I believe any mental problems are not caused by a lack of neurotransmitters like serotonin. If someone has mental problems they are caused by something else which science can not explain as of yet. There is no scientific proof that a neurotransmitter deficiency causes mental illness, just educated guesses. We must remember that 50 years ago they thought having big ears was a sign of mental illness. Today we understand it was caused by them being boxed in the ears by mental ward staff and getting cauliflower ears (wrestling term).
We must remember our bodies are very good at regulating themselves and from my experience with medical science it is very unlikely that neurotransmitter deficiency would be so common. The fact that many depressed people take SSRI’s which increase serotonin and are still depressed is an example of this. The fact that SSRI’s have been shown to increase suicidal thinking and action is further proof. Not to mention that OCD is treated with SSRI’s, If lack of serotonin was a cause of OCD it would be present in every depressed patient in the world.
If you spend just a few minutes with a person who’s in a full-blown manic state, they’ll often look indistinguishable from a schizophrenic. Go to a mental ward and you’ll find catatonic depressives who look indistinguishable from catatonic schizophrenics. People with severe OCD? Often mistaken for schizophrenics. There are plenty of people walking around with schizophrenia who are mistakenly labeled with “Asperger’s Syndrome” (and vice versa).
If schizophrenia is the only real disorder, then what should one make of all the “look-a-likes”?
Besides confining your reading material to books that are decades out of date, what training do you have in this area?
edited to add: I would also like to know what psychiatric illness you think all psychiatrists have.
I will put this here again since some people seemed to have skipped over it Personally I believe schizophrenia is the only “real” mental disease. Dr. Thomas Szasz who is a psychiatrist even wrote a book about it called The Myth of Mental Illness. Read up on the Anti-psychiatry - Wikipedia movement.
So we know why Dr. Szasz believes what he does but to this point you are only parroting his beliefs. What facts do you have to support your notion? I believe psychiatry tries to take every little human quirk that makes humans, humans and tries to call it a mental illnesses. They do this because most psychiatrists are mentally ill themselves and it makes them feel better to believe everyone else is
Based on your notion, those Psychiatrist described above are Schizophrenic? What type are they? catatonic, paranoid or disorganized? or maybe they fall under Schizo-affective disorder. Riddle me this, exactly how does a Catatonic or disorganized Schizophrenic Psychiatrist have the where with all to complete an assessment, create a treatment plan and dispense meds? Yes it does categorize “every little human quirk” as a mental illness. Have you bothered to actually read through the DSM? Common sexual fetishes like foot fetish ect are classified as mental illness. Not to mention being gay was in the DSM as a mental illness until the 1970’s
Disorders making the dsm all have one thing in common, the disorder impacts the person to the point where normal and expected coping skills are challenged and threatened. That is why all the disorders have a checklist of symptoms that must be met along with associated psycho social impairments. Its not just enough one has a foot fetish, it is that one elevates the fetish over day to day responsibilities like feeding kids, going to work, eating and sleeping and on and on.
If you were to ever to meet and develop an intimate relationship with someone suffering from borderline personality disorder and were to survive it, you in short order would add at least on more diagnoses to your short mental illness list. And that diagnoses is Axis II, not considered a major mental illness just a common run of the mill personality disorder.
I was at the paint store the other day ordering some sand colored paint for my patio. It kept comming out moss green because one of the primary colors used in the mix was not firing as it should have been. The nozzle may have been plugged, it may have been out of paint, it may have had an electrical problem but the bottom line was I was not getting that color.
I imagine our mental state could very well be expressed as colors. We can only have one color at a time even though it may rapidly change or not be the correct color responding to a situation. We have certain base neuro chemicals being released in varying amounts and combinations to form an almost infinite amount of mental states of which we can only have one at a time.
I have seen non proffessionals in almost all walks of life who seem to be especially perceptive and intuitively are able to manipulate the mental state of someone else around them. On a much larger scale religions, politicians, cult leaders etc. have used their skills to their own advanatge. We have some basic human needs that if they are fullfilled within normal ranges of exposure should give us a healthy color, too much or too little may give us off colors of mental states.
I think one of the trickiest aspects is trying to figure out why we all respond so differently to the same things. What some of us see as a loving friendly gesture others might see as an opportunity to take advantage of someone. I can clearly see mistakes I made in parenting and how they are reflected in my children as adults. I can also see how mistakes my parents made have reflected on the way I respond to things. Thankfully I can also see things we did right.
I believe that neoro science is ready to play a larger roll in all aspects of mental health even though they may not yet know all the ins and outs. Understanding the dynamics may be more important than understanding the specifics.
