Anxious over Anxiety
Thursday, May 2, 2013
Reflections
Overall, this project taught me how to better
understand generalized anxiety disorder considering the context of its
medicalized history and how it is represented within the media. During my
research, I found that there was much more that has yet to be thoroughly
researched about the disorder. Why does it appear in mostly women? Why is it a “white”
condition? Has it been implicated with colonialism at all? How does it manifest across nations outside of the U.S.? I hope for this
project to not be the end of my education on this subject as I continue my own
struggle with my mental and physical well-being. Well I remain unsure of whether to categorize my anxiety as mere stress or something worth being medicalized, this project has encouraged me to take these feelings and thoughts seriously as I move forward in my life.
What Can Be Done?
In order to address
generalized anxiety disorder to the fullest extent, our understanding of health
and mental health must be uprooted. Currently, health is understood as
something that exists in a vacuum and is mostly affected by germs and microbes
in our environment. We can stay healthy by washing our hands, eating well, and
exercising. We are also encouraged to go to the doctor regularly to ensure that
we are in good health. However, in many ways mental health cannot be understood
in this way. Mental health disorders are not “caught” through germs; they
manifest and are triggered with age. As long as there are stigmas attached to
mental health disorders, individuals will feel uncomfortable going into therapy
and receiving treatment. On the flipside of this, as long as any emotions and
worries outside of society’s defined norm are considered disorders, then
individuals’ problems will continue to be medicalized regardless if it is warranted.
A solution I’ve seen enacted right here on campus is
within the Tang Center’s “Do you!” campaign around things such as dating,
drinking, and sex. This campaign encourages individuals to decisions for
themselves according to their own needs. I’ve also seen it manifest in safe
spaces at events as a means to encourage individuals to do whatever makes them
feel comfortable in that space. This year at a panel for ASUC elections hosted
by GenEq, the introduction encouraged everyone present that it was okay to
leave the room if you felt uncomfortable and that it was important that you did
what was necessary for you to feel safe and healthy in that space. A move
towards inclusive spaces like this would be highly beneficial to those with
varying degrees of mental health. As society removes the stigmas attached to
panic attacks and other reactions associated with anxiety, hopefully those grappling
with these conditions can feel more included and able to venture into unknown
spaces.
There are still issues with symptoms of anxiety being
seen as illegitimate or irrational. If more people were educated and
understanding of the sensitivity some individuals exhibit to certain
experiences, individuals with anxiety would feel comfortable expressing these
fears. One of the best tools we can use for this is education. As I’ve learned
throughout the semester in my disability studies class, simply engaging with
differently abled individuals can be a crucial learning experience. I can only
hope that as time goes on our society will become more inclusive and
understanding of those with mental conditions.
Images of GAD
Images
of GAD
Generalized anxiety disorder is a unique case in that it
is racialized as white and gendered as female. Woodman has discovered in
reports that “prevalence was lowest
in the youngest age group and increased with age: The prevalence in women aged
45 and older was 3.5% for those with current GAD and 10.3% for lifetime
occurrence of GAD” (Woodman 3). Researchers also “found that homemakers and
unemployed respondents (mostly permanently disabled individuals and early
retirees) had a significantly higher prevalence of GAD than other subjects.”
(Woodman 3). Since I am unable to find information that explains why this
disorder has been prevalent in white, unemployed, older females, I will look to
images that depict GAD and attempt to theorize why this disorder is prevalent in
this group.
After completing a
search on google images, I found that the majority of people depicted with anxiety
were white women. A few results were men, and nearly every
single person was white.
(http://www.natural-holistic-health.com/wp-content/uploads/HLIC/5eabfb2483dc42cd5415f8a0f55c6c73.jpg)
What do images say to people who may feel like they have a certain disorder but are unsure? These images demonstrate that anxiety is a white woman’s problem. For men and people of color, excessive worry is not within the realm of medicalization and can be tackled presumably through other means. These images can be both helpful and harmful as white women’s worry is legitimized through medicalization.
What do images say to people who may feel like they have a certain disorder but are unsure? These images demonstrate that anxiety is a white woman’s problem. For men and people of color, excessive worry is not within the realm of medicalization and can be tackled presumably through other means. These images can be both helpful and harmful as white women’s worry is legitimized through medicalization.
Generalized Anxiety Disorder in the Media
GAD
in the Media
Much of our understanding of diseases and disorders can
come from media depictions of it. When we don’t personally know someone with a
certain disorder, it is difficult to get an accurate representation of how it
manifests in people’s lived experiences. For this section, I will analyze the
two depictions of generalized anxiety disorder that I have seen in the media.
