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‘Dozens of mental disorders don’t exist’

Anonymous
Posted by Anonymous
  • 135 Replies

‘Dozens of mental disorders don’t exist’

Has the drive to identify all illnesses created a ‘fiction’ of psychiatry?

In his riveting tale of how psychiatrists “medicalise” human suffering, Gary Greenberg recounts that, in 1850, a physician called Samuel Cartwright reported a new disease in the highly respected New Orleans Medical and Surgical Journal. Cartwright named it drapetomania, from the ancient Greek drapetes for a runaway slave; in other words, here was a disease that “caused african americans to run away”. It had one primary diagnostic symptom – “absconding from service” – and a few secondary ones, including “sulkiness and dissatisfaction just prior to flight”.

Drapetomania was, of course, consigned to the dustbin of medical history. It never made it into the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), the leading authority on mental health diagnosis and research. But, Greenberg suggests in his scathing critique of the DSM, it might well have done – had the manual existed at the time.

After all, he notes, homosexuality was listed as a “sociopathic personality disorder” when the DSM was first published in 1952, and remained so until 1973. “Doctors were paid to treat it, scientists to search for its causes and cures,” he writes in The Book of Woe: The DSM and the Unmaking of Psychiatry. “Gay people themselves underwent countless therapies including electric shocks, years on the couch, behaviour modification and surrogate sex.”

Greenberg, 56, is a US psychotherapist of 30 years’ experience and a prolific writer on mental illness (including his own depression after the collapse of his first marriage). But the target of his latest book is the DSM itself, the so-called “psychiatrist’s bible”, which aims to provide a definitive list of all mental health conditions, along with their diagnostic criteria.

Updated at regular intervals – DSM-5, the fifth edition, was published in May – it has considerable influence worldwide, including in the UK, where it underpins several clinical guidelines on mental health. Yet Greenberg holds that by imposing a pseudoscientific model on our “hopelessly complex” inner world, it creates a “charade” of non-existent disorders.

As World Mental Health Day approaches this week, he argues that, thanks to the DSM, “countless millions” are hooked on powerful antidepressants to cure a mythical “chemical imbalance”, while rates of mental disorders in children, including autism, bipolar illness and ADHD, have rocketed. The DSM is, he says, a “fiction” which medicalises human experience and allows psychiatrists “dominion over the landscape of mental suffering”.

Greenberg’s language may at times sound overblown but he isn’t alone. DSM-5, 14 years in the writing, has been criticised by many for the unhealthy influence of the pharmaceutical industry and its tendency to medicalise behaviours and moods that many would argue fall within the normal range.

“Few professionals are happy with the DSM,” Greenberg says on the phone from his home in Connecticut, where he lives with his wife, teenage son, cat, dog and “a dozen or so” hens. “We are forced to engage with a charade of diagnostic disorders that we don’t believe our patients have for the crassest of reasons – money.” (In the US, people have to have their diagnosis confirmed by the DSM to access insurance funds for treatment.) “It’s not just psychotherapists – even psychiatrists admit this is a deeply flawed document.”

The rot set in during the 19th century, he says, when expectations of medicine changed dramatically after the discovery of micro-organisms. “It created a desire for all mental suffering to be understood in the same way as physical suffering, such as smallpox or cholera. To consider craziness as another treatable disease which originates in biology had tremendous appeal.”

Playing into this is another factor, the influence of the pharmaceutical industry. Despite an attempted clean-up in recent years by the American Psychiatric Association, 67 per cent of the “task force” members responsible for DSM-5 are reported to have industry links.

Yet Greenberg believes that many psychiatrists – and even drug reps – are well-meaning. “It is intellectual rather than financial corruption. The idea that human suffering can be reduced to a biochemical imbalance – this is about ideology rather than money.”

