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Science, Diagnosis of mental Illnesses & the DSM V

I've been thinking...

So much about diagnosing mental illnesses has to do with societal norms. There are often no objective scientifically sound impartial & reliable tests to confirm them. Often mental illnesses themselves seem to be culturally defined & based on norms, religious beliefs & taboos .

Many mental illnesses can be detected in the brain through scans etc, they can see a tumour & determine by its size & location within the brain, what the likely effects will be on the patient. Schizophrenia can also be seen in the brain through fMRI scans that reveal the very unusual brain activity. Other tests (like blood tests) can sometimes link symptoms of mental illnesses to hormone imbalances, food allergies & nutritional deficiencies etc. There are other objective means that can be used for legitimate diagnostic purposes such as examining a person's history & noting that they've suffered repeated or one big concussion or other head injury.

The problems, for me, begin when someone receives a diagnosis NOT based on any objectively verifiable testing (& I don't mean a series of questionnaires!), the person gets labelled & possibly even MEDICATED! Many of these illnesses weren't in the DSM until fairly recently. Others that used to be there no longer are. The fifth edition is being written now & there will be new illnesses added still (which means PROFIT since costly drugs will be prescribed for them).

Am I the only person terrified by this prospect? While the period for comments by the general public to the editors of the DSM V about the proposed changes is over, & going into more detail here would require several blogs, the fallout in 2013 promises to be very vocal. If there are any other followers of this psych geek stuff out there, I'd appreciate your comments.

Comments

As one of my professors remarked:

'Everything will be termed as a 'disease' on DSM-V.'

I wished our society can be more accepting and less discriminative for those who don't fit into social norms. We aren't all perfect products from a certain genetic factory, and we should not be cut out from the same machines. Being unique is part of humanity, and part of what makes us all around the world special. :D
 
I share your concern, Soup. It seems that doctors are all too quick to reach for the prescription pad when it comes to mental and/or behavioral conditions. And it seems like some of them are social constructs. Back in slavery days, there was a disease called "drapetomania" that was found exclusively among slaves who had a tendency to run off! Yes, the desire to escape slavery was considered a disease! And don't forget, the word "hysteria" comes from the word for uterus, because that was considered a woman's condition. I could give other examples of how medicine has been misused in the guise of social control.

I am not saying that there is no such thing as mental illness or that medications should not be used, but I am concerned when the first response is to medicate without looking into other factors. Take depression, for example. It is said that depression is caused by a chemical imbalance in the brain. Well, if there is an imbalance, it should be able to be measured, right? I was astounded to find out that doctors do not test for this imbalance. That does not make sense. Diabetes is a malfunction of the pancreas where either not enough or no insulin is being manufactured. In order to successfully manage diabetes doctors and patients must constantly monitor insulin levels in the blood. Not so for depression or other "biochemical" conditions. It's a hit and miss method. Try this drug and if symptoms abate then it must be working.

Sometimes I think future generations will look back at us and say these were the Dark Ages as far as mental illnesses were concerned.
 
I do agree with the fact that there should be scientific back up before anyone is labeled as such. Especially if it's regarding meds and therapy that is costly.

However, the research is costly as well (as in getting hooked up with a therapist to discuss your problems), as well as seeing a vacuum to what "disease' you might have and looking into triggers/factors, rather than just brute force it with medication.

The reason, besides that 70% of the people who are involved of the coming together of DSM V are also involved in the pharmaceutical industry, the big problem lies that we cannot sideline people as such. If I mention something is "wrong" with me I should receive help. And as such, for the time being that I need help and am unable to "fit in" by the norms society expects me to, I need to be sidelined. But since that process takes more than 7 days, society in general has a "we can't wait for that" attitude. For what it's worth, I rather have scientists figure out what for example the entire deal of Aspergers is (as in "finished research) and until then I'll be a non-productive member of society. Or... even better, let me help in research as an "expert". I'm more than willing to sit down with scientists and researchers to express what I go through and let them have a go with that data.

Heck, I started my sessions at a therapist last year somewhere, and after 2 sessions the job center already got on MY back (MINE, not the therapists) to inquire what my problem was. The sent me to one of theirs, who wasn't neccesarily an objective therapist either. As long as this happens, I can't see change where we will invest in scientific back-up to sideline people and have disorders mapped out accordingly in "this age".

I do not take meds for anything, not for my ongoing "depressions", not for my ADHD and... well, there's no real medication for Aspergers, just for the simple reason that I don't believe in masking my problems. I rather have the fixed and solved... solved. If I mask them, they're still there. It's like swallowing a pill to go on "ignore" mode, both for your mental condition as well as "your life". One can wonder what's worse... living with a condition you come "accustomed" to and can manage somewhat, or be medicated, need to start all over and eventually hope you won't have any problems with complications, much like co-morbid disorders (my therapist told me to really, really, really consider not taking ritalin or whatever ADHD meds, because it might kick my autism up a few notches and I'm basically back to square one... with new rules)
 
The alliance between pharmaceutical companies & psychology/psychiatry is a frightening & ethically troubling one. There seems to be a tendency to include in the DMS 'conditions' for which it is known that a medication can be prescribed. In the upcoming DSM, GRIEVING is going to be included as a treatable condition! See for yourselves: Proposed Revision | APA DSM-5 . This alarmed me greatly. They even mention how the disorder will be considered to have manifested in a child (meaning that they too can e crammed full of pills).

Part of my concern with this 'everybody's nuts' trend is that it diminishes the impact of mental illnesses & disorders on those who truly are suffering badly from them. Since most people recover somewhat, even unaided, from even the worst losses, I can foresee the medical profession & big pharma taking credit for having 'cured' people who were not ill but distressed with good reason & who would've emerged from their crisis on their own (or even with talk therapy or a bereavement support group etc.) This will further broaden the scope of so-called illnesses that drug X will be prescribed for.

In this climate of quackery, it will be even more important for patients to be well informed & also to advocate for himself. In the case of those in a mental illness crisis, this will be almost impossible: hopefully, an informed & ethical relative or doctor will be there for him. For those Aspies, like ourselves, we'll have to be very good at discerning whether or not we think we're 'suffering from' some symptom or if we're experiencing it & whether it is a symptom at all (or just an unconventional trait).

King_Oni's situation underscores the dangerous role that government can play in intervening on its OWN behalf in a patient's health care. While nobody wants to see assistance go to fraudulent people who don't deserve it, using government-lackey doctors to discredit a patient with the sole intention of denying him the aid he needs is treacherous. Also, will we see a day where people like us will be forced to take some crazy amphetamine like concoction in order to 'cure' our solitary tendency & make us more extroverted so we can then be pushed into the work-force? Think of it: the upper will make you more gregarious, the anti-anxiety meds will calm the stress & greatly reduce the melt-downs & forced behaviour modification will make you act & look more normal. Bye Bye Asperger's & hello mock neurotypicality! We'll be the Splenda & the Nutrasweet of the NT world.
 

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