I just read Marya Hornbacher's NYT bestseller Madness: A Bipolar Life. It strikes me that thinking about madness as "mental illness" enables us--madmen, madwomen, and the medical establishment--to construct heroic narratives about battles with madness. The idea of mental illness--the idea of a lifelong biochemical bogeyman that, like cancer, strikes down innocent people who have to "fight" it--lets us think of ourselves as heroes in a struggle against natural forces that are ruthless and violent. In one way or another, memoirs of madness tend to be constructed as narrative in the same way: here is the monster I had to fight, here's how I fought it, see how I almost died in the battle, see how I won (or am winning) the battle, look at my battle scars, now listen to what I learned from the fighting. Often, these narratives cast medical science in a supporting heroic role: the faithful companion who hands the hero her sword. The idea of mental illness positions the medical and pharmaceutical industries themselves as heroic actors in a mighty struggle. It's very appealing from a narrative standpoint.
The heroic profits from mental illness must be appealing as well, at least to those who pocket them. From the NYT Business section, April 27, 2010: "The newer generation of anti-psychotics has surpassed cholesterol-lowering drugs to become the nation's top-selling category of medications, accounting for $14.6 billion of the nation's $300 billion in drug spending last year. . . . Seroquel, a pill usually taken once or twice a day that sells for more than $4 each, was the fifth-best-selling drug in the United States last year . . . " Now that's big business!