If you have scope in your day and the mental and emotional capacity to deal with evidence of yet another kind of imminent apocalypse, I would recommend you devote it to Jacques Peretti’s new series Billion Dollar Deals and How They Changed Your World (BBC2). It’s a brilliant concept brilliantly executed. The three-parter looks at the commercial imperatives covertly driving and shaping developments in such vitally important areas of our little but collectively lucrative lives as work, money and health.
Peretti opened with health, and the creeping medicalisation of what used to be considered normal parts of the human condition. He traced the evolution of one pharmaceutical CEO’s 1976 vision of making pill-popping as natural as chewing gum, from dream to near-reality. The third edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980 added 205 new categories, together with standardised tests for many, precipitating an avalanche of drugs – including, most famously Prozac – developed or repurposed to match these new markets. Research and marketing have become ever more closely entwined since.
Antidepressant and anti-anxiety prescriptions now cost the NHS about £60m a year. Does everyone who takes them need them, or has the bar for diagnosis – due to whatever confluence of factors – been set too low? And the questions, as Peretti noted, go wider still: are the drugs enabling poverty? If you medicate people so they can cope with unendurable circumstances, are you saving lives or effectively suppressing a necessary revolution? Or both? Peretti circled these rabbit holes without disappearing down them.
Doctors themselves questioned the increasing popularity of ADHD diagnoses. In the US, one in seven children is being medicated for the disorder with drugs whose long-term effects cannot yet be known: 10,000 of them two- and three-year-olds. One doctor estimates just 10% of children brought to him for treatment – and this is by a self-selecting group of parents who know he offers alternatives to pills – are genuine cases. But they all have a label that, as Allen Frances (a psychiatrist on the DSM-III task force) says, will follow them for the rest of their days. “All diagnoses should be written in pencil,” he says. “We should underdiagnose and find out how nature takes its course.”
Entrepreneurs are now looking to cognitive enhancers to beat the natural inclination to slow down occasionally, and more consistently as we age, during the day. “People don’t want to drop out any more,” says one user and purveyor of nootropics, as smart drugs are slightly painfully known. “They want to tune in.” What is life if, full of competition, opportunities and social media requests, there is no time to stand and stare? A better one, according to those set to make a killing from making it possible.
Price hiking and the mining of health data were also briskly and efficiently described, along with the ramifications for our pockets, our privacy, our welfare and our welfare state. It begins to feel less like a programme about back-room deals changing our world than about them taking it away from us, piece by profitable piece. I shall be taking copious notes during the remaining episodes and demanding another three-parter on what we can do to take back our assets and ourselves while they are still, just about, separate things.
The Pact (BBC2), a comedy-drama pilot written by James Britton and Rick Laxton about the mid-30s misadventures of Amy (Sarah Solemani) and Andy (Brett Goldstein), was, simply put, a joy. They promised as teenagers to get married if they were still single at the impossibly advanced age of 35. Of course the subject has been covered before (almost every subject has), but this was tightly written, and full of fine performances in the smaller as well as the larger roles.
I particularly enjoyed the unravelling of Amy’s sister Becca, played by Sophie Trott. She managed to capture the fibrillating catatonia that anyone who has dealt with a children’s party and a drunken parent singly or simultaneously must have identified with deeply. It’s full of the kind of tiny realistic details that make a story sing: the one bearable mum at the party; the retro club night that turns out to be set in the 90s; the laboriousness of texting while hungover. And I liked the little twist at the end and wish greatly to see it play out. Commission a series straight after Peretti’s Solutions to Everything, please.
