apply accumulated treasure and missionary zeal to helping. But the decline in church-going and the financial fortunes of religions means this isn't a viable alternative to the pill-for-everything trend either.

If there's any hope for a reversal in this unfortunate trend, it may be from increasing awareness about Eastern mind-body ties, holistic medicine, and more consumer-friendly versions of all this like Yoga (which appeals to the same vanity that causes people to want to pop pills yet is actually about something much deeper).

For now families have to do all they can to provide active daily support to those afflicted, whether medications are involved or not, to try to help modify negative behaviors in a non-judgmental way. It's called Unconditional Love.