# Mental disorders aren't necessarily valid

**URL:** <https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363>\
**Category:** Great Debates\
**Created:** [October 14, 2003, 1:12pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363 "2003-10-14T13:12:43Z")\
**Posts on this page:** 20\
**Page:** 5

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**Author:** ![Primaflora](https://avatars.discourse-cdn.com/v4/letter/p/898d66/32.png) [@Primaflora](https://boards.straightdope.com/u/Primaflora)\
**Post date:** [October 16, 2003, 10:01pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/81 "2003-10-16T22:01:47Z")

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> [@](#):
>
> \*Originally posted by TVAA \*  
> \*\*\*\* You’re joking, right?
> 
> \*\*

No, I’m not joking about parents of kids with autism not accepting the simple answers at face value. You don’t know much about the autism community if you think that all parents go away and just get on life with their kids with autism while swallowing the party line about recovery.

Investigate DAN protocols and NIDS protocols. Look at the biomedical interventions which are being done. Serotonin was used after a parent talked a doctor into trialling it. I live a double life with my kid. My conventional paed knows that I am doing biomedical intervention but he thinks it’s a crock so I just nod and smile and consult him for the bits that work from him while keeping him informed on what I’m using that might affect the meds he prescribes.

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**Author:** ![electric\_sheep](https://avatars.discourse-cdn.com/v4/letter/e/90db22/32.png) [@electric\_sheep](https://boards.straightdope.com/u/electric_sheep)\
**Post date:** [October 16, 2003, 10:26pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/82 "2003-10-16T22:26:35Z")

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> [@](#):
>
> \*Originally posted by NeSBiT \*  
> **I’m bipolar. I don’t think bipolar disorder has anything to do with cultural norms, is a physical problem, and should be medicated if you want to treat it.**

Culture doesn’t tell you that it’s physical, but simply that “it” is worthy of notice as a distinct issue, and is a problem.

\*\*

> [@](#):
>
> First, what is “unacceptable” behavior that would apply to all cultures? How about hallucinating…\*\*

Altered states of mind can be productive (especially dream-like states).

\*\*

> [@](#):
>
> thinking you’re god\*\*

Hey, I hear a guy called Jesus tried it and was pretty successful.

\*\*

> [@](#):
>
> becoming violent for no reason\*\*

A mark of a true warrior.

\*\*

> [@](#):
>
> extreme paranoia\*\*

In some cases, everyone really might be out to get you. All but the worst forms of paranoia probably lent some selective advantage in early human societies.

\*\*

> [@](#):
>
> hearing voices, being unable to sleep, loss of identity, etc.\*\*

Again, many cultures do not make these phenomena “clinical,” but instead incorporate them into their way of life, or even assign them some degree of reverence. In fact, until the 1800s or so, when the church recruited proto-science to hunt down “heretics,” the so-called “mentally ill” had a strong role in entertainment, with their own theatres and literature. Hell, you could make a strong argument that the whole Gothic movement was a manifestation of what we now see as “abnormal tendencies.” 😛 That modern society can’t cope with all of this is a cultural issue; but please, take this as an observation and not quite a condemnation.

\*\*

> [@](#):
>
> All of this has happened to me in my manic phases and I feel it’s necessary to stay medicated the for the rest of my life. As for my depressed phases- paranoia, hearing voices, extreme confusion, being unable to sleep, and being extremely suicidal. These were also problems.\*\*

If they were problems for you, I have no issue with you medicating yourself–that’s your choice. Frankly, I personally have problems with language and behavior when I get less than 10 hours of sleep, and would love to medicate myself. Is requiring much sleep a “disorder”? Only relative to an order where you need to be awake for over 14 hours.