The first is featured in the E! reality series “Married To Jonas”. The second
was in Michael C. Hall’s character on “Six Feet Under”. These depictions are
also of interest due to the ways they were implicated by gender and sexual
orientation.
I normally would not watch a series about Jonas Brothers’
married life, but I was very sick one day on the couch and managed to catch a
marathon of it. The series follows Kevin Jonas and his wife Danielle Jonas as
he navigates jumpstarting his career as well as his family. Danielle Jonas happens
to have generalized anxiety disorder and struggles with it throughout the show.
At first, she is uncomfortable telling her husband that she is having severe
anxiety and panic attacks again after being in a car accident. She asserts that
“I try to be strong for Kevin,” but
sometimes my body shuts down” (Larrabee). Originally, I was very surprised that
she wouldn’t share this key factor of her health with her husband.
As the show went on, it
became clear why she did not feel comfortable sharing this information with her
husband. Kevin Jonas was set upon starting a family and did not want his wife
getting pregnant while on her anxiety medication. He has his life plans set up:
get his wife pregnant, go on tour, come back and raise his family. Danielle’s
disorder is disrupting that for him. Instead of being supportive and
encouraging her to do what’s best for her health, he makes her feel
disappointed in herself that she cannot have his child yet (Larrabee). To solve
this, Kevin Jonas decided to whisk her away on a trip to Italy to get her to
relax. She set a goal before the trip to get off her medication so she can get
pregnant. When she was unable to get rid of her anxiety over the course of one
trip, she was “completely overwhelmed and felt like a failure” (Larrabee).
Nearly everything about
the depiction of Dani Jonas’ anxiety was implicated by her gender and status as
Kevin Jonas’ wife. Kevin wasn’t interested in her health for the sake of her
own well-being; he was only interested in her reproductive capacity. Dani was
depicted as unable to keep it together for her family and for her husband,
though certainly not for a lack of trying. Her health was only of interest to
the extent that it affected her abilities to produce children for her husband.
This was particularly troubling and demonstrated that we still have a long way
to go to understanding women’s health outside of their reproductive capacity.
The second depiction I’ve
seen of anxiety was on “Six Feet Under” with the character of David Fisher,
played by Michael C. Hall. The show features a few main characters that have
various mental disorders including bipolar and psychotic depression. David
Fisher is “healthy” throughout the series until he picks up a hitchhiker who he
finds attractive. He seems innocent enough at first, until he begins to ask
David for money and holds him captive. All other storylines are halted in this
episode David is forced to smoke crack, is doused in gasoline, then has a gun
shoved in his mouth to symbolize fellatio (“That’s My Dog”). His torturer
eventually leaves him and David makes it out alive, but not “well”.
After this incident,
David is seen experiencing symptoms of post-traumatic stress disorder as well
as GAD. He finds himself easily triggered in many situations and fearful that
he will see his attacker again. He has panic attacks and is unable to continue
his work at the funeral home. At the end of the season, he confronts his
attacker in jail and has a poignant conversation with his dead father who insists that “You can do anything,
you lucky bastard - you're alive! What's a little pain compared to that?”
(“Untitled”). However, this is not the end of David’s struggle with anxiety as
he adopts children and fears for their safety and continues to be triggered by
certain events. One of the most heart wrenching moments occurs near the end of
the series, when David is nearly unable to attend his brother’s funeral due to
his anxiety (“All Alone”). However, this storyline was not without controversy
as fans were concerned that David’s character was being punished for his
sexuality (Nussbaum). The creators and writers stand by their story though,
insisting that “I’m gay, Alan Ball
is gay; homophobic is the one thing you don’t get off calling the show”
(Nussbaum). While this is certainly not true, I’m inclined to see the storyline
as another extension of the trauma that many of the characters faced throughout
the series.
References
Buck, Scott. "That's My Dog." Six Feet Under. 18 July 2004. Television.
Larrabee, Dory. "‘Married To Jonas’ Recap —
Danielle: ‘My Heart Is Literally Broken’."Hollywood Life. N.p., n.d. Web. 01 May 2013.
Nussbaum, Emily. "Captive Audience." NYMag.com. N.p., n.d. Web. 01 May 2013.
Oliver, Nancy. "Untitled." Six Feet Under. 12 September 2004. Television.
Robin, Kate. "All Alone." Six Feet Under. 5 August 2005. Television.
