Posted by stan_the_man70 on April 10, 2015, at 9:38:35
In reply to 7 of the Biggest Artists in Medical History, posted by stan_the_man70 on April 9, 2015, at 20:03:12
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http://www.alternet.org/drugs/feeling-intense-emotions-doesnt-make-you-crazy-thats-not-what-big-pharma-wants-you-think
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Feeling Intense Emotions Doesn't Make You CrazyBut That's Not What Big Pharma Wants You to Think
In a new book, Dr. Julie Holland argues that pharmaceutical companies target women and medicate their emotions.
By Allegra Kirkland / AlterNetMarch 30, 2015
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In 2014, a great deal of ink was spilled about the need to stop calling women crazy. Though dismissing women as emotional and irrational is hardly a new phenomenon, a Washington Post op-ed by dating coach Harris OMalley provided the fodder for a thousand blog posts on the subject. As OMalley writes, Its a form of gaslightingtelling women that their feelings are just wrong, that they dont have the right to feel the way they do.According to Julie Holland, a psychiatrist who has had her own Manhattan practice for 20 years, this sort of minimizing attitude does serious damage. Not only does it hurt womens self-esteem, but it leads to women being diagnosed and medicated for psychiatric disorders at higher rates than men. In her new book Moody Bitches, Holland looks at how pharmaceutical industry ads target women, the hormonal differences between genders and our long, dark history of medicating womens emotions. She shared her findings with AlterNet in a telephone interview, which has been condensed and lightly edited for clarity.
Allegra Kirkland: Why did you decide to call your book Moody Bitches? Is it a reclamation of language thats traditionally been used to denigrate women?
Julie Holland: First of all, it was really a joke. I thought it was funny and so did other people I spoke to. Most of my patients are women. I certainly dont typically call women bitches. Part of it was reclamation for sure. That was important to me. If anyones going to call me a bitch I want it to be me.It is a sort of bigger message that its our birthright to be emotionally expressiveto feel deeply and to express what were feeling honestly. I really believe that not only would women be better off if they did a little more of this, but the world would be better off if women arent squelching a big part of them, and if men werent squelching that part of themselves too.
AK: The point of your book and your New York Times op-ed is that women should feel okay experiencing strong emotionsthat its perfectly natural and can even be beneficial for us. But that message also applies to men.
JH: It absolutely applies to men. For sure.
AK: And men are bound by such strict definitions of how to behave in an appropriate masculine way.
JH: Right. This is totally about the suppression of the feminine, not necessarily the suppression of women. Im sorry to use this word, but its about the yin as opposed to the yang. Theres a receptive energy and theres a penetrative energy. Were all trying to be more penetrative and were suppressing a lot of our sensitivity and intuition and empathy. I dont know to what end. It seems to me that its not doing women any good and its not doing society any good. Our world is imbalanced and theres a lot of penetrative energy: missiles and guns and rape and corporate greed and malfeasance. We need more feminine energy and we need to own that. Im not suggesting that people who need psychiatric medications throw them away. That is definitely not my message at all.
First of all, I worked at Bellevue for nine years in the psychiatric emergency room and I saw many very sick patients. And Ive had a private practice for 20 years in Manhattan where Ive seen all kinds of people who really cant get by without medication, be it anti-anxiety meds or sleeping pills. But Im absolutely also seeing a trend where theres a lower threshold for getting on medication, theres a much lower threshold for staying on medicine. People are getting on and staying for decades on medicines that were studied for less then a year. These are medicines that are not approved to be taken for decades. With Prozac, there are people who have been on it since the 80s. And weve learned how difficult it is for some of these people to get off their meds. There is an absolute withdrawal syndromethat isnt always discussed. Keep in mind that 80 percent of psychiatric medications in America are not prescribed by psychiatrists.
AK: Right, you mention in the book that theyre prescribed by general practitioners.
