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Psychiatrists Cast Doubt On Biomedical Model of Mental Illness
jones_supa writes "British Psychological Society's division of clinical psychology (DCP) will on Monday issue a statement declaring that, given the lack of evidence, it is time for a 'paradigm shift' in how the issues of mental health are understood. According to their claim, there is no scientific evidence that psychiatric diagnoses such as schizophrenia and bipolar disorder are valid or useful. The statement effectively casts doubt on psychiatry's predominantly biomedical model of mental distress – the idea that people are suffering from illnesses that are treatable by doctors using drugs. The DCP said its decision to speak out 'reflects fundamental concerns about the development, personal impact and core assumptions of the (diagnosis) systems', used by psychiatry. The provocative statement by the DCP has been timed to come out shortly before the release of DSM-5, the fifth edition of the American Psychiatry Association's Diagnostic and Statistical Manual of Mental Disorders. The manual has been attacked for expanding the range of mental health issues that are classified as disorders."
If they want a replacement they will need to provide one. Until then, people are being treated, with varying degrees of success, with the current model. Even if the model isn't actually an accurate description of what is going on, it is still a fairly useful guide to approaching the problems. Sort of like classical physics versus relativity. A real breakthrough in understanding would be great - and maybe with all of the brain imaging and various other things going on, that will emerge. But so far it seems to mainly be individual studies that aren't producing a cohesive theory or useful guide to treatment. They will need to find their equivalents of Einstein and Dirac.
Another problem with the recent releases of the DSM is that what is considered a disorder sometimes seems to be a question of politics or political correctness.
much of left-wing thought is a kind of playing with fire by people who don't even know that fire is hot - George Orwell
Would most people be better off undiagnosed?
In a word, yes. Since "most people" would not be ill, neither physically nor mentally. This new edition of the DSM risks to change that, as in it provides a convenient way to slap "diagnostic" labels on quite a few people who're today considered pretty much normal.
Cue the observation occasionally voiced that what today is called "ADD" (and but yesterday called "ADHD") and results in prescriptions of ritalin, only a few short decades ago was called "being a kid". We are going a little bonkers with the mental, yes.
Would be nice if true. Fact of the matter is most people get 15 minutes, a prescription, and sent home.
Violence is like duct tape. If it doesn't solve the problem, you didn't use enough.
I was diagnosed as bi-polar about 6-7 years ago after suffering a serious manic episode with full scale hallucinations. While it was not the first time this had happened to me, it was "the final straw" that led to me being diagnosed.
Since then I've been on Resperidone to control the manic phases, and Effexor to limit the depressive phases. I've had no hallucinations, breakdowns, suicidal thoughts, or any other problems since being put on the medication, except when I've run out of medication, thinking "Maybe I don't need it any more."
But the return of symptoms after 2-3 weeks without medication has me convinced that the diagnosis is valid and the medication effective.
I do not fail; I succeed at finding out what does not work.
When it comes to mental "illness", often the only (or at least the best) treatments are behavioral therapy, in which the "illness" is trained away.
For mild forms of mental illness (bearing in mind that what we call "mild" mental illness can be crippling and painful from the perspective of the individual), perhaps. I'm not sure I agree with the way you phrase your position, but it is at least a valid position.
But behavioral therapy supposes that patient has enough function to engage with the therapist; even in the days before neuroleptics, it was recognized that some forms of mental illness did not respond well to talk therapy. A severely disorganized schizophrenic will turn even the simplest statements into jumbled hash; a catatonic depressive might not have sufficient volition to even reply.
Therapy is pretty advanced when dealing with patients who can't function enough to take care of their basic survival needs -- I'm not talking about acceptance of particular choices or values (by society or by self), or even whether they fit in well enough to hold a job. Rather, individuals rendered unable to attend to basic functions like "avoid freezing to death in winter" or "obtain and prepare sufficient food to maintain life, without endangering others". In such cases it is often a useful adjunct, but supposes that the patient can improve enough to be establish some level of meaningful communication.
Psychiatrists take the Hippocratic oath? Considering their treatments and "remedies" they don't seem very good at upholding it.
"Wait. Something's happening. It's opening up! My God, it's full of apricots!"