\*\*

> [@](#):
>
> As for why I think it’s a physical problem and not entirely psychological- genetics, my grandmother and several uncles are bipolar, my childhood was fine(no abuse or traumatic experiences), and my depressed and manic times are not preceeded by any significant events.\*\*

Psychological problems are physical problems; the question is whether the root is to be found primarily in genetics or primarily in the environment. 🙂

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**Author:** ![MrAndrewV](https://avatars.discourse-cdn.com/v4/letter/m/b4bc9f/32.png) [@MrAndrewV](https://boards.straightdope.com/u/MrAndrewV)\
**Post date:** [October 16, 2003, 11:53pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/83 "2003-10-16T23:53:08Z")

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I am just going to jump in here at the bottom and drop my problems with the DSMIV.

TVAA has spoken at length on the tendency that parents have to accept explanations that take the blame off of them. I am not going to even touch autism here because I don’t know anything about it. But I do know alot about the ADD/ADHD/hyperactive child/‘problem child’ diagnosis.

I recently worked on a summer camp in New York state. It was a great experience for a South African with an Honours degree in Psych because I learnt that many of the stereotyped case studies about american psychology/psychiatry that we had been given were absolutely accurate.

One of the most important of these is that American youngsters are extremely over medicated. Let me keep this short: It’s true.

See we were always told which of the kids were on medication and what the meds were for (We were also told to keep it quiet and to treat them like all the other kids which, miraculously, we did). I was also told on a few occasions that a child was not going to take their medication while on camp and that I should be prepared for problems.  
Here is a list of the problems that I had:

Terrifying isnt it? No problems at all. Some of the kids that I had been told were (and I quote) “Exteremely Disruptive and highly ADHD” (whatever the ehck that means) were nothing of the sort. I KNOW what fucking ADHD looks like. I was there myself when I was younger and there was nothing wrong with these kids at all.

So what was the problem? The problem was that mommy and daddy where always high-powered doctors/lawyers/bankers/psychologists/ad execs. Make no mistake this camp was for the rich. The only problem that these kid had was that mommy and daddy were too busy working hard to actually raise them. When they had someone who _gasp_ listened to them and respected them they had no problems at all.

There was one kid who we shall call ‘S’. I was told by a fellow counsellor that she had been taken off her medication and that the change had been remarkable, in a good way.

See the previous S’s parents had been so happy with how well behaved she had been in school they sent her to camp as a reward. She frightened the counsellors because she was a robot.

She ate mechanically, she spoke mechanically she took part in the activities on camp only when someone asked her to. She was a drug-induced fucking robot. She was being praised for acting well when actually she was acting lobotomised. But her parents were thrilled.

Now this was just one small camp guys and there were at least half a dozen kids who had been obviously misdiagnosed. If there was such a high number in just that one camp how many more are there out there? It just makes me sick.

Oh and another thing: I don’t know how it is in your country but here you have to tell the insurance company what disorders you have before they will give you money for treatment. Alot of the time they will only give money for the most common treatment of a problem, even if there is evidence that suggests that treatment doesn’t work.

But maybe you guys are lucky. Maybe insurance company’s in your country are nice 😉

quote:“I’m the first to admit that psychiatry is a fairly imprecise system.”

Correct. I.e. it is not a science, even though it often pretends to be. Psychiatry and psychology are not sciences YET. Hopefully they will be soon. Until then the best that can be done is being done.

HOWEVER patients should be told the horrible truth about their disorders. They should be told that no-one knows the answers and that they are relying on best-guess treatments. It will scare the pants off them but at least then they will be being treated like adults and equals and not like ignorant children.

## /quote:

## cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

meaning, of course, the variation or disorder or label it as you will, is causing the individual who is experiencing it A Lot of Problems. Which is why mental illness is considered a disorder and handedness isn’t /endquote.

Well it would probably interest you to know that for a long time left-handedness WAS considered a disorder. Because it was considered a disorder children who were lefties were routinely beaten for bad schoolwork and stubborness which in turn made them avoid school.

I would classify that as “clinically significant distress or impairment in social, occupational, or other important areas of functioning” so I guess left handedness IS a disorder after all. At least acording to the DSM.

My point? Most, if not all, DSM diagnoses boil down to the whole “clinically significat…etc” This means that it is an individual’s interaction with society that determines whether they are diangosed as having a disorder or not. This places far too much importance on social norms and of the opinions of the clinician.

