Glorified madness: The birth of psychopharmaceuticals

The podcast discusses the birth of psychopharmaceuticals and their influence on our perception of mental illness. It explores the shift in mental health perception after World War II and the transition towards biological approaches to psychiatry. The podcast also highlights the development and popularity of drugs like clopromazine, Miltown, Valium, and Prozac. It discusses how drug companies targeted women to promote tranquilizers as a solution to everyday stresses. The Valium panic in the 1970s raised concerns about dependence on tranquilizers. The podcast also mentions the marketing of antidepressants like Prozac and the increase in diagnoses of anxiety and depression. It emphasizes the importance of psychotherapy and the difficulty in accessing it compared to drug treatment. The podcast concludes by noting that prescription drugs are no longer glorified in the media and there is more emphasis on alternative ways to maintain mental health. Overall, the rise of psychopharmacology has Welcome to my podcast, Glorified Madness, where I'll be discussing the birth of psychopharmaceuticals and how their emergence has influenced our perception of mental illness today. I will start by providing some background on how psychopharmacology first came about, highlighting key pioneering drugs before delving into how the media glorified their use in treating mental disorders, all of which is covered in Hertzberg's Happy Pills in America, from Milltown to Prozac. In post-war America, there was a shift in people's general perception of mental health. World War II revealed that anyone could develop a psychiatric illness, as even high-ranking soldiers that were fined before the war left the front line with shattered minds. This shifted away from ideas about degeneration and mental illness being solely hereditary. Meanwhile, Freud's psychoanalysis still dominated American ideas about mental illness and how best to treat it. Yet the 1950s saw a transition towards biological approaches to psychiatry, facilitated by the growth of the pharmaceutical industry. This period was also referred to as the post-penicillin boom, with companies competing to discover the next revolutionary drug, which turned out to be the psychotropics. Clopromazine was the first one to be discovered in 1951. It was marketed as a major tranquilizer for conditions like schizophrenia. However, its side effects limited widespread use. Nevertheless, clopromazine was a pioneer for psychopharmacology, providing the foundation for future drug developments. Researchers were still on the hunt for a drug indicated for anxiety, leading them to synthesize the minor tranquilizers, the first one being Miltown in 1955, a relaxing anti-anxiety so-called happy pill. Sales skyrocketed and it paved the way for the generation of Axialytics. However, it was soon replaced by the benzodiazepines, Librium and Valium, both of which became incredibly popular with companies achieving record-breaking sales. In fact, by the 70s, Valium became the most frequently prescribed drug, not just in America, but across the entire world. Why was this the case, you might ask? Well, they became a part of Hollywood culture. Celebrities went crazy for these don't-give-a-damn pills. Even the president at the time, John F. Kennedy, was taking them. But soon enough, they would grasp the public's attention through local appetizing. The minor tranquilizers were known as women's drugs. After the war, women were no longer required to work in factories, something which many had grown to like. In fact, it was reported that 80% of women wanted to keep their jobs, but it was argued that this would ultimately undermine males. Hence why drug companies tried to re-establish gender roles by placing women at the forefront of their campaigns. Women were encouraged to stay at home where their day-to-day life would revolve around cleaning, cooking and caring for their children. These housewife-y roles often took their toll on women, causing them to be more stressed and generally discontent with their lives. Drug companies argued the solution to this was their mother's little helpers. Yet these stresses were simply a part of everyday life. But still, women were urged to reach for the medicine cabinet to help take the edge off. It wasn't just housewives, though. Many ads featured stinktos. At the time, it was unusual for women to not marry. So unusual that it made people believe that there must be some underlying illness. Picture this, a sequence of photos of a middle-aged woman captured alongside her father, the only important man in her life. In the final photo, we see her standing alone, an anxious woman mourning his death and feeling a sense of failure for never marrying. This was in fact an ad for Valium, a drug believed to cure these types of women who were not neurotic at all. They were simply manipulated into thinking that tranquilizers were the answer to all life's problems. Believe it or not, happy pills were promoted just as much as other consumer goods. You could find them on TV, in newspapers, magazines. It's no wonder that there was such a big issue with overprescribing. In fact, it was reported in the late 50s that more