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Creating Disease: Big Pharma and Disease Mongering

Posted: 06/18/10 09:00 AM ET

You may think there is enough disease in the world already, and that no one would want to add to the diseases that we humans must deal with. But there is a powerful industry in our society that is working overtime to invent illnesses and to convince us we are suffering from them.

This effort is known as "disease mongering," a term introduced by health-science writer Lynn Payer in her 1992 book Disease-Mongers: How Doctors, Drug Companies, and Insurers Are Making You Feel Sick. Payer defined disease mongering as "trying to convince essentially well people that they are sick, or slightly sick people that they are very ill." This strategy has also been called "the corporate construction of disease" by Ray Moynihan, Iona Heath and David Henry in the British Medical Journal. "There's a lot of money to be made from telling healthy people they're sick," they say. "Pharmaceutical companies are actively involved in sponsoring the definition of diseases and promoting them to both prescribers and consumers."

Disease mongering got rolling in 1879 with the invention of Listerine, which was originally considered a surgical antiseptic. It was named for the famous English surgeon Joseph Lister, who performed the first antiseptic surgical procedure. Soon, however, Listerine's inventors, Dr. Joseph Lawrence and Jordan W. Lambert, were selling it in concentrated form as a floor cleaner and as a treatment for gonorrhea. In 1895 they began to market it to dentists for oral care, and in 1914 it became the first over-the-counter mouthwash marketed in the United States. By the 1920s, the Lambert Pharmacal Company, Listerine's maker, was confident they had found a cure; now all they needed was a disease. So they made one up: "halitosis." Before that time, halitosis was an obscure medical term that almost no one had heard of. Advertisers began to promote Listerine as a cure for this condition, which, they said, could blight anyone's chances of succeeding in romance, marriage and work. Soon, people all over America were suffering from halitosis.

The trick was to inflate a common, everyday condition to the level of pathology, which, if not attended to, could blight one's prospects for personal happiness and success. The ads the Listerine marketers crafted were mini-soap operas, in which people risked social shame and failure unless they used the product.

The Listerine marketers refined the marketing techniques that were pioneered by the patent-medicine makers of the 19th century. Novelist Henry James was so vexed by these hucksters he called them "nostrum-mongers." His brother, Harvard psychologist William James, who is considered the father of American psychology, was also exasperated by them, saying that "the authors of these advertisements should be treated as public enemies and have no mercy shown."

Payer identified several disease-mongering tactics. Among them:

• Taking a normal function and implying that there's something wrong with it and that it should be treated

• Describing suffering that isn't necessarily there

• Defining as large a proportion of the population as possible as suffering from the "disease"

• Defining a condition as a deficiency disease or as a disease of hormonal imbalance

• Recruiting doctors to spin the message

• Using statistics selectively to exaggerate the benefits of treatment

• Promoting the treatment as risk free

• Taking a common symptom that could mean anything and making it sound as if it is a sign of a serious disease

Healthcare watchdogs are now blowing the whistle on the major pharmaceutical companies who are engaged in this activity, and they have identified several "illnesses" as current examples of disease mongering. They are not saying these conditions don't exist -- they are indeed problematic for some people -- but that their incidence and relevance is wildly exaggerated in the pursuit of corporate profits. Among these "illnesses" are erectile dysfunction, female sexual dysfunction, bipolar disorder, attention deficit hyperactivity disorder (ADHD), restless legs syndrome, osteoporosis, social shyness (also called social anxiety disorder and social phobia), irritable bowel syndrome and balding.

Why should we be concerned about disease mongering? There is a huge psychological burden in thinking of ourselves as diseased when we are not. Beyond the psychological cost, there are financial costs, both personal and social. Treating these "illnesses" with pharmaceuticals is not cheap. Moreover, no tax-funded healthcare system can sustain the cost of drug treatment for all the risks for which the drug companies would like to treat the population.

Reversing disease mongering won't be easy. There is a near-limitless amount of money to be made from marketing pharmaceutical remedies for diseases that exist mainly in the imagination, and there are powerful economic, political, and professional interests who desperately want this process to continue.