Mid-Project Reflection
Somewhat ironically, as I complete this project I find
myself having more anxiety than ever in my day to day life. I made the
unfortunate decision to take 20 units this semester, plus continue working and
volunteering with various organizations on campus. When I found the workload to
be too much, it was already too late. I’ve found myself experiencing new forms
of stress and worry that I hadn’t before. While it is about things “worth”
stressing about, such as papers and finding housing, it is much more intense
and draining than any kind of worry I have experienced before. I find myself
too overwhelmed to complete some of the most basic tasks. Luckily, I snap out
of it within a few hours but end up “wasting” those hours in the meantime. It
got bad enough to a point that I did call the Tang Center to schedule a free
counseling appointment. I called and they scheduled me for my phone
consultation, which was already difficult to squeeze into my busy schedule.
When it came time for my phone consultation there was no one available and I
had to leave a message. By the time they got back to me, my schedule was far
too booked to continue with a phone call plus appointment. While these
experiences have certainly not helped this semester, I am learning to cope and
question why I feel the way I do. I plan on going in for counseling once finals
are over to work on getting things sorted out.
Implications of Biopower & Treatment
Implications
of Biopower & Treatment
Stemming from the effects of biomedicalization is the
placement of treatment in the realm of the individual. While this may seem
empowering on its face, individuals are considered responsible for their health
regardless if they have access to the resources necessary to treat themselves.
This is also further implicated with challenges when mental health is involved
since individuals may not even be diagnosed with whatever condition they’re
supposed to be treating. The symptoms of generalized anxiety disorder are easy
to gloss over in our culture as the fault of individuals. Looking to my mother’s
experience with this disorder, many have told her to “just stop worrying”. A
more dynamic understanding of this disorder is needed as we look deeper into
the societal pressures that may affect it.
The emphasis placed upon the individual to treat GAD
through things like self-help books is highly reflective of Foucault’s concepts
of biopower. Johnson notes how within biopower, “one
of the ways in which individuals are induced to embrace and activate power over
their own lives is in the name of health” (Johnson). Within
Foucault’s studies of surveillance, he was particularly interested in the ways
that individuals were observed in hospitals. He “wanted to find out how the
medical gaze was institutionalized, how it was effectively inscribed in social
space, how the new form of the hospital was at once the effect and the support
of a new type of gaze” (Foucault R138). He analyzes the manifestation of
biopower as contrary to history’s interests in controlling who dies. He
analyzes how within Western history, there was a shift from controlling who
could live to how they could live. It is a form of power that is productive and
forces life to appear in certain ways. It is important to note that it is not
something to be wielded by certain individuals or groups and is not
orchestrated by anyone in particular, but rather permeates how our society
functions.
Under a lens of biopower, GAD can be seen as a disorder
in need of treatment in order to produce individuals of a certain type that has
been defined as “normal” by society. These individuals are supposed to worry
less and consequently be more productive and valuable within our neoliberal
capitalist society. Individuals today are likely to search for treatment
options first on the internet. WebMD is one of these popular online resources
that many can use to diagnose themselves with certain conditions. Under their home
treatment section for anxiety, WebMD recommends recognizing your anxiety by
dealing with it, practicing relaxation techniques, and by exercising and eating
well (“Anxiety & Panic Disorders Health Centers”). These are all activities
that individuals can be expected to do in order to maintain their health. As we
see in Lauren Berlant’s piece, these things are not always in reach for
everyone. There are those who are unable to find a safe place to run or go for
a walk. Under the models of biomedicalization and biopower, individuals must
take these basic strides for their health or else some blame is fairly placed
upon them for their mental health status. When people possibly do not have the
time or resources to care for themselves, society now has more leverage in
placing the blame of the condition on the individual.
First steps towards treating GAD also include self-help
books and guides which are widely available to American consumers. These books
are “linked to American ideals of self-mastery
and self-invention, and they typically aim to inspire and instruct their
readers by providing wisdom and encouragement” (Johnson). The discourses
contained within these books “accomplish two vital functions of biopower:
first, all of life is rendered in calculable, scientific form and second,
individuals are interpellated as active agents who can act to improve their
health through techniques of self-government and self-management.”
(Johnson). While these books may be useful resources for those interested,
pressure is placed upon individuals to use these books whether they want to or
not. People of various states of mental health are expected to seek out these
resources in order to regulate their lives accordingly.
Resources
"Anxiety & Panic Disorders Health
Center." WebMD. N.p., n.d. Web.
02 May 2013.
Foucault, Michel. “The Eye of Power” (in reader).