This is not science. In fact it is the opposite of science: it’s hearsay.

ANd as to the guy who said that why a treatment works is not important as long as it works should go here:  
[http://www.epub.org.br/cm/n02/historia/lobotomy.htm](http://www.epub.org.br/cm/n02/historia/lobotomy.htm)  
where he will learn that for a while the lobotomy was being used as a FIRST resort in many psychological disorders.

Sure it robbed the people of all emotion and drive but who cares? The important thing is that they stopped complaining. Seriously tho the reason why it was so popular is because it lead to a 100% reduction in symptoms. This encouraged those in favour of the lobotomy, hardcore medical scientists that they were, to state that their patients were cured. After all: there were no symptoms that they could see (or in today’s jargon no “clinically significant etc…”).

And now children are, in their thousands, being given chemical lobotomies called Ritalin. Or whatever the heck they are calling it these days.

However I must also say that going onto ritalin did help me to overcome my ADHD. But then I actually had it. And after three years I didn’t need it anymore.

Well thats my rant, hope you liked it.  
Stay happy people  
-Andrew V

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**Author:** ![Guinastasia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guinastasia/32/5751_2.png) [@Guinastasia](https://boards.straightdope.com/u/Guinastasia)\
**Post date:** [October 17, 2003, 12:39am UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/84 "2003-10-17T00:39:04Z")

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> [@](#):
>
> \*Originally posted by electric!sheep \*  
> \*\*Grrr…the “show sig” box keeps getting unchecked. :mad: \*\*

That’s because the people who run the board only wish us to post our sigs ONCE in a thread.

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**Author:** ![electric\_sheep](https://avatars.discourse-cdn.com/v4/letter/e/90db22/32.png) [@electric\_sheep](https://boards.straightdope.com/u/electric_sheep)\
**Post date:** [October 17, 2003, 1:20am UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/85 "2003-10-17T01:20:05Z")

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> [@](#):
>
> \*Originally posted by Guinastasia \*  
> \*\*That’s because the people who run the board only wish us to post our sigs ONCE in a thread. \*\*

Link to this highly peculiar policy?

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**Author:** ![auliya](https://avatars.discourse-cdn.com/v4/letter/a/90db22/32.png) [@auliya](https://boards.straightdope.com/u/auliya)\
**Post date:** [October 17, 2003, 2:03am UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/86 "2003-10-17T02:03:19Z")

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> [@](#):
>
> \*Originally posted by MrAndrewV \*  
> \*\*Well it would probably interest you to know that for a long time left-handedness WAS considered a disorder. Because it was considered a disorder children who were lefties were routinely beaten for bad schoolwork and stubborness which in turn made them avoid school. \*\*

And what edition of the DSM was lefthandedness listed as a category of mental illness and subjected to the proviso:

> [@](#):
>
> cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

?

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<div class="post-metadata">

**Author:** ![NeSBiT](https://avatars.discourse-cdn.com/v4/letter/n/b5ac83/32.png) [@NeSBiT](https://boards.straightdope.com/u/NeSBiT)\
**Post date:** [October 17, 2003, 9:46am UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/87 "2003-10-17T09:46:58Z")