The way forward may be in immunizing ourselves psychologically against the messages from Big Pharma that invade our lives on every hand. We have to learn to stop being suckers.

How? Heath believes our fear of suffering and death make us susceptible to disease mongering. Today, because the comforts of religion are no longer real for many people, death seems more final, resulting in a panicky rush to use anything that offers better health and increased longevity. So it may be that the best way to resist disease mongering is not to beat our heads against the fortress of Big Pharma, but to develop the psychological and spiritual maturity that makes us resistant to their efforts to instill fear and dread in our lives.

It's been said that one of the main ways we humans differ from other creatures is in our desire to take a pill. The pharmaceutical companies know that. Yet our health is determined mainly not by the pills we choose to swallow, but how we choose to live our lives -- the ways we eat, exercise, work, play, love and relate to others. Realizing that, we can outsmart the efforts of the disease mongerers to pathologize every moment of our existence.

~ Larry Dossey, MD

References:

L. Dossey. Listerine's long shadow: disease mongering and the selling of sickness. Explore. September 2006; 2(5): 379-385.

R. Moynihan, I. Heath I, D. Henry. Selling sickness: the pharmaceutical industry and disease mongering. British Medical Journal. 2002;324:886-891. Available at: http://bmj.bmjjournals.com/cgi/content/full/324/7342/886.

L. Payer. Disease-Mongers: How Doctors, Drug Companies, and Insurers Are Making You Feel Sick. New York, NY: Wiley & Sons; 1992.

Listerine. Wikipedia. Available at: http://en.wikipedia.org/wiki/Listerine.

Special Collection on Disease Mongering. Public Library of Science (PloS Medicine). http://www.ploscollections.org/article/browseIssue.action?issue=info%3Adoi%2F10.1371%2Fissue.pcol.v07.i02.

 
 
 
You may think there is enough disease in the world already, and that no one would want to add to the diseases that we humans must deal with. But there is a powerful industry in our society that is wo...
You may think there is enough disease in the world already, and that no one would want to add to the diseases that we humans must deal with. But there is a powerful industry in our society that is wo...
 
 
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HUFFPOST SUPER USER
joan411
Artist of my life, on
08:13 PM on 06/22/2010
BAN PHARMA ADVERTISING. It is more harmful to our health than cigarettes or liquor!!! Why on earth do the lay public need to be told about a new drug on the market if not only to create the illness it was designed to "treat?" "Ask your doctor about..." premise is so obviously B.S., but it is the subconscious damage those ads can do that really disturbs me. Think about the sad teardrop and how many you know are now on anti-depressants... well, then there's VIAGRA and the growing family of drugs (no pun intended) to treat so-called impotence when I'll bet 99% of the men prescribed that drug are no more limp than the excuses their poor wives give for avoiding their 24/7 advances!!! Uh, nope... broke a nail... stubbed my toe ...tap dancing lessons start in 15 minutes... How 'bout a drug that makes us fear and resist all drugs? Drugophobia! I want to invent that one...oh and it will also make you lose tons of weight, want a lot of sex, AND decrease your blood pressure... that is when it's not making your hair fall out, your teeth yellow and your jaw lock.
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cable1977
Against logic there is no armor like ignorance
08:52 AM on 06/23/2010
"It is more harmful to our health than cigarettes or liquor!!! "

I agree with you that pharmaceutical advertising is bad and should be eliminated, but to suggest that its worse than smoking or liquor is pure, exaggerated nonsense. What illnesses have been "created" by pharmaceutical advertising? Please be specific, with evidence showing that they don't actually exist. What you are talking about is overselling a disease and convincing people that they may have it when they don't. That is not the same as "creating" a disease.
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Red45
We can turn the tide
11:11 PM on 06/21/2010
Thank you for this brilliant article. The way prescription drugs are pushed on us in every media for minor ailments that--in many cases, we didn't realize we needed drugs for---is alarming. Even more alarming is that the first 10% to 15% of the ad or commercial gives the benefits of the drug and the rest of it is all the reasons we shouldn't take it else face myriad horrific consequences up to and including death. WHAT??! Am I over-reacting?
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HUFFPOST SUPER USER
jgarma
09:49 PM on 06/21/2010
Beautiful... so right on and very important to insert this information and insight into our conscious understanding.