I overstated my case; my bad. I still think evaluating someone’s thoughts and feelings is more subjective than saying they have a broken bone or a blocked artery.
Maybe so, but plenty of purely physical medical conditions are less easily diagnosed than broken bones. There are some where a number of different problems could produce basically the same physical symptoms, and some where the only obvious symptom is that the patient is experiencing pain – which is subjective and self-reported.
If you take a look at the New York Times column “Diagnosis” you can read about real-life hard to diagnose cases. Modern medicine is often able to get to the bottom of things eventually, but it’s not always as easy, obvious, or objective as looking at an X-ray and seeing that a bone is broken.
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I believe psychiatry tries to take every little human quirk that makes humans, humans and tries to call it a mental illnesses.
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How do you reconcile the three statements above? Are you really saying that psychiatrists are all schizophrenic?
There is a risk of that, but under the newer guidelines they attempt to only present mental illnesses as illnesses if they are harming the quality of life of the person who has it.
Slaves that ran away used to be considered mentally ill. So did gays. So did women who wanted more out of life than to be chattel (I believe). Even today pretty much anyone who expresses an unpopular opinion will be asked ‘did you take your meds’ or have it implied they are mentally ill for having unpopular beliefs. So there is a serious risk of the term being used/abused as a form of social control.
But I get the impression the psychiatry profession is trying to only focus on illnesses that harm a person’s quality of life now, not ones that are socially unpopular.
But even with that you have problems. Where does sadness end and depression begin. A lot of sadness exists because of trauma and unmet needs, not because of an organic illness.
SSRIs are mostly placebo. When the actual studies are looked at (both published and unpublished) it is found that about 80%+ of the effect of SSRIs is the placebo effect, they barely work better than sugar pills. Not only that but they only seem to help on the severely depressed, for those with minor or moderate depression they do almost nothing. The whole SSRI thing is, to me, a sign of why financial interests and medical interests should be separated more. If people who stand to make money fund the studies only the studies showing positive effect get published.
However antipsychotics do seem to work on a lot of people, especially for things like positive symptoms (hallucinations, delusions) of psychosis. Drugs for bipolar seem to be fairly effective too.
I think the reason that SSRIs–or any drug used in the treatment of psychiatric disorders–work inconsistently in the treatment of a specific mental disorder (say, depression) is likely similar to the reason that not all cancers (or even cancers of the same organ) respond to the exact same round of chemotherapy in the exact same way. While the end result of cancer is the same (there are cells growing out of control, they are fucking shit up, and if we don’t stop it you will die), the underlying types of cancer are very different. I suspect the same is true of something like depression. We’re diagnosing the end result (you feel like crap/are crying all the time/can’t give a shit/sleep all day), but don’t know the exact mechanism of the underlying cause. Even if we can narrow it down to “not enough serotonin”, we don’t really know why in any particular individual case.
So most med choices are probably experiential best guesses based upon the symptoms as presented and described by the patient. There seems to be a lot of cost/benefit analysis in the assignment of first-line drugs. SSRIs are often a first line because their side effect profile is, for a psychiatric drug, not that terrible. For some people, they work. For some people, they’re an absolutely wrong choice and make things worse. It’s often impossible to know who those people are in advance.
The thing is, if therapy isn’t working, the alternative to treatment is doing nothing. And, as someone who has suffered from dark days such that I can’t go an hour without crying for no reason, and who sometimes even on less-dark days suffers from complete anhedonia, doing nothing isn’t really a good option. I agree that some doctors over-medicate; I’ve personally suffered at the hands of a doctor whose response to a particular drug making things worse was to just add another drug.
Diagnosis is imperfect, medication is imperfect, and the results are imperfect. This doesn’t negate the existence of the underlying illness. Even if the cause isn’t specifically a serotonin deficiency (which it isn’t in my case), there is clearly something wrong.
ETA in response to Wesley Clark: I think a strong case could be made for SSRIs being the least powerful and effective of the possible treatments for depression; however, the low side-effect profile makes it still a decent first line choice. Antipsychotic side effects are, IME, much worse.
I don’t think that’s even close to true. You’re right that there is a long and sad history of people being considered mentally ill for opinions or behavior that are merely unusual, and a society’s biases are reflected in psychology as well. But let’s not make it sound like everyone who has an unpopular opinion is really considered ill. It’s usually a figure of speech.
In addition schizophrenia used to be treated and still is (quite well in fact) with Electro convulsive therapy which works by erasing memories . If schizophrenia was in fact caused by a excess of dopamine as we believe today then Electro convulsive therapy would have no effect.