All in the mind

Big Pharma is driving the mental health crisis, says Bryan Hubbard

Steve Jobs, the founder of Apple, was a marketing genius. He went against traditional wisdom, which states that you study a market and its needs, then produce a product or service that addresses those concerns.

Jobs did the very opposite. He created a product that nobody even guessed they needed—iPod, anyone?—and then made it so desirable that everyone suddenly wanted one.

Big Pharma has taken a leaf from Jobs’s playbook. For the last 60 years, it’s been medicalizing mental health issues, and it’s been parcelling up a range of emotions and thoughts into individual “problems.”

To give you an idea of the scope of its sullen craft, the 1960 edition of the DSM (Diagnostic and Statistical Manual of Mental Disorders), the psychiatrist’s bible, listed around 160 mental health issues; the latest edition, published in 2022, cites more than 450. Go back further to 1918, when psychiatry was in its infancy, and it had just 22 mental health issues to diagnose.

Has the scope of our mental health problems nearly tripled in 60 years? Even the DSM’s editor, Allen Frances, thought not. “The diagnostic exuberance of the [latest] DSM confuses mental disorder with the everyday sadness, anxiety, grief, disappointments and stress responses that are an inescapable part of the human condition,” he said in a 2019 interview with the Psychiatric Times.¹

Instead, could it be that Big Pharma, a la Jobs, has created a market and then come up with the remedy? If so, their dark arts are crippling society.

Nearly 30 percent of young people in England alone have been declared unfit to work, often because of mental health problems such as ADHD, anxiety or autism. Among the under-16s, 760,000 English children have been declared “disabled” because of a mental health issue, and the country also has around 2.5 million people diagnosed with ADHD.

It’s not only an English phenomenon. In Iceland, 20 percent of young people are taking an ADHD medication. Among American children, 11 percent have been diagnosed with the problem, and half of these—around 3.5 million—are taking medication.

This tsunami of overdiagnosis and treatment has been driven by the drugs industry. Back in 2012, WDDTY got hold of a private email sent out by one drug company to its sales force, urging them to encourage psychiatrists to prescribe more ADHD medication as too few children were taking the drugs, especially in Europe.

There’s been a small pocket of resistance in the psychiatric community. Some are arguing that many of these problems are natural reactions to life’s hard knocks. They’re transitory and certainly don’t need treating with drugs. Mental health issues aren’t set and fixed complaints—as arthritis might be characterized, for instance—but are predicated on feelings and emotions that can change.

The point is well made by Edinburgh GP Gavin Francis in his new book The Unfragile Mind: Making Sense of Mental Health (Profile, 2026). He argues that mental health issues are more cultural and social than medical.

Mental health diagnoses in Japan, for instance, are quite different from in the West; cultures across Asia do not separate mind and body, so psychological distress isn’t “all in the head.” It’s often expressed through physical symptoms, such as stomach pain or fatigue, and has less to do with emotions like sadness.

In the West, a diagnosis pins the butterfly to the wheel. The naming of the problem was driven by Big Pharma and by the US health insurance system that needed to have a diagnosed condition and a standard remedy before it would pay out.

Ultimately, mental health problems are thoughts that are like shadows that stalk our lives for a while. Define them, and they become more substantial.

So perhaps a better approach is the one described by psychiatrist Benji Waterhouse when he tried to delineate the secrets to happiness: high resilience to stress; loving friends, family and partner; fulfilling work; financial security; manageable targets; eight hours’ sleep; limited use of alcohol, drugs and social media; regular exercise; a healthy diet; access to nature; faith or spirituality; a naturally positive outlook; a pet, if you want one; a gratitude journal; and a 100 percent charge on your phone.

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