Tag Archives: overdiagnosis

In this talk of the nation on NPR, there is a discussion between Gary Greenberg, author of “Manufacturing Depression: The Secret History of a Modern Disease” and Peter Kramer, MD, author of “Against Depression” about the increase in diagnosis of depression. Mr. Greenberg believes the disease is overdiagnosed. He says the move from unhappiness to depression was a long and gradual process. He said it all started in the 1960’s when Merck created an antidepressant drug called elavil and needed to sell it. Merck’s marketing campaign said in order to sell the drug you must associate it with a disease. At this time, Frank Ayd wrote a book for doctors called, “Recognizing the depressed patient” to provide doctors with a script to look for patients who fit into that diagnosis of depression.

Mr. Greenberg also states that Merck was not only advertising the drug but they were also advertising the idea of depression, they were advertising the “disease”. He also points out that doctors still don’t know much about the biochemistry of depression but that one wouldn’t know that when they go to see their doctor. In the discussion they also mention the Hamilton Rating Scale for Depression (HRSD) which is a questionnaire that rates the severity of symptoms observed in depression such as low mood, insomnia, agitation, anxiety and weight loss and the fact that this scale is the most commonly used for rating depression and it doesn’t always give a depressed person the correct diagnosis and/or treatment.

Peter Kramer states that “it is hard to measure depression with the Hamilton scale and it cannot assign the right medication”. Both Kramer and Greenberg agree that those depressed don’t always get the correct treatment. Mr. Greenberg says, antidepressants don’t do much better than a placebo if one isn’t majorly depressed. He also believes that there are social issues of depression like one losing their job, working too much and not having enough time for family, etc. but says that the country doesn’t care much about that, they would rather treat it with medication.

I thought this discussion was very interesting because it shows what Conrad and Schneider wrote about in the article “From Badness to Sickness” about the power of the medical profession and how drug companies with a profit motive can create diseases such as depression to make money and get away with it. In the article by Conrad and Schneider, they state, “The medical profession dominates the organization of health and has a virtual monopoly over anything that is defined as an illness a “medical” treatment. All the medical profession has to do is make a claim and turn something like unhappiness into depression, so that they can medically treat it with a pill.