http://collections.plos.org/plosmedicine/diseasemongering-2006.php

I had this for several years while I was on dialysis and even though this was caused by the toxins affecting my nervous system it wasn’t taken seriously then by the medics in charge of my case. What a hoot it was, having to walk all night long for two years trying to calm them down just to sleep and then being told it really wasn’t that bad by my medics then. Thank God it is taken more seriously today and there is a treatment. The attitude displayed by some here reinforces my opinion that there medics out there who are unable to listen, really listen openly. I’ve dealt with the serious illness professionaly and in my personal life and I really wish some doctors mental thought processes could be medicalised and treated too.

I am not on any medication, but would like to point out that it’s not a simple “urge to move your legs” like you get if you need a stretch, but a horrible feeling that doesn’t correspond to any other sensation I have ever had. At times, the “urge” leads to involuntary leg twitching, sometimes of a highly visible nature (stamping and kicking). It tends to happen when sitting for long periods of time (used to travel by car around mainland europe), and pretty much every night before I fall asleep.

It may not be a “disease”, but it’s annoying to have people laugh at it, when I find it affects my life in a negative way.

But I feel Teek is suffering from a bad case of “irregular verb syndrome”, conjugated this:

I have a really bad case of the ‘flu
You have a mild cold
He or she is a malingerer…

i posted the Glaxo article to point out what a big defence the pharma giant had launhced, not to legitimise RLS. what i said in terms of trivialising real conditions applied to depression, not restless leg syndrome – i have utter confidence in saying that, even tho i have a habit of moving my leg up and down if i’ve sat down for ages or i’m concentrating, i would never label it as a syndrome and take drugs for it – just get up and stretch your legs!!!!

let me make myself clear. i think RLS is the perfect example of medicalisation of something trivial, whereas depression is seen as trivial but is in many cases a genuine, often serious medical disorder that needs treatment.

please don’t misunderstand my intentions, therefore, in posting the above article!!

Was also interested in the link posted by Teek and the Glaxo comment about restless legs syndrome. A relative of mine has suffered from restless legs for about 50 years – long before the medical profession even gave it a name (his doctor refused to acknowledge the problem for years), let alone found a drug to treat it. It’s only in the past few years that he’s been given medication for it and it has made a huge difference to his life. So I think what Teek says is right: it’s easy to trivialise a complaint (which, in the case of RLS, has a silly-sounding name) that can actually make people’s lives a misery.

http://business.guardian.co.uk/story/0,,1763199,00.html

putting this on the agenda is top work again Ben, i tend to agree that every twinge, niggle, i’m-feeling-a-bit-down, headache etc must be given a label and a pill to go with it – i like the analogy of placebo diagnosis, this sort of thing does indeed placate those of us who need reassurance that something really is wrong wen in actual fact we just need to go for a walk/drink some water/have some chocolate or sex/eat properly etc.

still, i think there’s a danger in making genuine conditions (true clinical depression, post-natal or not) into a trivial matter, when these things are often really serious and have a basis in the biochemistry of the brain.

But depression? I’m not so sure. And I think we should tread carefully with drug treatments. There was an interesting article by Susan Greenfield in yesterday’s Guardian (http://education.guardian.co.uk/egweekly/story/0,,1760103,00.html). She says,

“Already there are reports of an alarming increase in the use of prescribed and black market drugs medicating the classroom, whether it be Ritalin for enhancing concentration, Prozac for enhancing mood or Pro-vigil for extending alert wakefulness.

The problem with these drugs is that they do not target a single trait, such as mood, or concentration, or wakefulness – partly because we do not yet understand how these functions are generated as a cohesive operation in the brain. Rather, drugs manipulate, in a very broad way, the chemicals in the brain. And that, in turn, could have widespread and long-lasting effects.”

Does anyone remember Thomas Szasz whose book “The Myth of Mental Illness” was popular once upon a time. Here is a quotation from an article “Mental Disorders are not Diseases” writen in 2000:

“Psychiatrists and their allies have succeeded in persuading the scientific community, courts, media, and general public that mental illnesses are phenomena independent of human motivation or will.

THE CORE CONCEPT of mental illness–to which the vast majority of psychiatrists and the public adhere–is that diseases of the mind are diseases of the brain. The equation of the mind with the brain and of mental disease with brain disease, supported by the authority of a large body of neuroscience literature, is used to render rational the drug treatment of mental illness and justify the demand for parity in insurance coverage for medical and mental disorders.

Reflecting the influence of these ideas, on Sept. 26, 1997, Pres. Clinton signed the Mental Health Parity Act of 1996, which took effect on Jan. 1, 1998. “This landmark law,” according to the National Alliance for the Mentally Ill, “begins the process of ending the long-held practice of providing less insurance coverage for mental illnesses, or brain disorders, than is provided for equally serious physical disorders.” Contrary to these views, I maintain that the mind is not the brain, that mental functions are not reducible to brain functions, and that mental diseases are not brain diseases–indeed, that mental diseases are not diseases at all.

When I assert the latter, I do not imply that distressing personal experiences and deviant behaviors do not exist. Anxiety, depression, and conflict do exist–in fact, are intrinsic to the human condition–but they are not diseases in the pathological sense.”

You can find the complete article here:
http://www.szasz.com/usatoday.html

Owen

To answer questions first: Melissa, yes, the treatment is the same for both postnatal and ordinary depression. PV: No, I don’t think that depression is “nothing more than feeling a bit out of sorts with the world.” In fact, I think that depression is an immensely serious problem, as you do; the misery that women with new babies experience is absolutely genuine, as are the other kinds of depression that people suffer.

The point I come back to again, though, is whether depression is an illness. Now I don’t pretend to have a simple answer to that but I do think it’s a question worth asking. And the answer isn’t necessarily “yes” or “no”; it could be “sometimes”.

To expand a bit further. Last year I interviewed an academic psychiatrist about postnatal depression for an article I was writing. He said that the rates of depression among women who had just had a baby were about the same as in the population at large, ie about 10-15 percent. In that sense, he said, “postnatal depression” wasn’t a useful term. But he added that for a minority of women, there did seem to be something about giving birth that actually triggered the depression.

For the same article I interviewed women who’d had PND. I was struck in particular by one woman who seemed to match his description: her baby hadn’t been especially demanding or difficult (as is often the case when women have PND), but it sounded as if something had “flipped” after she’d had the baby; she really did experience a dramatic change in personality and became seriously depressed. She was convinced that there was a physical cause behind it.

But I also think that it’s very hard to say where unhappiness ends and depression begins. It seems to me, based on the evidence of friends and acquaintances, including some diagnosed with PND, that it doesn’t take much to get a GP to prescribe anti-depressants. After all, somebody goes along to their GP and says they’re feeling depressed: who is the GP to say, “No, you’re just unhappy?” And what expertise do GPs have in the area anyway?

I come back to the question of whether it’s an illness. Somebody loses his entire family in a car crash: understandably he enters a deep depression. Does that mean he’s suffering from an illness? Or is he experiencing a normal human emotion? You might argue that it doesn’t matter what we call it: if it can be made better by medication, why worry? But it makes me uneasy.

And it brings me back to Ben’s original article, which was about pharmaceutical companies medicalising ordinary problems. It suits pharmaceutical companies if lots of people are diagnosed with depression because they get to sell their SSRIs. Perhaps the pharmaceutical companies are right – the fact that they have a special interest in getting their drugs prescribed doesn’t of itself mean that they’re wrong. But I think we ought to ask the question.

Kim