Johnson, Davi. "“How Do You Know Unless You Look?”:
Brain Imaging, Biopower And Practical Neuroscience." Journal Of Medical
Humanities 29.3 (2008): 147-161. Academic Search Complete. Web. 2 May 2013.
Wednesday, May 1, 2013
Medicalization
Medicalization
In order for a condition, disorder, disease, or any other
social “ill” to be recognized by the medical community, it must go through a
process of medicalization. This process varies by the disease and by the
historical moment that it is situated in. Medicalization has been defined as “the
processes through which aspects of life previously outside the jurisdiction of
medicine come to be construed as medical problems” (Clarke, Fishman, Fosket,
Mamo, Shim R169). These processes occur when doctors and researchers come to
see the problem in question as something that could be solved by medicine.
In order to understand the medicalizing process of
generalized anxiety disorder, we must look to its history, which has
unfortunately has been difficult to track. Woodman notes that “The relative mildness of the symptoms and
the high rate of comorbidity with other psychiatric disorders--the highest of
all the anxiety disorders--have caused some to view it as an associated feature
of a number of other disorders rather than as an independent disturbance”
(Woodman 1). One of the first people to deal with anxiety in the medical
community was Freud, who noticed that free-floating anxiety that occurred frequently
in the general population (Woodman 1). Since then, generalized anxiety disorder
was lumped in with other anxiety disorders such as panic disorder and social
anxiety disorder. However, in 1980, the APA decided to separate “anxiety
neurosis (DSM-II) into (1) panic disorder, characterized by spontaneous
episodes of intense anxiety, and (2) GAD, a residual category for patients who
have chronic, sustained anxiety without panic attacks (DSM-III)” (Woodman 2).
This separation was made due to the different reactions patients had to imipramine
and benzodiazepine for panic disorder and generalized anxiety disorder,
respectively.
The history of the
medicalization of generalized anxiety disorder could also be understood as
biomedicalization. Biomedicalization is similar to medicalization, but is
further implicated by capitalism and the commodification of health (Clarke,
Fishman, Fosket, Mamo, Shim R170). Biomedicalization can be understood as how “health
itself and the proper management of chronic illnesses are becoming individual
moral responsibilities to be fulfilled through improved access to knowledge,
self-surveillance, prevention, risk assessment, the treatment of risk, and the
consumption of appropriate self-help/biomedical goods and services (Clarke,
Fishman, Fosket, Mamo, Shim R170).
The biomedicalization of general anxiety disorder is
found within the various medications marketed towards those with anxiety. In
the mid-90s, many medications for depression flooded the market and
demonstrated to pharmaceuticals that there was also the possibility of an “anxiety
market” (Conrad, Leiter 163). They went to the FDA for approval for Paxil as a
drug for panic disorder, obsessive compulsive disorder, as well as generalized
anxiety disorder. Conrad and Leiter argue that the production of Paxil for
these purposes “contributed to the medicalization of emotions, expanding
medical jurisdiction over emotions such as worry and shyness” (Conrad, Leiter
163). Conrad and Leiter note how SAD and GAD were obscure disorders when they
first became medicalized but gained traction as the wording for their criteria
changed with the introduction of new prescriptions (Conrad, Leiter 163).
The recent history of the medicalization of general
anxiety disorder is highly implicated by capitalism and the market. Since the
FDA approved the use of Paxil for SAD and GAD, “GlaxoSmithKline has spent
millions of dollars to raise the public visibility of SAD and GAD, by sponsoring
well-choreographed disease awareness campaigns” (Conrad, Leiter 164).
Paradoxically, these campaigns defined these disorders as both common and
abnormal. They were depicted as common in that the media campaigns demonstrated
that many experienced these symptoms. However, they were still deemed abnormal
as they were subject to medical intervention, in the form of Paxil (Conrad,
Leiter 164). These marketing campaigns were very successful and made Paxil one of
the top three most recognizable prescription medications in 2003 (Conrad,
Leiter 164).
References
Adele E. Clarke, Janet K. Shim, Laura Mamo,
Jennifer Rush Fosket, Jennifer R. Fishman. “Biomedicalization: Technoscientific
Transformations of Health, Illness, and U.S. Biomedicine” (in reader).
Conrad, Peter, and Valerie Leiter.
"Medicalization, Markets and Consumers." JSTOR. American Sociological Association, 2004. Web.
Woodman, Catherine. "The Natural History of
Generalized Anxiety Disorder: A Review."MedScape Today. N.p., n.d. Web. 01 May 2013.
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