Most people blame Big Pharma and the docs in its pocket for elevating everyday anxiety to depression, depression to bipolar disease and childhood behavior problems to major psychiatric diseases.
But there are others to thank for the national pathology of creating and treating diseases that aren't even there.
There's the 200 US medical education and communication companies (MECCs) who ghostwrite journal articles for Big Pharma--"just sign here, Doc; we've reviewed the data"--for $20,000 to $40,000 per article.
Like Complete Healthcare Communications (CHC) whose phalanx of 40 medical writers, editors and librarians has submitted over 500 manuscripts to journals for clients Pfizer, Sanofi-Aventis, Wyeth, Schering-Plough and AstraZeneca according to its promotional materials, with an acceptance rate of 80 percent.
And the MECC which wrote up the Merck-designed and paid for Vioxx trials less the death data which ran in Annals of Internal Medicine first author of the Advantage study Jeffrey Lisse recounts to the New York Times.
And of course there are the medical journals themselves which can make $450,000 off one article reprint as Big Pharma disseminates its messages under their masthead ("look, Doc--it says RIGHT HERE") and untold ad page revenues.
In 2006 Journal of the American Medical Association (JAMA) editor in chief Dr. Catherine DeAngelis had to apologize for Big Pharma tainted articles defending antidepressants during pregnancy and linking migraine with coronary risks in women. The docs were getting money from antidepressant and heart medication manufacturers respectively. But ten months later she ran a pro Fosamax--a Merck drug--article about a study "designed jointly by the non-Merck investigators and Merck employees" and "supported by contracts with Merck and Co."
Three Merck authors on the study disclosed they potentially owned Merck "stock and/or stock options" and the article's 11 other authors disclosed 40 research grants, consultancies and other financial relationships with drug companies including Eli Lilly, Pfizer, Roche, SmithGlaxoKline, Wyeth, Novartis, Procter & Gamble and Merck.
Last summer the AMA was also criticized for earning $50 million a year selling the names, office addresses and practice types to data miners and detailers the better with which to sell doctors drugs.
Hey, doctors can opt out of the program says the AMA.
Of course advertising and public relations agencies have also helped the national thrall to Big Pharma by portraying a bad day as a Prozac deficiency, unruly children as Ritalin deficiencies, insomnia as an Ambien deficiency and old age as a hormone deficiency.
Slick PR firm, Cohn and Wolfe, is credited with vaulting "shyness" to a national psychiatric problem the answer for which is Paxil and creating faux grassroots patient groups like Freedom From Fear to push their clients' drugs.
And Wyeth's ad agency serenaded the nation with the message in its The Change You Deserve campaign that if we were not enjoying things the way we used to do, if we were lacking in what agencies used to call get-up-and-go, it was time to go on the antidepressant Effexor.
But Mr. and Ms. Plasma TV Screen are not off the hook either.
As long people ask themselves, "I wonder if I have Restless Legs Syndrome?" "Excessive Sleepiness?" "Intermittent Explosive Disorder?" they've taken the bait.
As long as people derive more of a thrill out of dosing and experimenting on themselves--in spite of the dangerous side effects and sometimes because of them--than having a life in which they define the problems and answers, Big Pharma has its living room lab animals.
Martha Rosenberg is a cartoonist for the Evanston Roundtable in Evanston, Illinois.