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> [@](#):
>
> \*Originally posted by electric!sheep \*  
> \*\*Culture doesn’t tell you that it’s physical, but simply that “it” is worthy of notice as a distinct issue, and is a problem.
> 
> um, I just personally believe that’s it’s a physical problem.
> 
> \*\*
> 
> Altered states of mind can be productive (especially dream-like states).
> 
> They can be useful when you _want_ to be in an altered state.
> 
> \*\*
> 
> Hey, I hear a guy called Jesus tried it and was pretty successful.
> 
> If by successful you mean getting stabbed and crucified
> 
> \*\*
> 
> A mark of a true warrior.
> 
> True warriors are calculating and not random. And they don’t go after their friends for no reason.  
> \*\*
> 
> In some cases, everyone really might be out to get you. All but the worst forms of paranoia probably lent some selective advantage in early human societies.  
> Not true. There has never been a case of everyone in the world being out to get someone. And some paranoia is good, but I had the worst kind.  
> \*\*
> 
> Again, many cultures do not make these phenomena “clinical,” but instead incorporate them into their way of life, or even assign them some degree of reverence. In fact, until the 1800s or so, when the church recruited proto-science to hunt down “heretics,” the so-called “mentally ill” had a strong role in entertainment, with their own theatres and literature. Hell, you could make a strong argument that the whole Gothic movement was a manifestation of what we now see as “abnormal tendencies.” 😛 That modern society can’t cope with all of this is a cultural issue; but please, take this as an observation and not quite a condemnation.
> 
> hmm. Being unable to sleep for me did nothing useful but make me extremely confused, I doubt I could write literature or entertain in this state. Hearing voices isn’t as problematic, but it does tend to increase paranoia. And loss of identity, well, hard to communicate when you don’t know your name and lose all knowledge of language, even harder to be in a movement or play a role in anything.
> 
> \*\*
> 
> If they were problems for you, I have no issue with you medicating yourself–that’s your choice. Frankly, I personally have problems with language and behavior when I get less than 10 hours of sleep, and would love to medicate myself. Is requiring much sleep a “disorder”? Only relative to an order where you need to be awake for over 14 hours.
> 
> nope, requiring 10 hours of sleep is fine. but it is a problem when you intentionally sleep more to avoid life. which I did sometimes.
> 
> \*\*
> 
> Psychological problems are physical problems; the question is whether the root is to be found primarily in genetics or primarily in the environment. 🙂
> 
> ah, the old nature v. nurture, the current consensus is it is a combo of both, and not a majority of either. I tend to agree with that.
> 
> thanks for the reply, as a satanist I can respect your views on the problems with cultural norms  
> \*\*

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<div class="post-metadata">

**Author:** ![TVAA](https://avatars.discourse-cdn.com/v4/letter/t/c57346/32.png) [@TVAA](https://boards.straightdope.com/u/TVAA)\
**Post date:** [October 17, 2003, 11:24am UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/88 "2003-10-17T11:24:20Z")

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> [@](#):
>
> \*Originally posted by Primaflora \*  
> \*\*Cite? You’re wrong BTW. There is no single developmental stage at which autism develops. Not all children have a period of apparent normality.

\*\* No, [most don’t](http://depts.washington.edu/autism/Outlook/STY4mrkout.html). We now know that the majority of children who will eventually be diagnosed as autistic can be identified as such before their first birthdays. A minority are seemingly normal until they’re about 2 or 3.

> [@](#):
>
> **and the common features are?**

Lack of basic interpersonal responses (making eye contact, attempts to communicate non-verbally, etc.), stereotyped movements, unusual focus or interesting in seemingly meaningless tasks, extreme behavioral rigidity (significant distress if schedule is altered or interupted), tendency to follow patterned behaviors.

> [@](#):
>
> \*\*which are?

\*\* [Here’s an interesting one.](http://health.ucsd.edu/news/2003/07_15_Courchesne.html)

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<div class="post-metadata">

**Author:** ![TVAA](https://avatars.discourse-cdn.com/v4/letter/t/c57346/32.png) [@TVAA](https://boards.straightdope.com/u/TVAA)\
**Post date:** [October 17, 2003, 11:35am UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/89 "2003-10-17T11:35:35Z")

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> [@](#):
>
> \*Originally posted by auliya \*  
> \*\*This is rubbish **TVAA**. I have just done a major project on this exact subject and I can provide you with 30 good references to research studies to prove it, if you are interested. I am in no doubt that you aren’t of course, because they wouldn’t agree with your biased and totally unsubstantiated position on this subject. \*\*

That is rubbish, **auliya**.

For psychiatric disorders overall, psychopharmaceutical treatments are estimated to be effective (note: not curing, just being clinically helpful in reducing or controlling symptoms) about 60-70% of the time. Unfortunately, this statistic includes the 20-30% of people who get better on their own!