Yep,
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HUFFPOST COMMUNITY MODERATOR
Atchka
Fierce, Freethinking Fatties
04:26 PM on 06/21/2010
Dr. Dossey,
Would you include obesity in this category? Although metabolic diseases are serious, the rush to label obesity a disease seems to have more do with paving the way for insurance to cover (dubious) weight loss drugs and weight loss surgery than actually dealing with metabolic diseases.

The fact that we don't have an accurate assessment of the mortality rate after Weight Loss Surgery should be a red flag when it is comparable with the mortality rate of obesity itself.

Peace,
Shannon
09:23 AM on 06/21/2010
One of the most profitable drugs are the statins but have they been over marketed.? An interesting piece from TIME http://www.time.com/time/magazine/article/0,9171,1973295-1,00.html "An estimated 12 million American women are routinely prescribed statins, which carry a risk of serious side effects. Yet there is little evidence that they prevent heart disease in women........."
".....But as Dr. Beatrice Golomb, a professor of medicine at the University of California, San Diego, says, they don't reduce deaths overall. "Any reduction in death from heart disease seen in the data has been completely offset by deaths from other causes," she says. Which raises the question: If statins do not help prolong women's lives, why are so many women taking them?

Read more: http://www.time.com/time/magazine/article/0,9171,1973295-1,00.html#ixzz0rUeGX4K0

Its a good question. ?
10:41 PM on 06/20/2010
Now..my point. I wish to add so-called "Type II Diabetes" to the list of invented diseases. High blood sugar is not a disease. It is a symptom of over-consumption of glucose (carbohydrates) by individuals not genetically capable of utilizing glucose as a fuel source. This "malfunction" of insulin is prevalent in at least 1/3 of the population. The invention of this disease has resulted in these individuals not just from their symptoms, but from the treatment they are given by conventional medicine. Any doctor who prescribes insulin to these insulin-resistance individuals is guilty of malpractice and the pharmaceutical companies who "push" insulin therapy through their incessant advertising are, flatly, criminals. Why would you give insulin to people who are "insulin-resistant?" The high levels of insulin floating around their bodies cause inflammation, fat storage, and the inability to utilize stored fat and the "patients" develop a complex of other symptoms including obesity, high blood pressure, low HDL, high triglycerides, and coronary artery disease. This "disease" would not exist if doctors understood the role of insulin in metabolism and that high blood sugar is the result of "insulin malfunction." Since these individuals cannot metabolize glucose, the simple solution is to not eat anything that digests as glucose...in other words...all digestible carbohydrate. Eat a large amount of fat and moderate protein, and blood sugar will remain low and stable. No drugs, and absolutely no insulin! Sorry big pharma...you lose.
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cable1977
Against logic there is no armor like ignorance
09:10 AM on 06/21/2010
Just out of curiosity....do you have some published works that show your experience in metabolism research? Are all of the studies on PubMed discussing Type II diabetes false (including the many not at all supported by the pharmaceutical industry)?
03:25 PM on 06/21/2010
Who sponsors the research on PubMed? Drug companies I would imagine.
It is not "rocket science." Dr. Richard Bernstein developed the glucometer in a form that could be marketed to individuals with the idea that an individual could self-test blood sugar and determine what foods caused a rise in blood sugar. His solution was to then eliminate those foods from the diet. That is so "common sense" that it is mind-boggling. But Big Pharma began marketing glucometers with the idea that the individual would get a high blood sugar reading, then calculate how much insulin to take to "cover" the rise in blood sugar, artificially driving down the blood sugar. Many of the other "diabetes" drugs artificially drove down blood sugar without addressing the cause and some were taken off the market because of the alarming side effects. It just seems so simple...determine what foods raise your blood sugar and don't eat them. I am fortunate (and my brother was also blessed in this regard) that I have severe symptoms from blood sugar/insulin swings and know when I've eaten something that has triggered them. But basic physiology is all it takes to know that glucose requires insulin to metabolize; fat and protein do not. High blood sugar..don't eat carbs. No need for meds.
02:07 PM on 06/21/2010
Thanks for your great post! You are one of the few people I have ever fanned on HuffPo! As an almost 50 year-old woman who has recently lost significant weight, in part because I have had to avoid my doctor in case he "labeled me" as a diabetic because of my weight and insulin resistance, I have been working on developing my own process to deal with the issue, and of course, exactly the things you speak of are included in the approach that is now working so well for me. I am now blogging about my experience, although it's very early days yet and I am still only speaking of the first phase of what I've been doing when there are many phases to the process. I would be thrilled if you ever have the time if you would stop by my blog and share your thoughts with me. And thank you so much for your terrific contributions here. You're a star actually!