Greenberg’s book tracks in painstaking detail how the DSM’s decisions have created “false epidemics” of over-diagnosis and over-treatment. In 1994, for example, the diagnostic threshold for bipolar disorder was lowered to cover people without full-blown mania (instead, they have elevated moods that doctors call hypomania, but which Greenberg describes as exuberance). As a result, bipolar diagnoses soared, as did prescriptions for mood stabilisers and antipsychotic drugs, which in the US were for the first time being advertised directly to the public. “Suddenly, everyone and his brother was bipolar,” says Greenberg. About six million people are now diagnosed as bipolar in the US, and in the UK, it’s one in 100.

He also describes how a loophole in the DSM criteria was exploited “by one of the few real bad guys in psychiatry” to establish a juvenile version of the disorder, without any solid evidence. This was at a time, coincidentally, when powerful antipsychotics were being rebranded as mood stabilisers. As a result, diagnoses of child bipolar illness increased 40-fold over a decade. “In 2007 alone half a million children, 20,000 of them under six, were prescribed drugs that a decade before would have been prescribed only in the most dire circumstances,” says Greenberg.

The side effects of some of the drug cocktails children were prescribed included obesity, diabetes and suicidal thoughts.

In an attempt to reduce bipolar diagnoses in children, DSM-5 has introduced a new illness, called Disruptive Mood Dysregulation Disorder (DMDD), to cover intensive temper tantrums. But this too is proving controversial, with fears that it may capture some children who may be volatile, but who are not ill. “Clinical trials of treatments for DMDD are probably already under way and may well lead to another treatment epidemic,” he says.

A different tale concerns Asperger’s syndrome, which was first included by the DSM in 1994. Greenberg explains that this had some beneficial effects. “It may not have been a disease but calling it one gave a hitherto neglected group of children access to support and educational services, as well as a sense of identity and community.” The result though, was that from a worldwide prevalence of four in 10,000 for autism disorders (including Asperger’s) in 1988, 20 years later this was one in 88. Alarmed at diagnostic rates “getting out of hand”, DSM-5 has removed Asperger’s, replacing it with the umbrella term Autistic Spectrum Disorders. This means a “higher threshold for diagnosis”, according to Greenberg, and possibly less access to educational benefits for future generations.

He is unimpressed with the DSM-5’s new Hoarding Disorder - “Is an eccentric old man living amid his junk sicker than a billionaire who is always thinking of the next way to make a buck?” – and argues that anyone over the age of 50, including himself, would qualify for another new entry: Mild Cognitive Disorder.

Greenberg is particularly dismissive about DSM-5’s changes to the criteria for Major Depressive Disorder. Until now, this diagnosis was specifically excluded in cases of recent bereavement, on the grounds that grief is normal. That exemption has been removed in DSM-5, leading critics to argue that grief has been medicalised.

“The exemption clause was an embarrassment because it challenged the idea that depression is caused by biology and led critics to demand that other external factors, such as divorce and redundancy, be exempt too,” he says. “So they got rid of it, which means that if you are depressed while bereaved you can be classified as mentally ill.” Not that bereaved people who are depressed shouldn’t be helped, he adds. “But is it really a medical problem?”

So what needs to happen? Psychiatrists, he believes, must narrow their scope – to make a “reasonable claim” for certain mental illnesses falling within their domain. “When the DSM was published there were 14 mental disorders and now there are 250 – it needs to scale back.”

There is a place for drug treatments, he says, although “you only have to look at the clinical trials to see they help some people but not all.”

Above all, psychiatrists need to be more honest with their patients, he believes. “They shouldn’t tell people their illness is caused by a chemical imbalance when there is no evidence this exists. Psychiatry has little knowledge of the underlying processes governing mental health and it should not pretend otherwise.”

SOURCE:

http://www.telegraph.co.uk/news/health/10359105/Dozens-of-mental-disorders-dont-exist.html



Posted by Anonymous on Apr. 10, 2017 at 3:13 AM
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Replies (1-10):
kjb1984
by Silver Member on Apr. 10, 2017 at 3:34 AM
2 moms liked this

Complete and utter bullshit.

