There are ways and ways of saying things.
Robin Marantz Henig’s recent article “Valium’s Contribution to our New Normal” in the New York Times Sunday Review revisted the Myth of Mental Illness meme, this time in the form of an argument about how the once ubiquitous anti-anxiety pill, immortalized by the Rolling Stones in their 1966 song, “Mother’s Little Helper,” helped “people who were basically fine” deal with “the ups and downs of daily life. ”
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Anxiety (that is to say, any form of anxiety short of full-scale panic attacks, full-blown OCD, trip-to-the-emergency-room-level impairment) Henig went on to suggest, was a convenient fiction cooked up in mid-century America by the pharmaceutical industry and pill-happy doctors. Because, as the author once put it to an interviewer, “the ordinary, everyday anxiety it treats did not exist before Valium came along as a way to treat it.”
A few days after Henig’s article, Thomas Insel, director of the National Institute of Mental Health, published a blog post where he too shared thoughts on the “fictive” quality of mental disorders. “We lack cures, we lack vaccines, and we lack diagnostic biomarkers,” he wrote. “Terms like ‘depression’ or ‘schizophrenia’ or ‘autism’ have achieved a reality that far outstrips their scientific value.”
Like Henig’s piece, like so much popular writing on mental health today, Insel’s post had a certain emperor-has-no-clothes ring to it, as he deplored the relative lack of progress made in research psychiatry over the past half-century, when scientific advances in the treatment of other medical challenges, like childhood leukemia or cardiovascular disease, have simply soared.
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So why was the first article so troubling — even potentially dangerous — while the second inspired hope?
It comes down to one very simple and basic point of difference: Insel’s piece pointed to the limitations of science in accurately capturing the complex truth of mental illness due to a categorizing system that has for decades focused on grouping together the symptoms of mental disorders, rather than on trying to break down the underlying brain characteristics associated with those disorders. Henig’s article, like so many of its ilk, made light of the symptoms altogether, denying the reality of the suffering that they convey and, by extension, the reality of painful mental disorders themselves.
Valium has long served extremely well as a vehicle for proving the perfidy of psychiatrists and the drug companies behind them. It was indeed dispensed in outrageous-seeming numbers in the 1960s and early 1970s. It did indeed lead to tragic levels of abuse and addiction. Its use did correspond to the tail end of a time when an oppressive mystique of female domesticity was making life highly unpleasant for women who didn’t — wouldn’t or couldn’t — find happiness within its constraints.
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And yet — the Valium Mystique, or the investment of all sorts of historical and social forces of oppression in one little pill—has its limits as a concept. For one thing, it only holds water if it was indeed true, as Henig says, that the women taking it were essentially perfectly well-functioning mildy neurotic types looking for happiness-enhancing “brain styling.” But, for the most part, they weren’t — at least according to the conclusions of a team of researchers who, in the late 1970s, were charged by the Carter Administration with looking into whether or not perfectly fine American women were indeed being trivially overmedicated with Valium. “It was patients with high levels of distress who had received medication, and high distress correlated with diagnosable illness,” psychiatrist Peter Kramer, best known for his best-seller Listening to Prozac, and a member of that research team, has written.
It’s also inconveniently true that drugs like Valium were marketed as much to men as to women.
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Despite the fact that we remember them today as “salves for harried housewives,” tranquilizers like Valium, and its predecessor, Miltown, were “nicknamed Executive Excedrin in the 1950s and widely used by businessmen, male talk show hosts and celebrities,” notes McGill University historian Andrea Tone in her excellent 2009 book, The Age of Anxiety: A History of America’s Turbulent Affair with Tranquilizers. And it’s true, as Tone reminds us in vivid historical detail, that anxiety, great or mild, is and has always been part of the human condition. As have been efforts to numb it – 19th century Americans, she notes, used patent medicines containing opiates or alcohol.
What happens to our long-cherished Mother’s Little Helper tale if you replace the notion that women were being singled out and mentally shutdown via Valium with the counter notion that those women were in real pain? You get another story: of women visiting doctors in search of help. Of doctors then offering help that wasn’t very good help because, frankly, at that point, they didn’t have much by way of good help to offer. American psychiatry has had some really dark chapters, particularly in the mid-20th century, when the use of tranquilizers like Valium skyrocketed. But to deny the reality of the suffering that motivates people – men and women — to spend time and money on seeing doctors is just inhuman. And, unlike widespread Valium prescribing, it’s a practice that hasn’t been reduced over time .