In studies of the effectiveness of antidepressants, the placebo response accounts for between 25-50% of the clinical response of antidepressants (it’s most often around 30-35%). That’s much higher than many other types of drugs.

Researchers have also found that people respond more the placebos that have noticable physiological side effects (presumably because they find it easier to believe they’re taking a real drug), which brings into question most comparisons of drug effectiveness to placebos.

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**Author:** ![TVAA](https://avatars.discourse-cdn.com/v4/letter/t/c57346/32.png) [@TVAA](https://boards.straightdope.com/u/TVAA)\
**Post date:** [October 17, 2003, 11:44am UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/90 "2003-10-17T11:44:00Z")

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**electric!sheep** , by your logic being a political dissident is a neurological disorder.

Yes, all aspects of human behavior are ultimately driven by physiology, but it doesn’t follow that an undesirable behavior is caused by a problem with physiology.

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**Author:** ![rickiwatts](https://avatars.discourse-cdn.com/v4/letter/r/b9e5f3/32.png) [@rickiwatts](https://boards.straightdope.com/u/rickiwatts)\
**Post date:** [October 17, 2003, 5:17pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/91 "2003-10-17T17:17:11Z")

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TVAA:

You are argueing a very strange point. You’re trying to say that since many mental diseases have hard to objectively diagnose symptoms and causes, that they are therefore not valid diseases.

If you are searching for the ‘objective’ in psychology at this point in history I think you will fail. A patient can testify that they hear voices coming from the walls, but there is no instrument that can measure this. The lack of measurement does not mean the patients symptoms are not occuring, or he is not suffering and in  
need of treatment.

Lets look at SentientMeats example:

SentientMeats mother is diagnosed with panic attacks. She experiences moments of extreme terror for no discernable reason. Medical science can only theorize as to what causes a fear reaction in a human being with no triggering stimuli. Medical  
technology can observe the biological changes that occur during a panic attack, but  
since little is known how a ‘normal’ brain works, doctors can only study and theorize.  
I think you are mistaken as to what a panic attack is. If someone were to experience terror while stuck inside a burning building, that is completely normal. Terror in the absense of any real or abstract threats, if they occur in great power and frequency, can harm a persons well being, and are labeled a mental disease.

I don’t see the problem. Science cannot yet pinpoint the causes of these mental conditions. Doctors are therefore are useing what they do have, observations from patients, and attempting to codefy them into a list of conditions and symptoms. I don’t think anyone here is argueing that these people are not suffering. Then why is there a debate over doctors trying to solve a difficult problem scientifically?

I think the real problem here is that TVAA is really mad about something that has nothing to do mental diseases or their diagnosis. Mostly from his multiple comments about health insurance.

\*\*\*please forgive my pore speling

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<div class="post-metadata">

**Author:** ![electric\_sheep](https://avatars.discourse-cdn.com/v4/letter/e/90db22/32.png) [@electric\_sheep](https://boards.straightdope.com/u/electric_sheep)\
**Post date:** [October 17, 2003, 8:02pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/92 "2003-10-17T20:02:45Z")

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> [@](#):
>
> \*Originally posted by NeSBiT \*  
> \*\*um, I just personally believe that’s it’s a physical problem. \*\*

Oh, all phenomena are most definitely physical; cultural critique has nothing to do with that. I’m only attacking the “it” and “problem” parts. 🙂

\*\*

> [@](#):
>
> They can be useful when you want to be in an altered state.\*\*

Agreed, I have nothing against the modification of _personally_ undesirable states (though sometimes they can lead to works of artistic significance). Unfortunately, psychiatry goes much further in its diagnoses.

\*\*

> [@](#):
>
> If by successful you mean getting stabbed and crucified\*\*

Hey, we all die, but at least some of us are remembered for centuries ahead. 😃

\*\*

> [@](#):
>
> True warriors are calculating and not random. And they don’t go after their friends for no reason.\*\*

Alpha-males can do a good job of solidifying their control by keeping even their friends in line, but they obviously need to have some self-control. For all my love of Caligula, I do realize that he didn’t last very long. 😛 In any case, if random violence doesn’t bother the “afflicted” one, then it’s basically a question of how society relates to it. All notable societies have proscriptions against _some_ things, of course, but that doesn’t make those judgments any less subjective. Shared subjectivity is a far cry from objectivity.

