Why the Medicalization of Everyday Life is Good

(I've posted this at another journal of mine, but I'm reposting it here.)

It is a common claim that Americans take too many drugs, that we are society that is overmedicated. Conditions like attention deficit disorder and depression are said to be overdiagnosed and drugs like Prozac and Ritalin overprescribed. In short, so it is said, we make the mistake of taking ordinary differences in mental and physical abilities as genuine diseases to be treated medically, instead of problems of character that require more complex solutions.

Not only are all of these claims false, but I will argue the opposite: the medicalization of ordinary life is ultimately a positive development.

It never ceases to amaze me that, in a society that develops and benefits from so much of the technological progress of recent decades, opposition to future technologies runs at such a high level. From stem cell research to genetically modifed crops, Americans (as well as many Western Europeans) incessantly cry "it's unnatural!" and invoke the specters of Brave New World and Frankenstein. (Brave New World is perhaps my least favorite book for this very reason.)

This is not the case everywhere, particularly in Southeast Asia, where increasingly more of the breakthroughs in biotechnology are coming from. According to Ramez Naam, author of the superlative More Than Human: Embracing the Promise of Human Enhancement, while a meager 20% of Americans advocate genetic engineering, 63% of Indians and an astounding 83% of Thais do. All the more reason why nations like China and India will overtake the West in the coming century (and why I may have to move to Asia).

What is interesting is that many Americans oppose augmenting human nature through genetic and cybernetic technologies, but have no issue with medical research to treat and cure diseases. The fact of the matter is, however, that research to treat a disease almost invariably can be used to enhance a normal condition.

Let me give but one example to illustrate. Attention deficit/hyperactivity disorder (ADHD) is commonly treated by the drugs Ritalin and Adderall. However, when "normal" indivduals take these drugs, their ability to pay attention and focus also improves.

Why is this? Part of it is the nature of the disease. Attention, like many human traits, is distibuted among the population along a normal distribution, or bell curve. Thus, most of the population falls near the average, with smaller percentages the further away in either direction.

ADHD, instead of being a condition with distinctive symptoms that one either has or does not (one example of this would be schizophrenia), is defined in a way that will include everyone below a certain point in that distribution. In other words, all it means to have ADHD is to be, say, in the bottom 20% (I'm not sure of the precise number) with regard to attention. This would be like saying that the dumbest fifth of the population suffers from "Intellect Deficit Disorder".

To extend the example of our hypothetical "Intellect Deficit Disorder", giving Ritalin only to those diagnosed with ADHD would be like giving a drug that increased intelligence only to those diagnosed with IDD. Such a thing would be absurd; if anyone could benefit from it, why shouldn't it be accessible to all? Many mental disorders, like depression and social anxiety, fall in the same category as ADHD.

Thus far, I have been giving an argument that would seem to oppose the point I'm trying to make. This is because I see "medicalization" as the means to fostering a wider acceptance of the use of medical treatments to improve human abilities. The more people who are diagnosed with these conditions, the more who take drugs, and the better off society is as a whole.

Why? Well consider what these drugs do. Prozac and other Selective Serotonin Reuptake Inhibitors (SSRIs) can work on both the depressed and the healthy (although the effects are not quite the same for everybody) to increase their happiness. The happiness that comes from an SSRI is not the mindless contentedness of Huxley's idiotic "soma" but a kind of increased energy to get things done and a better resilience to the setbacks that everybody faces from day to day. Not only are the conditions for an individual improved, but our economic productivity as a society increases. (This doesn't necessarily entail an overworked population, the value of which is questionable, because if an individual finishes her work sooner, there's no reason why some of her increased productive energy couldn't be devoted to leisure pursuits, should she so choose.)

The major objection here, would be the negative side effects of drugs, for instance, Prozac's sexual side effects. However, as our understanding of biology improves, increasingly selective drugs are developed that produce fewer adverse side effects. There are more antidepressants on the market today that have fewer or no sexual effects; I'm on two myself and experience no discernible impediments.

Thus, I will be honest; I'm being a bit disingenuous with the title of this post. Medicalization in itself is not the good thing, but rather, the acceptance of technological enhancements to human functioning. Quite frankly, the objections to human enhancement are silly (in part because the distinction between pathology and normality is often completely arbitrary) and basically come down to two: one is that it is "unnatural", the other is that unintended side effects could produce negative, even fatal, results.

The first is merely a prejudice, which I won't bother taking the time to refute here (I've done it elsewhere); the second is largely mitigated by the extensive process of animal and human testing that precedes the approval of any treatment for public consumption. This may not answer every objection, but is sufficient for the purposes of this post.

In short, I ultimately think that it should be up to individuals to decide what treatments or enhancements they want for themselves, and in the case of children, families rather than governments should decide. For this reason, I oppose disastrous and wasteful policies like the so-called "War on Drugs", as well as the efforts of radical rightwing organizations to impede the release of drugs that fail to satisfy their rigid and narrow constraints of what is acceptable behavior for human beings.

And really, like I've said, should the US become even more of a society of Luddites and bioconservatives, we will be all the more quickly and easily surpassed by those who lack our prejudices. The development of these technologies ultimately cannot be stopped, and in the future, like all the progresses of humanity in the modern era, history shall recognize those who opposed them as the truly short-sighted ones.