medicalization and mental illness
After widely publicized concern that anti-anxiety benzodiazepines such as Xanax would be excluded under new Medicare guidelines, the federal government appears to be reversing course. The stigma associated with medication and mental illness can be measured, in part, by reaction to Tom Cruise's diatribe on the medicalization of postpartum depression and Brooke Shields' response in a New York Times op-ed:
- In a strange way, it was comforting to me when my obstetrician told me that my feelings of extreme despair and my suicidal thoughts were directly tied to a biochemical shift in my body...
My sense is that postpartum depression is less stigmatizing than plain vanilla depression, perhaps because the body changes so much with childbirth that a speedy return to "normal" is anticipated:
- With a doctor's care, I have since tapered off the medication, but without it, I wouldn't have become the loving parent I am today.
There is a large research literature on stigmatization of mental illness. This case suggests to me that mental illness may be less stigmatizing when it is (1) acute rather than chronic; (2) demonstrably linked to changes in physical health or biochemical shifts; and, (3) associated with a social good (such as motherhood) rather than a social bad (such as illicit drug use). I notice that Shields' editorial uses the term "postpartum depression" eight times and the generic "depression" only once. Do people still subscribe to the "pull yourself up by the bootstraps" theory (or Cruise's novel prescription of "diet and exercise") for other forms of depression?