The two primary (New York) intellectual organs, the New York Review of Books and The New York Times, have recently featured two powerful cultural icons saying exactly opposite things.
Marcia Angell, the first woman editor-in-chief of the New England Journal of Medicine and now at the Harvard Medical School, in an ongoing, two-part series in the New York Review of Books (part 1 of which is in the June 23 issue), argues against the firmly ensconced American view that mental illness can be (and it has been) resolved to brain functioning.
The New York Times, for its part, once again supports, with a profile of Nora Volkow, the visionary director of the National Institute on Drug Abuse (NIDA), the slightly more come-lately view of addiction as a brain disease.
Angell has fought her way to cultural icon status by combating the medical-pharmaceutical-industrial complex, first in her position as editor of the NEJM, and subsequently from her ethics perch at Harvard (where she also sometimes treads on toes).
Angell is naturally led to an anti-brain-disease position because it has been fostered and foisted by the pharmaceutical industry with which she has been warring. Quoting her in the New York Review of Books, the modern "psychiatric revolution" appeared due to "the emergence over the past four decades of the theory that mental illness is caused primarily by chemical imbalances in the brain that can be corrected by specific drugs." This revolution was spearheaded when the antidepressant "Prozac came to market in 1987 and was intensively promoted as a corrective for a deficiency of serotonin in the brain."
Today, Angell points out, 10 percent of all Americans over the age of 6 are on antidepressants. This figure must grow, since younger Americans are being medicated at a much higher rate than current adults - there was a 350 percent jump in youth mental illness diagnoses in the two decades after the introduction of Prozac, a figure that continues to climb.