Tens of millions of Americans, both adults and children, are prescribed one or more psychiatric medications. For example, one in six adult women takes antidepressants. On some university campuses, up to 25% of students without it Prescription report of taking prescribed stimulants such as Adderall or Concerta to help with studying. Even preschoolers as young as 2 or 3 are being treated with stimulants, antipsychotics, and other drugs for disruptive behavior.
How did that happen? Every January, I teach his two-week crash course on this question here at the University of Virginia.
Source: Alexandros Chatzidimos/Pexels
I call this class “Prozac culture.” prozac It serves here as a metonymy for the cornucopia of psychiatric drugs people use today, including antidepressants, stimulants, and sedatives like Xanax. Although Prozac itself is now off-patent and available in generic form as fluoxetine, it remains one of the most widely prescribed drugs (even without advertising) and is therefore one of the It holds a symbolic status that other medicines do not have. All students know about Prozac.
Written by Prozac cultureWhat I mean is the therapeutic ethos that emerged in response to the demands, expectations, and norms of the early modern world.
Profound changes, driven primarily by technology, are transforming the norms that govern our social lives, eroding old social roles and rules, and favoring autonomy and self-actualization over other ideals and normative imperatives. We have created an expanded space of “choice” that emphasizes. The demand for self-mastery and self-optimization is now influencing the standards by which most of us evaluate ourselves and establish our place in society. The pressure to meet these demands, combined with the ambiguous criteria for measuring relative success in doing so, creates new tensions, anguish, and personal suffering. Prozac culture is a response to these struggles.
background
Historically, the starting point for Prozac culture was the therapeutic revolution of the 1950s. Soon, a number of existing compounds were discovered to have beneficial psychoactive properties. First antipsychotics appeared on the market, then new anxiolytics, sedatives, stimulants (Ritalin), and antidepressants. Miltown (1955) for anxiety and irritability and similar benzodiazepines starting with Librium (1960) and Valium (1963) produced the first psychiatric blockbusters.
If we go back even further, we find that in the 19th century, various elixirs and tonics (proprietary medicines) were popular for alleviating ailments such as anxiety and fatigue, and offering a newfound enjoyment of life. . Also during this period, new conditions for the anxious were defined, such as neurasthenia (“nervous fatigue”) and neuroses, and specialized clinic-based practices were established to treat them. I am.
Going back to the 1950s, we see the field of medicine beginning to expand as various forms of antisocial and deviant behavior are redefined as mental illnesses that require treatment. This expansion of medical control, called “medicalization,” spread to every conceivable form of suffering and life problem in the following decades. When the 1980 edition of the Diagnostic Manual of Psychiatry was published, hundreds of new or reconceptualized disorders appeared. Since then, the boundaries of disorders such as depression, attention-deficit/hyperactivity disorder (ADHD), and autism have become increasingly flexible, with more amorphous symptoms grouped together.
From its inception, medicalization involved a complex interplay between the understanding of medicine and its therapeutic content. The medicalization of common forms of suffering, such as tension, lack of energy, helplessness, and loneliness, encouraged drug use. The routine use and sale of drugs encouraged further medicalization and use of drugs. The success of drugs (biochemicals) promoted new theories of biological causation, which subsequently further promoted their use, including in children. Thus began a circle of interaction and self-reinforcement that continues to this day.
From the 1950s onwards, the pharmaceutical industry played an active role. In my class, we explore the company’s many marketing strategies, including the practice of “detailing” pharmaceutical representatives, direct-to-consumer advertising, sponsored medical research, and sponsored “thought leaders.” We also briefly consider the role of other popularizers, such as the media, patient advocacy groups, celebrity patients, and new genres of personal pathological depictions.
Virtually everyone, including high school students, now speaks the language of symptoms and disorders, swaps drug brand names, and claims that their brain is “out of balance,” “neurodivergent,” or “adjusted.” I can now imagine that it is “insufficiency”.
the other half of the story
Professional activities are part of the Prozac cultural story. But that doesn’t help us understand why the story of diagnosis, drugs, and nerves has become so persuasive to the public. To do so, we need to focus on new norms of self and the demands they imply.
In class, we try to explain how major sociological changes such as the decline of tradition, secularization, and increased mobility are expanding the scope of individual choice while also making it more difficult to know what to do. He pointed out that the custom of public mourning is disappearing.
At an everyday level, ask students to write a short reflection on the question, “What kind of person is that person?” good. In a competitive environment, they write, you must possess both recognized accomplishments and important personal qualities, from intelligence to confidence to physical fitness. And they must do all this with proper self-expression. No task is more complex or uncertain than this. “He’s good at everything,” one young man wrote, but he “doesn’t seem like he’s trying or that he cares.”
We also see the new norm in other ways. We explore the pressures to perform that people feel justify the use of non-prescription stimulants (watch the Netflix movie “Take Your Pills” on this topic). We explore how the definition of disability categories such as ADHD has changed to reflect the failure of dominant ideals of self-actualization. Symptoms of ADHD no longer center on inattention, but include situationally problematic behaviors that suggest a lack of motivation, self-control, or self-interest on the part of the individual regarding future goals or outcomes.
The new norm constitutes a chronic stressor driving Prozac culture, and drugs and neurobiology are offered as solutions.
In recent years, non-experts, especially social media influencers, patient experts, and content creators, have increasingly played a role in spreading Prozac culture. As the class watches online videos, we discuss why receiving a diagnosis has become so popular and what role it plays in the story of identity. Psychiatric labels can help ease the stress of failure. One student said, “As long as there is an explanation of the diagnosis, it’s okay even if it’s incomplete.” got itHe says this because scientific-sounding explanations of the brain shift the cause of difficulties to the body and away from the self.
conclusion
Ethics cannot be avoided in any course on Prozac culture. In every situation we talk about our ideals, norms, aspirations and images of a good human life. The assumption behind this course is that if we can bring these poorly articulated values into clearer view, we may be in a position to consider alternative relationships with the world. .To stimulate our thinking, our final reading includes a chapter from German social theorist Hartmut Rosa’s provocative little book uncontrollability of the world. Rosa suggests that if we can receptively approach the world as a gift, rather than as a set of objects to be mastered or manipulated, perhaps the world will work for us in new ways. He claims he might come back to life.