As someone on venlafaxine, I concur about the ups and downs being gone more than through CBT. CBT requires such an effort that at least to me it seemed that if I could seriously benefit from CBT, I wouldn't need it in the first place since then I wouldn't have the problems I've had functioning. Venlafaxine is not an ideal medication for me but because I have epilepsy, it reduces the options what doctors can prescribe me. Out of curiosity, I ask if you notice the effects some other way? For me, an unfortunate effect has been a lowered ability to concentrate. At first, I noticed that every time I was getting a bad, depressive thought, I just forgot it and thus didn't end up in my depression cycle. It's, however, not a "precision weapon" so other thoughts are often "collateral damage" so I often forget what I'm thinking of even if I try to concentrate really hard. In the past, I instead associated to something negative in my life from almost anything and thus my productivity was lower not because I forgot thoughts but precisely because I didn't - I was able to constantly make jumps like "I heard this unusual word the first time when I saw movie X and there was a poster for movie X in location Y which was where I met girl Z for the last time" and even much more far-fetched associations to anything that made me feel sad and I just couldn't stop those associations from being constantly formed. Now that i no longer do that, I'm also a lot less angry with myself and that might have harmed my productivity in a different way, I'm more forgiving to myself if I skip exercising, do a shitty job and so on (although I know that prior to my medication, my perfectionism was quite extreme by most peoples' standards). So how has your productivity level changed on lithium?
And to "normal" people, i.e. those few that have never gone through depression or had to take antidepressants: If you're curious to find out what it can be like, you can first think about what it's like to suddenly be reminded of something by making an association Then imagine that you constantly associate things with something negative - as if you had had e.g. pictures of all bad things you've ever experienced and all people that have hurt you placed all over your room/cubicle/house...
According to Wikipedia about 1/4 th of the world's population is infected with some sort of parasitic infection (ie: worms). IIRC, some estimates are as high as 1/3. Doctors are terrible at detecting these things (doctors are also terrible at detecting malnutrition, ie: a lack of a certain vitamin. They don't really ask diet related questions, for example, doing a simple analysis comparing your symptoms to the symptoms of any deficiencies you may have based on your diet. So many health problems can be fixed by this). If your read the symptoms of these parasites many of them seem to be similar to the symptoms of depression, ADHD, and other mental disorders ( "Delayed intellectual development" ).
http://en.wikipedia.org/wiki/Parasitic_worm
(the entire article is worth reading).
Studies have shown that a good percentage of people who get medication for these infections benefit from it.
It stands to reason that if such a high percentage of people in general have these sorts of infections a much higher percentage of people with health or mental or other problems, especially symptoms known to have a high correlation with those infected, have these problems. Why is it that animals and dogs get regularly treated for these things but not humans. I suspect that if these things are regularly screened for and doctors did more to ensure people didn't have these infections and to regularly treat and screen them we would all generally be much better off.
My wife and I adopted four siblings who were later diagnosed with Bipolar, all before they were six years old. But only after the state transfeered them to our insurance. County Mental health counselors, school behaviorist, school psychologists and school nurses have continually given us misinformation, refused to make basic accommodations, and denied them a 504 plan because there was no evidence of the medication being helpful, despite a doctors report. This isn't because they are evil, but more so because they are un-exposed, lack knowledge, and never see the cycle (euphoric, dysphoric, depressed) from start to finish.
So I asked them, sarcastically, would it help if we took them off medication for two weeks of the data collections. They then threatened to call Child protective services if they found we weren't giving our children doctor suggested medication. They spent next four months every time there was a hiccup in my child's life calling us asking us if the kids got their medication. My response was it doesn't matter the school has not found there to be any medical benefit in providing it.
Medication has been the saving grace for our kids and they will tell you they don't like life without it, or even getting late.
CBT is a wonderful advance in psychology.
but most honest practitioners of it will concede that a short course of (the correct) meds will make CBT a lot more effective.
how do you tell someone to calm down when they can't hear you above their own screaming? sometimes people get into a state where they're simply not going to be receptive of any talk-based therapy. if this happens to somebody in your life, you'll be glad that drugs exist, and in enough variety that one of them is quite likely to be just the ticket.
an analogy i've heard is that the patient is like someone walking through snow wearing nothing but underwear. giving them meds is like handing them a coat and scarf. it'll work, but eventually that person has to get themselves out of the snow because it's pretty damn cold.
You are correct about the diagnosis accuracy. I worked during my studying years, in a mental institution. The reality is that if you send a patient to four different doctors the patient is going to come back with five or more mutually exclusive diagnosis. Psychology is less accurate than astrology.
I suffer from major depression. When I go off my mess I feel like crap. I stop being able to concentrate and I feel overwhelming hopelessness. On the wrong medication I was failing basic courses at uni. On the right medication I got credit/distinctions on average and have not only held down a job for 3 years but excelled at it.
I have gone off my medication in the past because I wasn't convinced that the problem was chemical rather than environmental. When I go off my medication I'm sometimes fine for months. But eventually things get worse. I've been on the same medication for 4 years now, I've yet to have any issues.
I explored several options before settling on medication. Even then I explored the possibility that the depression was environmental or situational. I've been proven wrong each time.
Are some people incorrectly medicated? Definitely. But the idea no-one needs this medication to live a fulfilling life is reckless and ill informed.