Rachel Becker

Rachel Becker

April 30, 2012

Both of Ethan Watters' (2010) chapters for this week presented disorders that I thought I knew about and then made it clear that I didn't know nearly as much as I thought. It had honestly never occurred to me that Anorexia could present in more than one format. Calling it a disease suggests that its course will be the same for each person and in each case. And as for depression, I had never thought of the disease as something that people had to be convinced they had. For both of these disorders – how are symptoms and treatment different when there is no public conception of the disease? How is this informed by a global spread of information? And is this sharing of information helping more than it is harming?

Based on our earlier discussions on body alterations – both surgical and through products – it would not surprise me to hear that eating disorders were on the rise anywhere. Watters (2010) says that he saw an abundance of ads for “health care regimens” including cream to remove cellulite and pills to suppress appetites. It strikes me as incredibly misleading that these would be for health at all – both are totally normal aspects of the human body. So, right from the start it is clear that our conceptions of what it means to be healthy and what we want people to look like don't have people's best interests in mind. Advertisements that feature skeletal women are equally damaging. They send the message that you must resemble them in order to be famous, and of course people are famous are considered to be ideal. The average person obviously wants to emulate the idolized; that is why the celebrity endorsements are so important and influential.

Again, because I thought of Anorexia as a disease, I thought of it as concrete. When I was in high school one of my best friends was suffering from Anorexia and I, therefore, received a bit of a comprehensive education on the disease as she went through treatment/hospitalization. It seemed to me that the disease started from an internal struggle. I saw how information about the disease was discussed online and how that could easily become global. There are pro-ana websites where people could share tips and encourage each other to recover or continue dieting; it was all very competitive. Anorexia is a strange thing because it is both an individual struggle and something that a community has formed around. All anorexics have something in common, after all. Watters (2010) explains that Lee found the entire process to be incredibly addictive and found that he felt superior to other people; there is a level of control that can be very comforting and empowering. In the West, Anorexia provides an identity. This is an entirely different perspective than what Watters (2010) presents. In Hong Kong, prior to the highly publicized deaths that Watters (2010) discusses, Anorexia was an extremely isolated disease. Now, I suppose, that my conception of Anorexia has to include that this the basic sentiment of the disease – a physical feeling of blockage that is not necessarily related to a desire to be thin and that can exist entirely separately from a social discourse.

Watters (2010) cautions that in diagnosing a disease, we risk an increase in cases of it. The influence of the west is so great that our definitions carry over; we assume that what we write in the DSM will apply to all Americans, let alone the rest of the world. In diagnosing an illness, it is validated both for doctors and for patients. It creates a “feedback loop.” Watters (2010) also says that we have a limited number of symptoms to “choose” from when we are experiencing inner turmoil. He says, “When someone unconsciously latches onto a behavior in the symptom pool, he or she is doing so for a very specific reason: the person is taking troubling emotions and internal conflicts that are often indistinct or frustratingly beyond expression and distilling them into a symptom or behavior that is a culturally recognized symptom of suffering” (p. 32). Interestingly, when a symptom becomes too common as a sign of suffering, it tends to fade away. It isn't considered to be suffering in the same way if everyone has it. This made me think that maybe no one has Bulimia or Anorexia, but rather are enacting symptoms for a larger reason. This is a huge concept, and something that I am still grappling with. This article really challenged my preconceived notions of mental illness, especially when Watters (2010) pointed out that traits we consider sickness could have been revered in the past. This takes everything is relative to a new level.

The most interesting part of Watters' (2010) chapter on depression in Japan was the idea that depression had to be sold as a concept, let alone a disease that had to be treated. In the west, we spend a lot of time and money distancing ourselves from our bodies and our symptoms. You can take a pill for almost anything and we are incredibly trigger happy with prescriptions. This is now increasingly true in Japan as well. Watters (2010) says, though, that in the east, it is considered essential to feel sadness – it can make you a wiser person. Depression is not an easy illness to diagnose. There is, by definition, a fluidity and an abstraction to it. I wonder now if this is partly intentional so that the diagnosis, and then prescriptions, can apply to more people. Watters (2010) has made it abundantly clear that disease is a business. We would rather treat our symptoms individually than look at the greater picture. I am now wondering how much of the way our medical system is conducted and conceptualized has to do with profit over patient wellness. I would hypothesize that most of the system is designed without the patient in mind.

When discussing the route that the medicalization of depression took into Japan, the World War II disease of neurasthenia is the clear precursor. It was a disease of the elites, which means that the disease became “trendy.” It also means, as is the case with all things that affect the upper class, that the disease got more attention and more interest in treating it. Neurasthenia became Japan's “national disease” despite its Western origin very quickly (Watters 2010). This transition has not been nearly as smooth with current definitions of depression. Watters (2010) says that Japanese and Americans feel depression differently, and therefore talk about it differently. Should diseases that might manifest with different symptoms all fall under the umbrella of the same disease? This is true for Anorexia, too. If something can have such drastically different outputs, who is it helping to categorize them all together? It seems to me that it is only helping to over simplify and results in many intricacies being missed.