Perhaps someone can refute or confirm a claim I’ve read about the DSM: It’s heavily influenced by the American healthcare system and its private insurance companies. The folks writing the DSM don’t want patients with uncommon conditions to run into “That’s not a real disorder, so we won’t pay for treatment of it” situations with insurers. They throw in a whole bunch of disorders and symptoms which to a casual observer seem unnecessary and out of place; these DSM entries exist so that a doctor has so many potential boxes to tick off on his paperwork that he can secure payment for treatment of even the most unusual patient.
So you’re taking the opinion of one psychiatrist as your basis for dismissing the opinions of all psychiatrists. That again is…interesting…reasoning.
But anyway, let’s say your and his hypothesis is right. Why is the brain, uniquely among all organs in nature, so devoid of flaws? Why is there only one significant psychological defect which can manifest?
(and if you wish to say: “having psychological defects is normal, and shouldn’t be labelled pathologies”, then why the special status of schizophrenia?)
OK, so how do you classify all of, anxiety, depression, bipolar and dementia as listed earlier.
alzheimer’s is not a mental illness?
This is a gray area I think, no pun intended.
Alzheimer’s is a physical disease that literally degrades and destroys brain tissue. This does cause mental issues, but they are a symptom and not a chief illness.
I’m not sure why this makes it distinct from other illnesses that have physical effects on the brain and subsequently the behaviour of the sufferer.
I’ll grant that to a point. I suppose I see Alzheimer’s as more of a chronic physical disease. Mental illnesses are by and large chemical imbalances. It is a subtle difference, but a notable one I feel.
mental illnesses exist in the way all other illnesses exist. To say that mental illness does not exist is like saying back or organ illnesses do not exist.
I believe that when mental health proffesionals become better at incorporating what is known about nuero science and our ability to manipulate our own nuero chemicals they will become more effective. Some mental health issues are truly diseases that can only be treated with drugs at this time.
That’s one of the present criticisms of the DSM-V (latest edition, released May of this year)–that neuroscience hasn’t advanced enough in the past decade to make a new edition worth it. They say it’s just a shuffling of previous knowledge, rather than a reflection of new discoveries.
That said, psychiatry as it is practiced today can do wonders for people. I know a lot of people who criticise the field because they’ve never met someone who’s mentally ill, ergo mental illness must not exist. The physicians I’ve worked with don’t call anyone who sheds a tear “depressed” any more than they call someone giddy “manic.” Many conditions are not subtle, and the diagnosis isn’t a difficult one. But sure, there are overdiagnoses, just like with every disorder. The number of people who refuse medications because they’re “allergic” is way out of proportion to the number of actual allergies. Ditto for celiac disease. Does that make every allergist and gastroenterologist bad physicians?
I read Dr. Szasz book about 25 years ago and even back then I disagreed with much of his conclusions. While some of his criticisms are valid, particularly the coercive uses of psychiatry in the era in which he wrote (the 1950’s/early 60’s), his leap to “mental illness doesn’t exist” is an overreaction.
There’s also 50 years of further advancement in understand the brain since then that has refined our notions of mental illness and ability to treat it.
In other words, I didn’t miss your post and I didn’t “skip” over it, I just don’t feel like rehashing in detail the flaws of a book/world view that is now 50 years out of date.
Psychiatry is probably the softest, most subjective branch of medicine. If a doctor says you have high cholesterol, that’s an objective, tangible thing. He reached his conclusion by doing a blood test. But a psychiatrist makes a diagnosis purely by observing the patient’s behavior. If he says, for example, that you’re hostile, that’s not objective; it’s his word against yours. Maybe he’s right, maybe he’s a dick who invites hostility, maybe the two of you simply rub each other the wrong way. Dealing with people is a very touchy-feely thing.
It’s strange to me that a person would say the only real mental illness is schizophrenia, even though schizophrenia is co-morbid with a bunch of the so-called “fake” disorders.
It’s also funny how the fake disorders seem to commonly show up in families with schizophrenia. Is the person with schizophrenia in cahoots with their cousin with ADHD and Tourette’s, their uncle with autism, their aunt with schizoaffective disorder, and the baby sister with OCD and bipolar disorder? Why is the schizophrenic the only one deserving of your compassion, if all of these diseases are caused by the same genetic vulnerability?
Alzheimer’s has been mentioned, but Parkinson’s is another. Parkinson’s doesn’t just affect how a person walks and moves, but it’s also associated with a slew of psychiatric problems. Ditto Huntington’s Disease. Why don’t you try walking up to a Huntington’s patient and tell them to just shrug off their manic-depression, anxiety, and compulsive behaviors? I’m sure they’d love to hear how they have been so led astray by the psychiatry. These diseases demonstrate that our minds do not exist independently of our bodies. Jigger with the basal ganglion enough, and you’ll end up with a movement disorder and a whole bunch of other stuff. Or just the movement disorder. Or just the “whole bunch of other stuff.” Granting more gravitas to one set of symptoms, just because you can see them, makes no sense.
You seem to be confusing physical problems like Parkinsons with mental problems.
The only way to believe that psychiatry is less “real” than the rest of medicine is if you hold some absurd Descartian view that the mind does not reside in the body and is not subject to the laws affecting other organs. Of course, most people do hold this view on some level. But those people are wrong.
It’s not unreasonable to consider that mental illness is overdiagnosed. It’s true of many types of illnesses. That doesn’t mean there aren’t real mental illnesses, or that the majority of diagnoses are invalid. Mental illness is not like a broken bone that can be detected with an X-ray, but it’s not something where the diagnosis is arbitrary either.
You seem to think there’s a meaningful difference between the mental and physical symptoms of brain dysfunction. There’s no reason to think there is.
Go find yourself a bi-polar roommate for a year or so and then come back and tell us it’s an imaginary disorder.
No, they don’t. Mental illnesses are diagnosed using other information as well, such as the patient’s self-reported behavior, thoughts, and feelings, and their responses to tests and assessments such as the Beck Depression Inventory.
If schizophrenia is the only real mental disease, then what were you talking about in your OP when you said most psychiatrists are “mentally ill”? What mental illness do all psychiatrists have? Are they all schizophrenic?
FWIW, I do believe the psychiatrists over diagnose mental illnesses, but that doesn’t mean it’s all made up.
Yes.
And again I ask: if we accept that there are many disorders of the brain, both congenital and acquired, that can affect memory, balance, vision, coordination…all parts of the brain…why is the mind and consciousness so special that it can suffer at most one possible defect?
OTOH, if we’re going to call all psychiatric disorders “normal variation”, then why not the disorders of the rest of the brain? So when Bob has an epileptic fit that’s just Bob being Bob.