The experience of psycho-pharmaceutical drugs as a circulating commodity at the global scale has been documented by journalists, but it is an area not widely explored by anthropologists. Most anthropology (see Sue Estroff) has ethnographically assessed psychiatric wards and other sites of medical care in the United States and Western world, but aside from the work of Arthur Kleinman in China, it seems that most psychological anthropology addresses cross-cultural emotion states (Unni Wikan, just to name one example).
I was recently reading an special issue in Culture, Medicine and Psychiatry (Issue 36, 2012) that observed the dearth of research performed on people's experiences of psychotropic drugs from an anthropological perspective. Allison Schlosser and Kristi Ninneman from Case Western Reserve University note that this is a largely unexplored area of research that must be probed through the question of pharmaceutical efficacy and how these drugs are interpreted in the everyday lives of patients. After reviewing some of this literature, I feel as if the gaps in information could be partially filled by the work of Neil Thin of the University of Edinburgh, who studies well-being and happiness. In his book, Social Happiness, Thin notes that
"Inflationary prescription of anti-depressant drugs continues, despite clear empirical evidence that for most patients the benefits, if any, are largely due to placebo effects that could be achieved more cheaply, sustainably, and effectively by psychotherapy and/or social therapy" (Thin 2012:11).
Thin's astute observation of this fact has led him to devise a policy-driven scheme guided by the observation of happiness, which is aligned with some of the work by Economist Richard Layard of the LSE, who writes widely on these issues. However, I would propose: could it be that happiness is a cultural artifact of a broader social memory with regard to Western conceptions of well-being? After reading Paul Connerton's How Societies Remember, it is clear that personal memory claims, in which we can configure ourselves as interpolating our pasts, also contain elements of unconscious manipulation, as provoked by the process of recalling particular events in the social sphere.
With this being said, which is more 'sticky' in our brain: the memory of negative, traumatic personal memories OR those of which create positive transformations? How does our mind negotiate this? It is clear that memory has great relevance to traumatic experience and the study of Post-Traumatic Stress Disorder (PTSD), however, the European memory of the Great War, an example cited by Connerton, as well as the American memory of President John F. Kennedy's assassination reflect negative events. However, the autobiographical construction of these events, which is seemingly an intentionally-driven process, is abstracted in the sense that there is a conditioning process, partially influenced by the histories that are learned in school.
What kinds of medical pathologies are learned and constitute an essential part of our remembered experiences of illness? The first that comes to mind is the Red Cross, an international organization that played an integral role in providing medical intervention in the midst of several World Wars. However, governments also intentionally create this 'remembered' medicalized past in which there was once a time in which vaccines, pills, and doctors were either scarce, less effective, or non-existent. This is a persistent trend throughout the history of medicine, which is projected as 'evolving' throughout time with advancements in technologies that undergird it. Yet, has the field of medicine advanced in the realm of mental health? Why are these drugs considered so problematic at large and if they cause such negative side effects, why are they still prescribed? What makes them so salient culturally and in the field of medicine? When was this field established and what kinds of sociocultural and historical trends arose in conjunction with the rise of psychiatric medicine and treatment? Can this be an extension of our learned, social memory?
I ask this complex set of questions in order to better refine my own ideas, however, I hope to engage others in this debate. I have read some historical accounts of this rise, such as Happy Pills in America, but there seems to be little anthropological assessment of some of these inimical issues within the field of medicine.