The wide usage of antipsychotic medications may indicate social rather than biological etiology

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3 Responses

  1. Baxter says:

    Speaking from experience as someone with bipolar disorder, I think that under-diagnosis would be much more of a problem than over-diagnoses. Of course it’s never good to take chances with a child’s health in either case, but maybe it’s best to err on the side of caution, and treat the illness even if it’s only suspected, before it gets worse.

  2. Keri Iyall Smith says:

    What a fascinating question you raise in this post “Can we effectively say that anything is a purely biological condition?” What do you think?


    • Well, the evidence is mixed but I think the answer is no – nothing is altogether biological, just as nothing is entirely social. I think the issue is the notion of “purely biological.” While this is how the medical fields (particularly in the last several decades) have framed illness, continually pushing for the consideration of biological etiology over all other possible sources of illness, it seems quite evident that we simply don’t know what CAUSES illness. There is clearly a biological element to all of these conditions, given that they often respond to medication and that the body is simply a biological organism, but that doesn’t mean that the root cause is in the body. Biology, after all, responds to social stimuli. And, while there’s uncertainty (no matter what anyone claims to know) about etiology, there’s actually quite obvious evidence of social effects on symptoms. So, I think maybe a more relevant question than the one I posed is actually what these changing notions of illness tell us about the social – so, taking it as a given that nothing is purely bio or social, what’s the message about social influence or environmental influence if there is increasing evidence that biology is not the only important factor? Also, I think this is an interesting moment to look at over-diagnosis because it seems possible that there is another option — which is that there is a biological phenomenon that causes certain illnesses (though I’m not sure which ones) but that then, the diagnostic category is used to identify conditions that seem similar, but which might not actually be identical. So, we wind up with people with possibly biologically-driven symptoms lumped into a category with people whose symptoms may appear similar but are not in fact the same. So I guess the answer is that I’m not sure, but I tend to think that there is a fine line (though a real one) between disease and conditions that may appear similar but are more transient or caused by situations. This is a fairly similar argument that Allan Horwitz and Jerome Wakefield’s argument about depression and “normal sadness” and I think it’s one that usefully assimilates social constructions arguments alongside the biological evidence. In the end, I guess my answer would be that I think sociologists and biologists alike should focus more on the intersection of the bio and social.

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