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.