\*\*

> [@](#):
>
> Not true. There has never been a case of everyone in the world being out to get someone. And some paranoia is good, but I had the worst kind. \*\*

In _the_ world? No, of course not. Every active force in _your_ world? Possibly, but probably not.

\*\*

> [@](#):
>
> hmm. Being unable to sleep for me did nothing useful but make me extremely confused, I doubt I could write literature or entertain in this state. Hearing voices isn’t as problematic, but it does tend to increase paranoia. And loss of identity, well, hard to communicate when you don’t know your name and lose all knowledge of language, even harder to be in a movement or play a role in anything.\*\*

Again, if these are problems to you, fine, but they are problems to _others_ based entirely on how and when those others interact with you.

\*\*

> [@](#):
>
> nope, requiring 10 hours of sleep is fine. but it is a problem when you intentionally sleep more to avoid life. which I did sometimes.\*\*

It’s above average, and poses problems to people around me, so maybe it’s not quite fine.

\*\*

> [@](#):
>
> thanks for the reply, as a satanist I can respect your views on the problems with cultural norms\*\*

Well, I don’t have legitimate “problem” with cultural norms, since any judgment about them would itself be subjective, but I do want to point out their functional significance. At the end of they day, however, I might attack them anyway.

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<div class="post-metadata">

**Author:** ![electric\_sheep](https://avatars.discourse-cdn.com/v4/letter/e/90db22/32.png) [@electric\_sheep](https://boards.straightdope.com/u/electric_sheep)\
**Post date:** [October 17, 2003, 8:08pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/93 "2003-10-17T20:08:27Z")

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> [@](#):
>
> \*Originally posted by TVAA \*  
> **electric!sheep, by your logic being a political dissident is a neurological disorder.**

It is neurological. Whether it is a disorder or not depends on which order you support. 😃

\*\*

> [@](#):
>
> Yes, all aspects of human behavior are ultimately driven by physiology, but it doesn’t follow that an undesirable behavior is caused by a problem with physiology. \*\*

Please read my posts. Judgments of undesirability and problem are independent of explorations into physiology or causality.

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<div class="post-metadata">

**Author:** ![TVAA](https://avatars.discourse-cdn.com/v4/letter/t/c57346/32.png) [@TVAA](https://boards.straightdope.com/u/TVAA)\
**Post date:** [October 17, 2003, 8:12pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/94 "2003-10-17T20:12:58Z")

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> [@](#):
>
> \*Originally posted by rickiwatts \*  
> \*\*You are argueing a very strange point. You’re trying to say that since many mental diseases have hard to objectively diagnose symptoms and causes, that they are therefore not valid diseases.

\*\* I’m not disputing that they may be valid syndromes (although their symptoms are still defined far too vaguely, so even this is questionable). I am disputing the claim that the syndrome is linked to a known disease process.

> [@](#):
>
> \*\*SentientMeats mother is diagnosed with panic attacks. She experiences moments of extreme terror for no discernable reason. Medical science can only theorize as to what causes a fear reaction in a human being with no triggering stimuli. Medical  
> technology can observe the biological changes that occur during a panic attack, but  
> since little is known how a ‘normal’ brain works, doctors can only study and theorize.

\*\* Panic attacks do not necessarily occur without a stimulus. Severe phobias are essentially panic attacks with an obvious stimulus (although not necessarily a rational one).

How many people are afraid of spiders, even though most spiders are not only harmless to humans but extremely beneficial (through killing insects)? How many people do NOT have a fear of cars, even though cars are a major source of injury and death?

“Normal” human responses are often no more justified than phobias, and sometimes much less.

> [@](#):
>
> \*\*I think you are mistaken as to what a panic attack is. If someone were to experience terror while stuck inside a burning building, that is completely normal. Terror in the absense of any real or abstract threats, if they occur in great power and frequency, can harm a persons well being, and are labeled a mental disease.

