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Eh, I don't know. The DSM-V has been widely seen as a disappointment, from what I've read, but trying to go to the other extreme and define mental illness in strictly physiological terms is clearly not the way forward, either. How would you even do that? Still, I think the action is more right than wrong, because the DSM-V is so subjective. I've had a couple of family members go through therapy / psychiatric work and it's not uncommon to see five different caregivers and get five entirely different diagnoses. Often, the diagnosis is just a reflection of a given caregiver's pet "hammer". If you specialize in Asperger's, you tend to see Asperger's. If you specialize in depression, you tend to see depression. If you think mental illness is basically caused by brain chemistry issues, then you will neglect the time consuming and messy talk therapies and CBT in favor of magic pills. If you are fascinated by schizophrenia then you will diagnose someone in the manic phase of bipolar disorder as schizophrenic. And so on.
This nonsense has to stop and I think that divorcing NIMH research from the DSM-V is at least a step in the right direction, however imperfect it may be. At least there is an honest recognition that current approaches aren't working in any meaningful, accountable, measurable way.
Mordant, thank you so much. I too have seen labels slapped on people in institutional settings (childhood bipolar, in particular), and the resulting damage that it caused. From what I have read, contributors to the DSM series have even falsified their "evidence-based" research. In my opinion, why didn't the NIMH and other organizations protest earlier???
My 27 year old son is currently being assessed by a therapist, and I really need an exact diagnosis, a clear prognosis, and a treatment plan as empirically rooted as it can be. It's important to me to understand what is in his best interest, how best to relate to him and be present for him, what he's truly capable and incapable of and why. These are the things any parent would want to know. Sadly, I can't have much confidence that I'll get that in a way that if I took him to two other docs I'd get a very similar assessment. Even in medicine there's room for disagreement (I'm reminded of the disparate opinions my brother got for bone cancer in his leg -- chemo, surgery, or amputation). But at least they agreed on a diagnosis!
ANYTHING that seeks consistent results would seem an improvement. And the NIMH has a lot of clout. They realize that without restoring some credibility to mental health care, we are all headed for ... well, madness.
I truly hope your son gets the correct diagnosis, and hopefully, good treatment. I would say to trust your gut feeling....if the therapist says something to you or him that doesn't feel right, then back away. I also find that the psychiatric industry generally treats symptoms and not the root cause of problems. Nonetheless, some talk therapy can be of benefit, and of course, medication may help as well. I assume that a physical has been done and that any illnesses, vitamin deficiencies, etc. have been ruled out. I hope you get some answers soon.
And it certainly will be interesting to see what direction the NIMH takes in the future.
John, unfortunately it is a very political manual meant to make it easier to prescribe drugs and other various "treatments." You are right when you say nothing is ever etched in stone, but that doesn't play out in the real world of psychiatric diagnosis. I have worked in institutions and have seen how quickly a psychiatric label is put upon someone. After that, the person is seen only in the terms of their "disorder." And the power that these psychiatrists and psychologists wield is unbelievable....and totally unwarranted.
Much mental distress is due to situational problems (job loss, unhappy marriage, children with academic problems, etc.) Our reactions to these problems can involve anxiety, anger, depression, etc. These are NORMAL reactions. The psychiatrists want to convince you that you need help managing these reactions and thus they sell you into paying for therapy and drugs. They profit from human suffering.
Now are there times when therapy and drugs are warranted? Yes there is.....but our current system based on treating symptoms and not the whole person. And of course the drug companies want you hooked on their products, whether it's helping you or not.
There are many articles on the Internet which will inform you about the crisis in mental health care. You can also look up the history of the DSM and it's contributors. Google "False Epidemic of Childhood Bipolar Disorder." "Revolution in Swedish Mental Health Practice" is another one. What you read will scare you.
...Is the Institute doing the right or wrong thing with this decision. Just interested in what people's opinions are.
Medical science has a LONG way to go. It was not that long ago doctors were draining blood from people to cure them of an illness (blood letting).
And they still "remove" an organ like a gallbladder or appendix if there is a problem - Not working? Remove it then!
In my opinion, a proper "fix" would be to replace the organ with a properly functioning one or repair the existing organ so it functions properly. We are not "there" yet.
Psychiatry has an even longer way to go. That is because the human brain, like a computer, has both "software" and "hardware" (if you will). And it has only been recently that we could use computers as a comparison (because they had not been invented yet!)
And speaking of computers and technology, there are a LOT of new electronic diagnostic gizmos out there these days. I think a fresh look at psychiatry would be an excellent idea.
Medical science has a LONG way to go. It was not that long ago doctors were draining blood from people to cure them of an illness (blood letting).
And they still "remove" an organ like a gallbladder or appendix if there is a problem - Not working? Remove it then!
In my opinion, a proper "fix" would be to replace the organ with a properly functioning one or repair the existing organ so it functions properly. We are not "there" yet.
Psychiatry has an even longer way to go. That is because the human brain, like a computer, has both "software" and "hardware" (if you will). And it has only been recently that we could use computers as a comparison (because they had not been invented yet!)
And speaking of computers and technology, there are a LOT of new electronic diagnostic gizmos out there these days. I think a fresh look at psychiatry would be an excellent idea.
Psychiatry is certainly necessary but a large segment of it still is little more than witch-doctoring. I did some consulting work for a psychiatrist, a dept head of a prestigious hospital. My work was non-medical but I would be in the room when they were talking about what drug to prescribe for what problem. It was basically like a dart throwing exercise--try this, try that, try the other.
Read the story of how the frontal lobotomy was 'invented.' He would basically drill a hole in the patient's head, take an instrument like an apple corer, and randomly move it around inside the head. For this he won the Nobel Prize in medicine.
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