JH: Its also just the new normal. The more women who are on meds, the more its in the mix, its common, you have friends who are taking them, your doctors talking about them, you see all these ads for all these different meds. Did you see the Apple Watch commercial where at the very beginning of this beautiful, glossy video they show you like 20 different versions of the watch? So right away youre not thinking, Should I get a watch or not? Youre thinking, Should I get the silver one or the white one? Youre already advancing the conversation....Were seeing so many ads and people have so many friends on meds and its so easy to just get them from a doctor that its turning from, Should I be on psychiatric medication, to Which one should I take? So thats new. Ive watched it develop over 20 years and its really alarming.
AK: Theres a long history of women being medicated and even institutionalized for invented illnesses like hysteria and frigidity. Do you see the high rates of psychiatric drug prescriptions for women as part of that historical continuum or is this something new?
JH: What Im starting to see more and more are these ads. There are great websites for ads from the 50s and 60s, not just targeting women. Remember at that time Big Pharma could only advertise to doctors. So theyre advertising to doctors basically saying, If this patient is calling you too much and bugging you, heres a medicine that will get her to stop.
The ads now feature everyday women with everyday problems. First of all, there was 9/11, and theres no question that led to an increase in money spent on advertising, targeting women who were scared, who are having a normal response to an unnatural event. The ads were completely targeting them. There was one that just read, Millions can be helped by Paxil.
AK: Which is an incredibly vague statement.
JH: Right. And there were just words: "worry," "anxiety," with a picture of a woman clutching her handbag walking down a city street. It was genius. It was evil genius, but it was genius. And now what theyre doing is killing me. I dont know if youve seen those binge eating disorder ads. Shire makes Adderall, which is generic now, so the only brand amphetamine Shire has left is Vyvanse, which is a medicine for ADHD. Its an amphetamine just like Adderall but it lasts 12, 13 hours. They paid some doctors and they paid for a full-page ad in the journal that the study ran in, and it says in the journal that they also paid the writers and the editors. So they have this Shire-paid, really crappy study showing that at high dosage every single day for weeks, Vyvanse separates out from placebo. Basically, they show that if you give a woman high-dose amphetamines every day, she will binge less.
They have ads where they show a woman surrounded by pizza and hamburgers and donuts and it says, "If you eat more than you want to and you feel guilty afterwards, you may have this disorder." Which is sort of like saying, "If youre a woman, you have this."
First of all, if youre not on the pill and youre not on SSRIs, youre going to go through a certain day or two when youre eating more carbs or sweets before your period. They have ads for doctors where they say "binge eating disorder is a shameful disorder and your patient may not volunteer this information so be sure to ask whether theyre eating too much and feeling guilty about it." F*ck*ng Shire. Its not bad enough that all of these kids are taking their meds. They want to get some women hooked on speed before their patent expires. These are addictive medicines. And theres no evidence that this disorder has any pharmacological basis that needs to be medicated.
AK: You write that psychiatric drug prescription rates are highest for women between the ages of 35 and 64. This overlaps with the time when women are most likely to be raising families and at the peak of their careers. Do you think women are trying to handle all of these stressors and thats why they are asking for and receiving psychiatric medications at higher rates?
JH: This is not going to go over well, but Im going to say a couple of things. First of all, perimenopause symptoms in terms of insomnia, irritability and mood changes happen all through your 40s. People have this idea that menopause is a one-day event that occurs some time in your mid-50s. Its not. Its a marathon of symptoms through most of your 40s, into your 50s; it can last 7-14 years.
The other issue is that my practice is full of women in their late 30s and early 40s who would like a child. Maybe theyre not dying to be married, but theyd like a child. And they would prefer it to be in a monogamous relationship. And theyre living in New York City where guys have a shelf life til they are 50 and no one really wants to commit because its possible they can upgrade somewhere else. And theyre not happy. Theyre freaking out because this is something they always thought they were going to have and they wanted but theyre not getting.
