Does 'Popping a Pill' turn Normal into 'Abnormal'?

When does an everyday ‘problem in living’ become a mental health problem?

Posted Feb 13, 2015

It is worth considering when an everyday ‘problem in living’ becomes something that should be categorised as a mental health problem. It is a fact of life that we all have to deal with difficult life situations. Sometimes these may make us anxious or depressed, sometimes we might feel as though we are ‘unable to cope’ with these difficulties. But they are still problems that almost everyone encounters. Many people have their own strategies for coping with these problems, some get help and support from friends and family and in more severe cases perhaps seek help from their doctor or GP. However, at what point do problems of living cease to be everyday problems and become mental health problems?. In particular, we must be wary about ‘medicalising’ problems in daily living so that they become viewed as ‘abnormal’, symptoms of illness or disease, or even as characteristics of individuals who are ‘ill’ or in some way ‘second-class’.

Below are two useful examples of how everyday problems in living might become medicalised to the point where they are viewed as representing illness or disease rather than normal events of everyday living.

First, experiencing depression is the third most common reason for consulting a doctor or GP in the UK, and in order for GPs to be able to provide treatment for such individuals, there is a tendency for them to over diagnose mild or moderate depression (Middleton, Shaw, Hull & Feder, 2005). This may have contributed to the common view expressed by lay people that depression is a ‘disease’ rather than a normal consequence of everyday life stress (Lauber, Falcato, Nordt & Rossler, 2003). If lay people already view depression as a ‘disease’ or biological illness, and GPs are more than willing to diagnose it, then we run the risk of the ‘medicalisation’ of normal everyday negative emotions such as mild distress or even unhappiness.

Second, some clinical researchers have argued that the medical pharmaceutical industry in particular has attempted to manipulate women’s beliefs about their sexuality in order to sell their products (Moynihan, 2003). Some drug companies claim that sexual desire problems affect up to 43% of American women (Moynihan, 2003), and can be successfully treated with, for example, hormone patches. However, others claim that this figure is highly improbable and includes women who are quite happy with their reduced level of sexual interest (Bancroft, Loftus & Long, 2003). Tiefer (2006) lists a number of processes that have been used either wittingly or unwittingly in the past to ‘medicalise’ what many see as normal sexual functioning—especially the normal lowering of sexual desire found in women during the menopause.  These include (1) taking a normal function and implying that there is something wrong with it and it should be treated (e.g. implying that there is something abnormal about the female menopause, when it is a perfectly normal biological process), (2) imputing suffering that is not necessarily there (i.e. implying that individuals who lack sexual desire are ‘suffering’ as a result), (3) defining as large a proportion of the population as possible as suffering from the ‘disease’, (4) defining a condition as a ‘deficiency’, disease or disease of hormonal imbalance (e.g. implying that women experiencing the menopause have a ‘deficiency’ or sexual hormones), and (5) taking a common symptom that could mean anything and making it sound as if it is a sign of a serious disease (e.g. implying that lack of sexual desire is a symptom of underlying dysfunction). While sexual dysfunctions are sometimes caused by medical conditions, lack of sexual desire and interest is itself often portrayed as a medical condition in need of treatment. Yet a reduction in sexual interest and desire can be a healthy and adaptive response to normal changes in body chemistry or as a normal reaction to adverse life stressors or relationship changes. ‘Medicalising’ symptoms in this way leads to us viewing what are normal everyday symptoms and experiences as examples of dysfunction or psychopathology.