http://winningtheobesitybattle.wordpress.com
03:34 PM on 06/21/2010
Thanks so much for your response to my post. I will definitely go to your blog and participate. The treatment of insulin-resistance is a major crusade in my life because I saw my grandfather and father live their final years in misery because of poor treatment of their condition. My brother, sister and I hope to avoid that awful fate because we ignored conventional medical advice and did our own research to find the true science behind what is mistakenly called "Type II Diabetes." (My sister is not as much a renegade as my brother and I, and she still sees a traditional doctor and takes some meds...she has had the least success in controlling her blood sugar of the 3 of us). My 22-year-old son has also adopted a low-carb lifestyle which has vastly improved his mood swings and "ADHD" (another invented disease). My daughter, who weighed 320 pounds at age 17 after being raised in a household trying to prevent "diabetes" with low-fat diets and failing miserably, did ultimately lose most of the excess weight and does watch her carbs/sugar. So, this is truly a family disease. I have apologized profusely and regularly to my children for "ruining their childhoods" by subjecting them to the wrong diet..but I trusted the establishment. No more. I am 57 myself and in excellent health..I'll post more on your blog..my family story is very interesting.
10:37 PM on 06/20/2010
Caveat emptor: My comment does not apply to "Type I" or insulin-dependent diabetes. In fact, part of my reason for posting is to recommend that the term "Type II Diabetes" be discontinued. It causes entirely too much confusion, and I am betting that I will get all sorts of replies concerning "Type I" diabetes. I am not referring to that medical condition. That condition must be treated with insulin therapy, although Dr. Richard Bernstein has seen amazing results in his patients and his own condition and has been able to diminish the amount of insulin taken through a very low-carb diet. See the rest below.
08:41 AM on 06/20/2010
So, the evil drug companies are convincing folks that they have (let's see) ... erectile dysfunction, female sexual dysfunction, bipolar disorder, attention deficit hyperactivity disorder (ADHD), restless legs syndrome, osteoporosis, social shyness (also called social anxiety disorder and social phobia), irritable bowel syndrome and balding ... when they really DON'T???

Is THAT the good doctor's argument?? Huh?? Whew.

Dr. Dossey is (evidently) a big fan of prayer. I am praying too. Praying that I never have occasion to call him MY doctor.
10:34 AM on 06/20/2010
**blueballs** No, that's not what he said or meant. "They are not saying these conditions don't exist -- they are indeed problematic for some people -- but that their incidence and relevance is wildly exaggerated in the pursuit of corporate profits." Direct quote right before your quote.

The man is saying that we, the public, are lead by the nose to believe that we are all sick and in need of a pill -aka miracle drug- to make us better and deplete our wallets.

