One of the things I've realized while writing this piece on how drug companies "create" illnesses is that journalists are appallingly complicit in the whole thing. Magazines such as U.S. News & World Report will blare headlines such as, "Living with Adult ADD. New hope for coping with the distraction and anxiety." In reality, there's a good deal of serious controversy over what ADD really is, and how it should be treated, but you won't get much of that in the piece. The emphasis in these stories will usually be on the neurobiological basis for the disorder—which is only one theory among many, though obviously the one favored by drug companies—and there will usually be key product placement early on, along with a ringing endorsement from some doctor who likely moonlights as a paid speaker or consultant for the company in question. (In this case, the company is Lilly and the drug is Strattera.) "Real people" experiencing the condition will be supplied by a patient-advocacy group rightly trying to raise awareness for the condition, although that group will, in turn, often be funded by the relevant drug company.

That's not to say that Adult ADD is bullshit. That's the thing—I'm not in any position to say. The only information I as a regular non-scientist can get will come from these glossy magazines, where it's clear that one side of the issue—the industry-favored side—is being heavily pushed. This is essentially an advertisement for ADD—and hence its treatment—rather than any sort of investigative journalism. So then I think, "Well, gee, sometimes I feel distracted and anxious," and it's off to the doctor I go, who, of course, is far more likely to prescribe a medical treatment than, say, a lifestyle change to deal with my condition. If I'm lucky, my doctor won't be moonlighting as a paid speaker for Lilly, but I don't know. (Would I even know to ask?) And let's be clear here. This isn't a conspiracy to invent a disease out of nothing. Doctors aren't paid to prescribe drugs against their better judgment. No. It's more subtle than that—something like a confluence of interests that gathers around millions and millions of dollars in pharmaceutical marketing money.

At any rate, from what I gather medical reporters are getting slightly better at calling foul when "news" of the hot new illness sweeping the nation comes via blast-fax, but it's still a real problem. And in a sense, who can blame them? They're under deadline pressure, nothing sells glossy magazines like unearthing a new disease, and they need quotes and case studies fast. Meanwhile, though, health care premiums keep rising...