than 10% of miltown prescriptions were given to patients without any reason. Psychopharmaceuticals formed a substantial part of consumer culture. They were exploited for commercial use with companies trying to generate as much profit as possible. Patients were regarded as consumers above anything else. Hertzberg's book takes a dark turn after the mid-1970s when he describes the Valium panic, an episode in drug history marked by growing concerns about the nation's dependence on tranquilizers. The distinction between prescription and recreational drugs became blurred, with Valium being revealed as the single most common drug found in overdose patients. News about the dangers quickly spread, raising alarm bells for the typical users, white middle-class women. These new claims against tranquilizers supported the women's health movement who heavily criticized Valium as a form of mind control enforced by a sexist society. They argued that these drugs were used to force women into their stereotypical roles and suppress what they deemed as unnatural emotions. After years of being under scrutiny, Valium's popularity diminished. Prescriptions reduced to less than half of what they were in previous years. Following the Valium panic, we exit the age of anxiety and enter a new era of depression, a disorder believed to be much rarer with milder forms just being symptoms of anxiety. However, researchers soon discovered that depression was in fact a disease itself that had been plaguing America all along. This led to the marketing of antidepressants like Prozac in the 80s. Prozac became the new blockbuster drug, accounting for around 45% of all prescribing drugs by the end of the century. Once again, depression was advertised as a woman's illness, although it was now related to how the death of their husbands or their children fleeing home left women feeling a sense of worthlessness. They called it the empty nest syndrome. Even though antidepressants were not addictive like Valium, people still became heavily reliant on them. The New York Times once reported a woman who had no intention to ever stop taking them, even if they were to affect her vital organs in the future. Their popularity continued to soar through the 90s when the FDA lessened restrictions on drug advertising. Around the same time, Wurzel published Prozac Nation, revealing the dark reality of depression. She expressed how it seemed like every person she encountered from any sort of background was on Prozac, as if depression had become some sort of trend ultimately mediated by drug campaigns. Though it was not all doom and gloom for this new age of depression, as Prozac also advanced neurochemical ideas into the etiology of the disorder. Antidepressants help to explain mental illness in biological terms, specifically the role of neurotransmitters like serotonin in creating chemical imbalances. Looking at the development of psychopharmacology has allowed us to distinguish between normal life stress and legitimate disorders like anxiety and depression, both of which can now be explained with neurochemistry, making diagnoses more accurate. Perhaps it is why they are currently the most diagnosed mental disorders, as we now have a better understanding of mental health. This increase in diagnosis correlates with the constant dispensing of anxiolytics and antidepressants. Although they're now given out for legitimate reasons, over-describing remains an issue. Doctors are simply providing a quick fix by chemically targeting the symptoms without assessing the psychological cause. Whereas psychotherapy has been regarded as a more effective treatment for depression, it may have disappeared for some time during the excitement surrounding pharmaceuticals, but psychotherapy still stands strong in treating mental illness. Unfortunately, it's much harder to access. Psychologists are in short supply and the sessions themselves are expensive, hence why drug treatment still dominates like it did in the late 20th century. In spite of that, we have still learned from history as prescription drugs are no longer glorified in the media. Nowadays, you will not find any form of propaganda that would encourage people to request pills for managing everyday stress. Advertising them is strictly prohibited, a very contrasting picture of what was seen in the 60s and 70s. If anything, there is now more information distributed about other ways you can look after your mental health, such as getting regular exercise. Taken together with psychotherapy, there is now a lot more emphasis on using drugs as an adjuvant. It's just proven to be difficult to put this into practice in this current climate. So from what I've covered in this talk, you can appreciate how the rise of psychopharmacology has majorly shaped modern day psychiatry. The development of psychotropics ultimately provided the link between psychiatric disorders and dysfunctional neurotransmission. Although the pharmaceutical industry still thrives off mental illnesses, the drugs they produce are no longer hailed in the media and promoted for everyday use. All in all, knowledge of the history of madness has ultimately aided our understanding of mental health as we know it today. Thank you for listening.