Humanity has a breadth and depth to it. We are not all the same. It is interesting then how some differences are accepted and others are not. It is particularly interesting how some differences are increasingly been made into diseases. The medicalization of human behavior is a real trend. If a human trait can be reclassified as a disease, then suddenly there is the potential to “treat it”, especially with a pharmaceutical agent.
Let us look at a ridiculous example. Height can vary considerably. Whilst there are genetic causes at the extremes of the height range, the vast majority of people are either to the taller or shorter end of the spectrum. It is not considered a disease to be five feet high even though this is at one edge of the range.
So why is it then that with behaviors we are increasingly regarding those towards one edge of the spectrum as having a disease? ADHD is a classic example of where particular traits have been reclassified as a disease and the people, mainly children, involved have been put on drugs. Attention spans like everything else vary, but this is not to say those at one end of the scale have a disease, particularly when these children usually have other talents which the school system may not recognize or reward. Even allowing for the fact that some children may have difficulty with sitting still, that does not make it a disease.
Shyness is another human trait. Some of us are more outgoing than others. In the 1990’s this was reclassified as Social Affective Disorder and people were treated with antidepressants. This has fortunately gone out of vogue. If shyness is a problem to people then there are ways of dealing with it; it does not make it a disease.
In a similar way the concept of depression has been expanded to include everyone who feels down. If it is not a disease to feel happy after winning the lottery, then it is not a disease to feel down, for example, after a death of a loved one or relationship breakdown. Whilst some people do have genuine depression, many others now come under this banner for basically having human emotions, which are reclassified as a disease.
We saw in the 1980s the reclassification of menopause, which is a normal part of life, as a disease. Many women were placed unnecessarily on hormone treatment, which was found to cause more harm than good. Some of the issues surrounding clinical trials, which supported hormone treatment, are still being investigated.
Some men at times have difficulty getting an erection. This is not new and is not a disease but was reclassified as one and named erectile dysfunction. Sure if taking a tablet helps you and you want to take one, then do so, but do not call it a disease. The latest attempts will be to make premature ejaculation and jet lag into diseases. Neither is. The first can be distressing and can be dealt with. The second is the obvious result of our ability to move time zones more quickly than our body can cope with. Calling sex addiction a disease is just making excuses for people who choose not to control their behavior.
The bottom line in all this is that a drug looking for a disease always accompanies the reclassification of a human trait, emotion or tendency. If people want to use pharmaceutical or even illicit drugs because it makes them feel a certain way or allows them to do something they might not otherwise do (remember the songs written in the 1960’s under the influence of substances) then the rights or wrongs of this can be debated.
However let us not use the label of disease to justify our actions and certainly let us not reclassify normal parts of life as a disease especially if the main reason is to boost the sales of pills.
Medical Doctor, author, speaker, media presenter and health industry consultant, Dr Joe Kosterich wants you to be healthy and get the most out of life.
Joe writes for numerous medical and mainstream publications, is clinical editor at Medical Forum Magazine, and is also a regular on radio and television.
Joe is Medical Advisor to Medicinal Cannabis Company Little Green Pharma, Chairman of Australian Tobacco Harm Reduction Association and sits on the board of Arthritis and Osteoporosis WA. He is often called to give opinions in medico legal cases.