\*\* But the nature of an abstract threat is necessarily subjective. And there are plenty of rational fears – such as a fear of being in the hospital – that most people would regard as strange or “sick”.

> [@](#):
>
> \*\*I don’t see the problem. Science cannot yet pinpoint the causes of these mental conditions. Doctors are therefore are useing what they do have, observations from patients, and attempting to codefy them into a list of conditions and symptoms. I don’t think anyone here is argueing that these people are not suffering. Then why is there a debate over doctors trying to solve a difficult problem scientifically?

\*\* Because they’re not giving the scientific information to the patients, and they’re giving them easy-to-understand pseudoscience instead.

> [@](#):
>
> **I think the real problem here is that TVAA is really mad about something that has nothing to do mental diseases or their diagnosis. Mostly from his multiple comments about health insurance.**

Oh, there are more reasons for the widespread use of drugs over therapy than insurance – that’s just one of the largest. Another is that most people are afraid of the social stigma that comes with therapy, whereas there’s no stigma associated with most physical illnesses and drug-taking. We’re quite big on drugs in this culture.

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<div class="post-metadata">

**Author:** ![electric\_sheep](https://avatars.discourse-cdn.com/v4/letter/e/90db22/32.png) [@electric\_sheep](https://boards.straightdope.com/u/electric_sheep)\
**Post date:** [October 17, 2003, 8:20pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/95 "2003-10-17T20:20:17Z")

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Um, yeah, what I meant to write above was:

> [@](#):
>
> > [@](#):
> >
> > \*Originally posted by TVAA \*  
> > **electric!sheep, by your logic being a political dissident is a neurological disorder.**
> 
> It is neurological. Whether it is a disorder or not depends on which _political_ order you support. 😃

…otherwise it sounds inanely redundant.

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<div class="post-metadata">

**Author:** ![TVAA](https://avatars.discourse-cdn.com/v4/letter/t/c57346/32.png) [@TVAA](https://boards.straightdope.com/u/TVAA)\
**Post date:** [October 17, 2003, 8:20pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/96 "2003-10-17T20:20:38Z")

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Look: how many of you are familiar with the claim that depression is a biochemical imbalance, a deficiency of serotonin in the brain? Probably most if not all – and quite a few of you would support that claim.

So explain these two points:

1. Although there are some cognitive effects of antidepressants soon after they’re taken, their antidepressant effects don’t kick in for about four to six weeks, and it’s sometimes considered necessary to wait for as long as twelve weeks before concluding that a particular antidepressant doesn’t work for a person. (This is why it’s considered dangerous to prescribe antidepressants to suicidal people: the activating effects can give them the boost they need to attempt suicide long before their depression is affected.) But the greatest change in neurotransmitters occurs within a week of the beginning of antidepressant treatment (usually between three and five days). Why do the antidepressant effects take weeks to begin when the biochemical changes peak in the first few days?

2. Amphetamines and cocaine both cause significant amounts of serotonin and norephinedrine to be released. Both of these neurotransmitters are commonly claimed to be deficient in depression. Yet neither drug is an effective antidepressant, even though both do what most people believe antidepressants do. How do you explain this?

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<div class="post-metadata">

**Author:** ![TVAA](https://avatars.discourse-cdn.com/v4/letter/t/c57346/32.png) [@TVAA](https://boards.straightdope.com/u/TVAA)\
**Post date:** [October 17, 2003, 8:28pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/97 "2003-10-17T20:28:01Z")

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**electric!sheep** : I acknowledge your point, but the definition of a healthy brain is broad enough to encompass many different configurations of a brain. If I love jazz and you dislike it, obviously this is due to a difference in the structures of our nervous sytem, but it doesn’t follow that one of us is healthy and the other isn’t.

Both Macs and PCs have fully functional operating systems, although they’re quite different from each other. One is not a defective version of the other: they’re two different things.

