Trends: From Anxiety to Depression and Back Again

Release Date: March 25, 2010 | By Maia Szalavitz, Contributing Writer
Research Source:

Poet W.H Auden dubbed the post-World War II nuclear era the “age of anxiety” and indeed, at the time, anxiety disorders were the most commonly diagnosed mental illnesses. Yet, by the 1990’s, American psychiatry was “Listening to Prozac” and instead of obsessing about angst, it focused its attention on depression.

Now, however, a new article in the The Milbank Quarterly by sociologist Allan Horwitz, dean for the social and behavioral sciences at Rutgers University, suggests anxiety could rise again.

Although conditions involving anxiety and depression are currently divided into several different disorders in psychiatry’s Diagnostic and Statistical Manual of Mental Disorders (DSM), most people who suffer from depression also experience anxiety — and vice versa. As a result, prevailing psychological theories and pharmaceutical industry marketing have tended to determine which diagnosis predominates.

“In the 1950s and ’60s, anxiety was the core non-psychotic condition for psychodynamic theory which was by far the dominant theory,” said Horwitz, referring to therapy based on the ideas of Sigmund Freud. At the same time, drug companies were beginning to market drugs known as “tranquilizers”— like Miltown, Valium and Librium — as anxiety treatments.

By the 1980s, however, a backlash against both Freud and tranquilizers had developed, Horwitz said, and a media panic over the idea of addiction to tranquilizers captivated the public.

“In my opinion, this is a bad rap,” said Edward Shorter, professor of the history of medicine and psychiatry at the University of Toronto. While benzodiazepine drugs like Valium can be addictive, research shows that the vast majority of people who become addicted to them are users of multiple other drugs as well — not people using them medically.

Rather than fight the growing stigma attached to anxiety drugs however, manufacturers started heavily advertising antidepressants like Elavil (amitriptyline). Then, in 1987, they introduced Prozac — and marketed it and similar drugs as fixing the “brain imbalance” associated with depression.

In 1962, 12 million people had been diagnosed with anxiety disorders and just 4 million were labeled depressed—but by 1975, 18 million people were diagnosed as depressed, compared with just 13 million with anxiety disorders. According to Horwitz, by 2000, 10 percent of the American population received antidepressant prescriptions.
Recently, however, there has been somewhat of a backlash. “You are starting to see some reaction against them,” Horwitz said, noting the recent controversy over whether antidepressants are even superior to placebo.

“There’s also the corruption of psychiatrists collaborating with the pharmaceutical industry, the suppression of negative results, the suppression of things like the data on these drugs raising suicidal ideation,” Horowitz said. Consequently, he predicts a shift back to a focus on anxiety, with the panic over tranquilizers largely forgotten.

“This makes physicians sound like idiots,” Shorter said. “But they are very much the prey of drug-company advertising. Whatever diagnosis is being advertised will end up as the diagnosis given clinically. That is the reality.”

# # #
FOR MORE INFORMATION:
Reach the Health Behavior News Service, part of the Center for Advancing Health, at hbns-edtior@cfah.org or (202) 387-2829.

The Milbank Quarterly: Heidi Bresnahan, director of publications, at (212) 355-8400.

Horwitz AV. How an age of anxiety became an age of depression. The Milbank Quarterly 88(1), 2010.

Supporting Documents

How an age of anxiety became an age of depression.

Tags for this article:
Depression/Anxiety   Mental Health  



Comments on this article
Please note: CFAH reserves the right to moderate all comments posted to the Health Behavior News Service. Any inappropriate postings will be removed.

sadnessaddiction says
March 26, 2010 at 8:13 AM

Pristiq's advertising is directly targeted at manipulating normal healthy women to want to be medicated. Women must stand up to big pharma’s bullying them to over-medicate with antidepressants washing out their emotions & personalities and interfering being mothers, sisters, brothers, daughters, partners and lovers.. Women are targeted for antidepressants by big Pharma in the same way that tobacco companies targeted us 70 years ago. Drug companies are so effective at selling unhappiness to women that women take more than twice as many antidepressants as men.Like effexor Wyeth/Pfizer plans on using modern marketing techniques and direct payments to doctors to have Pristiq over prescribed instead of used based on evidence based diagnosis. http://sadnessaddiction.blogspot.com/