I remember a satirical piece from a magazine (Mad?) I read years ago that went something like this:
"Do you wake up in the morning with an intense desire to have to urinate? Does your breath smell bad after a good night's sleep? Do you have crust around your eyes upon waking? Is your hair flat and tangled? Well, then you just might have...cancer! or a bladder infection! Or gingivitis! Or styes around the eye which could lead to... dun, dun, dun...blindness!! OMG!!! Get to a doctor today!! Before it's too late!" Now, that's a perfect example of disease-mongering. From about 40 years ago!
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HUFFPOST SUPER USER
Rob Halpin
09:16 PM on 06/20/2010
You missed the point completely. Astounding.
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HUFFPOST COMMUNITY MODERATOR
MoreDimensions
01:14 AM on 06/20/2010
A few years back an acquaintance told me the had very severe acid reflux disease. So bad in fact that the Doctor told them they would likely die young from esophageal cancer even though they were on a high powered prescription medicine to stop the problem.

i told them I was cured of Acid reflux by changing my diet and taking probiotics and digestive enzymes. This person gave it a try and 3 weeks later had no symptoms.

It really pays to become informed about medicine relative to both Doctors and natural treatments. In the end, it is much wiser to control your health then letting someone else control it for you.
HUFFPOST SUPER USER
Day Brown
12:26 AM on 06/20/2010
DNA reveals Native Europeans evolved in agrarian villages of 150-300 over the course of the last 10,000 years. If you want a healthy lifestyle, live in one. Raise your kids in one. Move grandparents in so the kids can visit with feet rather than waiting for someone to drive them.

In defacto quarantine, your immune system can cope with it. Even if a bug is picked up, there's not enuf new victims to infect, and then mutate, to keep it in circulation. Except for a few imported spices, villages grew all their own food. Nobody got e coli. Or poisoned with chemicals, or had the mental development of kids damaged by exposure to either pathogens or chemicals.
10:41 AM on 06/20/2010
As a 2nd generation American I grew up in a 3 generation household every other 6 months of the year. My mom's parents lived at our home for 6 months and then went to live with my uncle for the other 6 months. This went on their entire lives so it was perfectly normal, to me, to have my grandparents around all the time. I am thankful they were there. I did the same for my grandchild. I helped raise her for the first 3 years of her life. She lived w/me & my spouse and our daughter (who went to college to complete her degree and worked a job to pay for the schooling) and we have a close bond that we never would have acheived had I only seen her once a month or on an occasional weekend.
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HUFFPOST SUPER USER
Sheldon101
sheldon101blog.blogspot.com Wakefield transcripts
08:19 PM on 06/19/2010
sheldon101
-------------------
In the comments below, Dana Ullman declares that sheldon101 is actually Dr. Terry Polevoy. That's not true. I don't know where that idea comes from, except that we're both sensible and Canadian.

I'm top posting this comment as it isn't showing up.

Our biographies are different; "Canadian Quackery Watch is the creation of Dr. Terry Polevoy, a medical doctor who lives and works in the Kitchener-Waterloo, and London, Ontario area. He graduated from Michigan State University where he obtained his B.S., and then completed his medical degree at the Wayne State University School of Medicine in Detroit...

Anyone familiar with my comments, know that I claim never to have even taken a high school biology course. And I'm a Torontonian. In May, 2010, I discussed Connaught Labs, the Nobel Prize and Professor Michael Bliss. I wrote: "The traditional view is Banting and Best invented insulin.The Nobel prize went to Banting and McLeod. Banting gave half his prize money to Best. McLeod gave half his to Collip. I took one course in history from Michael Bliss, a great historian, who gets lost when it comes to recent politics. Bliss argues that McLeod did not get the credit he deserve."
http://www.wellsphere.com/health-education-article/insulin-salk-and-connaught-laboratories/1118886

Bliss has only taught at one university, the University of Toronto.

I don't know Dr. Polevoy, other than looking at his website. I have invited him to comment on Dana's fantasies.
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HUFFPOST SUPER USER
Sheldon101
sheldon101blog.blogspot.com Wakefield transcripts
08:39 PM on 06/19/2010
http://archives.cbc.ca/society/celebrations/topics/1455/ Michael Bliss on Banting, Best and McLeod.
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HUFFPOST SUPER USER
hxwhite
09:33 PM on 06/19/2010
LOL!!! Sensible and Canadian, God Lord in the most loving way spoken out loud, take me NOW!
07:03 PM on 06/19/2010
Let's not forget about 'overactive bladder syndrome'!!! It doesn't matter that frequent urination COULD be SIGN OF PREGNANCY OR A BLADDER INFECTION. What effect does the 'cure' for overactive bladder have on an unborn fetus?
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HUFFPOST SUPER USER
pplatonist
05:50 PM on 06/19/2010
Thank you for this great article.