Anonymous
by Anonymous 2 on Apr. 10, 2017 at 4:12 AM
6 moms liked this
That shit was too long to read
EntrepeneurMom
by The Major on Apr. 10, 2017 at 4:20 AM
1 mom liked this
How ignorant. Hoarding isn't just an old man trying to make money. It's a person living in piles of animal poop because they don't think they deserve better. Its someone picking a pebble over their family and children because they believe it's more important. How can anyone say they're not mentally unwell? There's a hundred other things I could pick apart from this, but it's not worth my effort.
Anonymous
by Anonymous 3 on Apr. 10, 2017 at 7:00 AM
2 moms liked this
Where I'm not agreeing that this guy is correct in saying thase issues don't "exist" at all, Ihowevee I do believe more and more of our issues are not chemical imbalances in our brains, but microbiome imbalances in our gut. We are just starting to see how much our gut microbes really control our bodies and their interaction with our genes. There have been lots of promising research that perhaps our gut has more control over our mental status than our genes. We have all heard the commercial "70% of our inmune system is in our gut"...well, mental issues may be based in our guts too.
Jojobug13
by Ruby Member on Apr. 10, 2017 at 7:07 AM
7 moms liked this
I believe many personality traits are now being treated as disorders. We all aren't meant to be mellow, even-keeled people. Some people are more emotional than others. That doesn't make them disordered.
SergeantSausage
by Ruby Member on Apr. 10, 2017 at 7:19 AM
4 moms liked this
I do believe a lot of disorders are made up.
MenopauseManiac
by Ruby Member on Apr. 10, 2017 at 7:29 AM

That doesn't make you sane.

Quoting Jojobug13: I believe many personality traits are now being treated as disorders. We all aren't meant to be mellow, even-keeled people. Some people are more emotional than others. That doesn't make them disordered.


Jojobug13
by Ruby Member on Apr. 10, 2017 at 7:31 AM
2 moms liked this
Nor does being emotional make you insane. I get so sick of everyone thinking people are all supposed to be the same
They aren't. It's the differences in people that make life interesting. If we were all medicated robots the world would be a very boring place.

Quoting MenopauseManiac:

That doesn't make you sane.

Quoting Jojobug13: I believe many personality traits are now being treated as disorders. We all aren't meant to be mellow, even-keeled people. Some people are more emotional than others. That doesn't make them disordered.

MenopauseManiac
by Ruby Member on Apr. 10, 2017 at 7:34 AM

Medication =/= robot.  You should try some.

Quoting Jojobug13: Nor does being emotional make you insane. I get so sick of everyone thinking people are all supposed to be the same They aren't. It's the differences in people that make life interesting. If we were all medicated robots the world would be a very boring place.
Quoting MenopauseManiac:

That doesn't make you sane.

Quoting Jojobug13: I believe many personality traits are now being treated as disorders. We all aren't meant to be mellow, even-keeled people. Some people are more emotional than others. That doesn't make them disordered.



Jojobug13
by Ruby Member on Apr. 10, 2017 at 7:36 AM
1 mom liked this
Been there done that. Never again. And I've tried many combinations. I was either sick as fuck. Or numb and emotionless. Or they completely changed my personality. No thank you. I'll stay who I am because I know now there's not a damn thing wrong with me.

Quoting MenopauseManiac:

Medication =/= robot.  You should try some.

Quoting Jojobug13: Nor does being emotional make you insane. I get so sick of everyone thinking people are all supposed to be the same
They aren't. It's the differences in people that make life interesting. If we were all medicated robots the world would be a very boring place.

Quoting MenopauseManiac:

That doesn't make you sane.

Quoting Jojobug13: I believe many personality traits are now being treated as disorders. We all aren't meant to be mellow, even-keeled people. Some people are more emotional than others. That doesn't make them disordered.

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