Merely having a brain whose properties others view as undesirable is not sickness, no more than having red hair and brown eyes is a deformity.

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<div class="post-metadata">

**Author:** ![electric\_sheep](https://avatars.discourse-cdn.com/v4/letter/e/90db22/32.png) [@electric\_sheep](https://boards.straightdope.com/u/electric_sheep)\
**Post date:** [October 17, 2003, 8:36pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/98 "2003-10-17T20:36:25Z")

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> [@](#):
>
> \*Originally posted by TVAA \*  
> \*\*Merely having a brain whose properties others view as undesirable is not sickness, no more than having red hair and brown eyes is a deformity. \*\*

And we disagree where, exactly?

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<div class="post-metadata">

**Author:** ![TVAA](https://avatars.discourse-cdn.com/v4/letter/t/c57346/32.png) [@TVAA](https://boards.straightdope.com/u/TVAA)\
**Post date:** [October 17, 2003, 9:49pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/99 "2003-10-17T21:49:33Z")

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“Disorder” != “sickness”

There are lots and lots of people who actively promote the idea that “disorder” == “sickness” – and even more people who don’t even know it’s a lie, and just repeat it because it’s what they’ve been taught.

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<div class="post-metadata">

**Author:** ![NeSBiT](https://avatars.discourse-cdn.com/v4/letter/n/b5ac83/32.png) [@NeSBiT](https://boards.straightdope.com/u/NeSBiT)\
**Post date:** [October 17, 2003, 9:52pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/100 "2003-10-17T21:52:34Z")

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> [@](#):
>
> \*Originally posted by TVAA \*  
> \*\*Look: how many of you are familiar with the claim that depression is a biochemical imbalance, a deficiency of serotonin in the brain? Probably most if not all – and quite a few of you would support that claim.
> 
> So explain these two points:
> 
> 1. Although there are some cognitive effects of antidepressants soon after they’re taken, their antidepressant effects don’t kick in for about four to six weeks, and it’s sometimes considered necessary to wait for as long as twelve weeks before concluding that a particular antidepressant doesn’t work for a person. (This is why it’s considered dangerous to prescribe antidepressants to suicidal people: the activating effects can give them the boost they need to attempt suicide long before their depression is affected.) But the greatest change in neurotransmitters occurs within a week of the beginning of antidepressant treatment (usually between three and five days). Why do the antidepressant effects take weeks to begin when the biochemical changes peak in the first few days?

The effects on the depression take weeks because even though the chemistry has changed, the person is still practicing negative behavior and is sometimes so used to being depressed that they cannot recognize that their mood has improved. This results in them continuing to show outward signs of depression. And it is NOT considered dangerous to prescribe antidepressants to suicidal people, the worse the mood the more likely they are to commit suicide, not the reverse. Maybe you’re thinking of the apparent improvement of mood in a person who finally resolves to kill themself.

> [@](#):
>
> 1. Amphetamines and cocaine both cause significant amounts of serotonin and norephinedrine to be released. Both of these neurotransmitters are commonly claimed to be deficient in depression. Yet neither drug is an effective antidepressant, even though both do what most people believe antidepressants do. How do you explain this? \*\*

um, they are pretty effective antidepressants. But as opposed to prozac, cocaine isn’t in your system 24/7, so it’s not a viable treatment unless you want to snort coke all day long.  
As for previous posts about the placebo effect and antidepressents. There also happens to be a placebo effect with cocaine and other recreational psychoactives. To me, there is a simple explanation. Normally norepinephrine, seratonin, etc are released due to an environmental stimulus, such as getting scared. The ole fight or flight response. So, if you perceive that you’re about to get high because you just snorted something your brain responds appropriately. This placebo effect doesn’t last because at some point the stimulus goes away, whereas when you’re taking a drug there is no outside stimulus so the drug just runs it’s course. A longterm placebo (taking one everyday) probably wouldn’t work because as time passed you would stop thinking about it so much and just automatically take your pill, kind of like if you faced violence on a day-to-day basis and eventually stopped getting an adrenaline rush in violent situations.

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