NPR did a very good story on how the definition of low bone density was dramatically expanded to increase the market for Fosamax.

"How A Bone Disease Grew To Fit The Prescription"
Link to text and audio: http://www.npr.org/templates/story/story.php?storyId=121609815
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HUFFPOST BLOGGER
Dana Ullman
Evidence Based Homeopath
05:00 PM on 06/19/2010
Larry Dossey has again hit the nail right on the head. People can and should realize that medicine has become a business, a really big business. Even many of the "skeptics" who comment here are their reps.

In one of my previous blogs, I wrote: The New York Times recently uncovered the fact that Pfizer admitted to paying $20 million in the last six months of 2009 alone to 4,500 doctors to "consultation" and to speak on their behalf (and this doesn't include payments to doctors outside of the US) (Duff, 2010). It seems to be time to stop calling them "drug companies" and call them "drug pushers." http://www.huffingtonpost.com/dana-ullman/how-scientific-is-modern_b_543158.html
05:07 PM on 06/19/2010
Heh, but homeopathy is the answer to ward off "paid shills", right?

The irony.
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HUFFPOST SUPER USER
pplatonist
05:50 PM on 06/19/2010
Would you consider answering Dana's excellent-- and very disturbing-- point, rather than just launching into another irrelevant attack on homeopathy?
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HUFFPOST SUPER USER
Sheldon101
sheldon101blog.blogspot.com Wakefield transcripts
05:38 PM on 06/19/2010
Not a Troll But Close
-----------------------------
There he goes again, writing the conclusion "many of the "skeptics" who comment here are their [Big Pharma] reps."

Without providing any evidence that this shill claim is true. The best he can do to fool the reader, is point out payments made by Pfizer to doctors to speak out on its behalf. I guess if you apply the laws of homeopathy to this claim by Dana, it is true. The law of homeopathy? That you can fool an amazing amount of people into believing that evidence of nothing is something effective.

What's wrong about Dana'a comment is that it is designed to elicit a response that leads away from the issues at hand. Have I fallen for it? Yup. On the other hand, responding to Dana always leaves me feeling better. I'm also sure Dana feels better after posting one of his flaccid zingers.

But it would be nice if it could avoid making each other feel better and discuss the issues at hand. That's up to Dana. If he continues, I hope he'll be more inventive.

My blog: www.vaccineswork.blogspot.com
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HUFFPOST BLOGGER
Dana Ullman
Evidence Based Homeopath
06:20 PM on 06/19/2010
People who want to understand why Sheldon101 writes what he writes might benefit from knowing who he is...Terry Polevoy, MD. Google him and see for yourself. It is time that he came out of the medicine closet and stop hiding who he is...though it is somewhat obvious why he hids his real name...

Even if I did not know who he is, it is curious why he chooses to hide who he is, especially because he posts so often, and his message is always the same: take more vaccines and more drugs and ignore everything else. I wonder why...though I think that I already know.

I am transparent...why aren't you?
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HUFFPOST SUPER USER
Sheldon101
sheldon101blog.blogspot.com Wakefield transcripts
09:04 PM on 06/19/2010
So Dana, what evidence do you have that I am Dr. Polevoy.?
04:57 PM on 06/19/2010
"Among these "illnesses" are erectile dysfunction, female sexual dysfunction, bipolar disorder, attention deficit hyperactivity disorder (ADHD), restless legs syndrome, osteoporosis, social shyness (also called social anxiety disorder and social phobia), irritable bo_wel syndrome and balding."

Good show! Half of what you are addressing her are psychological/brain disorders, we know about as much about the brain as we do about living on Mars.