Postpartum Depression History, Attention Focused On Postpartum Depression
Q: In the 19th century, a woman who experienced
depression or discontent was likely to be diagnosed as "neurotic"
and subjected to treatment ranging from vibrators (to induce
orgasm) to clitoridectomy (to ensure that she never had another
one again), with various talk, drug and institutional therapies
in between. In the 1950s, a neurotic woman might find herself
undergoing electroshock therapy, or, if she was lucky, she might
be offered the sedation of Valium. Today, the depressed housewife
is likely to find herself on one of the new antidepressants such
as Prozac, Zoloft, Paxil or Wellbutrin.
A:Andrea Yates, a reportedly depressed housewife, had, in the years
before she killed her five children, been treated with various
drugs, including Wellbutrin, Effexir and Haldol. According to her
husband, Yates suffered from postpartum depression. According to
Bruce E. Levine, Ph.D., author of "Commonsense Rebellion:
Debunking Psychiatry, Confronting Society -- An A to Z Guide to
Rehumanizing Our Lives," the combination of medicines that Yates
reportedly took, particularly if she was taking them at the same
time, may well have been a prescription for a tragic psychotic
break.
We often think of the history of psychiatry as a story of
progress, an evolution from barbaric and invasive treatments to
more sophisticated, humane care based on sound scientific
principles. And while it certainly seems like progress to move
from attacking depression with scalpels and electrodes to
treating it as a chemical imbalance with medication, in
high-profile cases like those of Andrea Yates and Columbine High
School's Eric Harris, who was also being treated with
antidepressants, critics like Levine have serious questions about
the efficacy and safety of these medications.
Levine, a practicing psychologist for more than 15 years,
believes it would be rash and reductive to lay the blame for
Yates' and Harris' homicidal impulses at the feet of American
pharmaceutical companies. But if we are going to treat depression
-- and postpartum psychosis, anorexia, oppositional defiant
disorder, premenstrual syndrome and dozens of other illnesses --
with tools from the chemistry set, says Levine, it is fair to ask
whether we know what we are doing at all.
Why are we now prescribing stimulants for women who, three
decades ago, would have been put on sedatives? Is this a sign of
progress, the result of better diagnostic tools and more
effective treatments? Or is it a sign of social engineering to
accommodate the changing expectations of women in society? Are
the cutting-edge psychiatric treatments of today any less
arbitrary than those of 30 or even 100 years ago? And if we don't
know exactly how a medication works, is it possible that, in rare
cases, we might inadvertently give a patient a medication that
triggers a psychotic reaction?
"The history of psychiatry is one of nearly unmitigated failure,"
says Levine, who also is a member of the International Center for
the Study of Psychiatry and Psychology, an organization that
educates the public on the dangers of psychotropic drugs,
electroshock and psychosurgery, as well as argues against the
idea that mental disorders can be traced to biochemical and
genetic causes.
The theory that depression and other disorders are caused by
"chemical imbalances" in the body that can be remedied by
psychotropic medication is, according to Levine, "just that: a
theory." Not only does he believe that psychotropic medication
is, at best, ineffective; he also claims that the rush to solve
social problems by medicating individuals is blinding us to the
ways in which people are rebelling against an "institutional
society" that doesn't meet human needs.
Speaking by telephone from his home in Ohio, Levine addressed the
ways in which pharmaceutical companies romance Americans, the
effects of the mental health industry on women and children, and
the possible role of psychotropic medication in the Andrea Yates
case.
(Several days after Salon's interview with Levine, Families USA,
a healthcare consumers group based in Washington, published data
showing that last year, leading pharmaceutical companies spent
more than twice as much money on advertising, marketing and
administration as they did on research into new medicines.)
You have written: "One of the greatest marketing feats of the
past 20 years is use of pharmaceutical companies' dollars to
convince the mass media that psychiatrists who prescribe these
companies' drugs are basing their treatment on anything
resembling science." What do you mean by this?
Thirty years ago people used to laugh at psychiatry. Since then,
the science has not advanced, but the marketing on the part of
pharmaceutical companies has. Just like any other corporation,
these companies bring out new models and new brands; when people
start to notice problems with one product, they bring out another
one which may not be any better than the last one, but its
problems are less well known. These are multibillion-dollar
companies that have made sure that professional organizations and
consumer groups hear the same