Between 1968 and 1972, David Rosenhan, professor in psychiatry at Stanford University, conducted an experiment. Rosenhan wondered if there was really such a thing as a state of sanity and one of insanity, and if they did exist, how one would tell the two apart. He pretended to be a psychiatric patient in order to be admitted to a clinic. The symptoms he had chosen did not correspond to any known case in scientific literature. As soon as he was admitted to the hospital, he stopped feigning symptoms and behaved friendly and correctly towards staff and patients. His goal was to get discharged without help from the outside. How long would it take to be declared completely sane? The answer was: somewhere between 7 and 52 days. (There were seven others who also got themselves admitted to psychiatric wards in different hospitals, with the same feigned symptoms). Many ‘patients’ were diagnosed with schizophrenia, and would often be declared ‘schizophrenic in remission’ on discharge rather than cured, or sane.[1]

The Rosenhan experiment is also described in ‘Mad science – 100 amazing experiments from the history of science’ (Reto R. Schneider, Quercus 2008). In his book, Schneider writes: ‘Once a pseudopatient had been categorized as a schizophrenic during the examination prior to admission, nothing that he did thereafter would rid him of this stigma. Inadvertently, a patient’s case history was skewed in such a way that it always ended up confirming the original diagnosis. […] People appear to be abnormally strongly influenced by predetermined classifications of disorders. If a person is seen as mentally ill, then everything he does is interpreted in this context. [2]

Well, that’s all rather shocking, but 1968, blogger person, that’s more than 40 years ago and this whole TEDxMaastricht 2012 is supposed to be about the future of health. Ah. True.

Well, the past is to be learned from, yes? Don’t make the same mistakes again, and all. Surely we know who belongs in the loony bin and who doesn’t now? Surely we don’t treat people for diseases they haven’t got? We’ve come a long way since 1968, haven’t we?

Yes. A long way. But the road  from 1968 to now is paved with pills. Dr. Ben Goldacre, who writes a blog called Bad Science, writes: ‘Times have changed. The pharmaceutical industry is in trouble: the golden age of medicine has creaked to a halt, the low-hanging fruit of medical research has all been harvested, and the industry is rapidly running out of new drugs. […] because they cannot find new treatments for the diseases we already have, the pill companies have instead had to invent new diseases for the treatments they already have. Recent favourites include social anxiety disorder (a new use for SSRI antidepressant drugs), female sexual dysfunction (a new use for Viagra in women), the widening diagnostic boundaries of “restless leg syndrome”, and of course “night eating syndrome” (another attempt to sell SSRI medication, bordering on self-parody) to name just a few: all problems, in a very real sense, but (…) you might consider that reframing intelligence, loss of libido, shyness and tiredness as medical pill problems is a crass, exploitative, and frankly disempowering act.’

Enter DSM, The Diagnostic And Statistical Manual Of Mental Disorders. Next year, DSM five will make its entrance into the world. It will be marketing people’s wet dream: bigger! Better! With LOTS of new diseases and pills! While even people who helped making DSM 4 admit that they have gone too far and created monsters.

Here’s what the future might look like if we keep gobbling up the dainty morsels thrown at us by the pharmaceutical industries and their aides, and accept that (dare I use the word?) normal behaviour is regarded as a symptom of mental illness, which might stigmatize you for ever:

– Saturday headaches because you got up late and didn’t drink five cups of coffee before your actual coffee break? No, no, no. You suffer from COD (caffeine obsession disorder).

– Just being your average shy birdwatcher with a few kilos too much is só last century. Phlegmatic Overweight Ornithologist Personality (POOP) is what you want to have. (As for the abbreviations: come on, everybody always phrases them so they make a nice word. And I bet pharmacologists have a sense of humour too.)

– Not coping too well with menopause? Women can have Irate Menopausal Personality (IMP) Their partners are PIMPs, Partners of Irate Menopausal Personalities.

– Having a good sex life and a libido to match after your thirtieth? You might be a victim of EVA: Elderly Vixen Abnormality. Don’t worry, there’s a cream that’ll work a treat and we’ll have you down in elasticated beige polyester trousers in no time.

– Medicalization will also change popular culture. James Bond is a sex addict with anger management issues, Superman is suffering from bi-morphic dual personality disorder (BMDPD), and count von Count from Sesame Street has OCD.

Sounds funny, doesn’t it? Wait till you’re refused a job because you suffer from POOP. Not as funny, is it? Don’t want that scenario? Then do as the doctor says, for once:

‘Defining the elusive line between mental disorder and normality is not simply a scientific question that can be left in the hands of the experts. This is a societal issue that transcends psychiatry. It is not too late to save normality from DSM-V if the greater public interest is factored into the necessary risk/benefit analyses.’

In layman’s term’s: if you don’t want to be diagnosed and drugged soon, don’t trust the experts[3] and act now. I remember this old poster that Pandora (a foundation for anyone who has or has had mental issues) had in 1974. It reflected the person looking at it and it had the text ‘Ever met a normal person? And, did you enjoy it?’ I don’t really care what normal is, but I do know that I don’t want Big Pharma to decide whether I am it or not. If you want to put your trust in others, put it in good old Rudyard Kipling, who wrote that ‘if you can keep your head when all about you /Are losing theirs and blaming it on you;/ […] Yours is the Earth and everything that’s in it. (The whole poem can be found here) Keep thinking. Use your brain, no matter how befuddled it is. It is yours and no one elses.

[1]    More information about the experiment can be found here

[2]    Staff from one hospital, when they learnt about the experiment, stated that such things could never happen at their institution. Rosenhan leapt to it and promised to send them a couple of pseudopatients over the next couple of months. Out of 193 admitted patients, 19 were diagnosed as fakers. Only Rosenhan hadn’t sent anyone.

[3]    Fun fact! Fellow patients to Rosenhan and the others who participated in the experiment often expressed their thoughts that the experimenters were not mentally ill at all, long before hospital staff did declare them sane. Or cured. Or at least no longer a danger to themselves, to others, or both.