So one thing I came across in the three years of researching this book is that there is evidence suggesting that SSRIs are interfering with mating. We already know that contraceptives totally interfere with mating, but it turns out that SSRIs also do so. I have so many patients that are on an SSRI and an oral contraceptive. In New York City that is a very common combination of medication, and it has a real impact on mating and sexuality. Im afraid its this kind of self-fulfilling prophecy where people are unhappy because theyre not mating, but theyre on drugs that completely interfere with their ability to mate.
AK: The American Psychiatric Association says men are much less likely to seek treatment for anxiety and depression. Could that skew the rates at which women are diagnosed and medicated?
JH: If you look at other cultures there isnt this two-to-one difference. There does seem to be a definite issue with hormones, in that if you look at kids rates of diagnosis of depression, or if you look at post-menopausal women versus men in that age group theres not this two-to-one difference. But there is that difference when women are cycling, say from around 12 to 55.
AK: Two-to-one difference in terms of rates of diagnosis?
JH: Yes. Theres no question that men are more reluctant to seek psychiatric help. Thats always an understanding in psychiatric care that there are a lot of men who are undiagnosed who really need treatment but arent getting it because there is still a lot of stigma there. Theres very little of that for women. But it is this suppression of the feminine thats at play.
AK: In some of the responses to your op-ed, some people took issue with framing mental health issues in relation to gender because, of course, not all men and women are the same. There are plenty of sensitive, intuitive guys and plenty of women who have no patience for the sob stories of others. Hormones obviously play a role, but how much can really be attributed to biology versus culture and nurture?
JH: You cant really pick them apart. A 300-page book is very different than an 800- to 900-word op-ed.There were major things I wanted in that piece that got cut out. Like I said in the beginning, there is the feminine, this yin and yang, in everyone. Not one person is all feminine or all masculine; were all a mix. Gender is fluid. I understand that. But I have to make some generalities. Id say that everything I say in Moody Bitches that isnt about hormones applies to both men and women. I think that the suppression of the feminine is a problem in both genders and the world needs more yin energy.
AK: I guess the only other concern is that it can end up reinforcing sexist stereotypes. Back when Hillary Clinton was running in 2008, members of the press actually asked if we could have a female president because she might get moody during her period. Maybe that connection could be reinforced in peoples minds?
JH: The other thing Id say is that moody doesnt necessarily mean hysterical. That someone can be emotionally expressive is not a bad thing. Thats sort of the message people are missing here. Im sorry for the shorthand; I just didnt think the title "emotionally expressive women" would sell books. But thats what Im talking about. The idea that a woman who is in tune with her body and knows how she feels and can speak her mind about it, that is scary to men. Emotionally expressive does not mean unstable.
AK:Some responses to your piece expressed concern that people who do genuinely need psychiatric help or medication would be discouraged because theyll think they can just get through it or that their feelings are within the range of normal. So where do we draw the line?
JH: I am not anti-medication in the right situations. These pills work. They make people feel happier and more relaxed. I get why people take them. But I am suggesting that there are healthier ways that are less of a quick fix that I think some of these people who are on meds should try. The whole survival guide section of my book is about that. You can add all these things to meds, or you can do them instead of taking meds. This idea that youre going to go to your internist or family doctor and get the same thing from them in six minutes that you get from talking to a therapist for an hour-long initial evaluation is ludicrous. You have to find out what the family history is, what the genetics are, whether theres been any medication use in the past and what the response has been. I fear people are taking it less seriously.
The other thing that I would say is I have patients who take a little dose of SSRIs just in the week before their periods; I have patients who take medications during the winter but not the rest of the year. You dont have to take a daily dose for years on end just because you have these phases where your mood is changing. You can take a more targeted approach instead of this blanket method. But obviously there are people who really do need their medication and I do not want to encourage them to man up. What Im saying is, dont repress or be scared to be sad or upset. The only reason were repressing all these feelings is for the comfort of other people, and I think thats a huge problem.
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For a record of all of Dr. Hollands sources, see the notes section on moodybitches.com.
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Allegra Kirkland is AlterNet's associate managing editor. Her writing has appeared in the Chicago Reader, Salon, Daily Serving and The Nation.
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