My ten-cents on the DSM-5 debate debacle, part 2

I was going to drop the DSM-5 discussion last week, but another article came to light, and I just couldn’t do it. Sorry. This time its an Op-Ed piece in the New York Times, Not Diseases But Categories of Suffering.

It’s not the current A.P.A.’s fault. The fault lies with its predecessors. The D.S.M. is the offspring of odd bedfellows: the medical industry, with its focus on germs and other biochemical causes of disease, and psychoanalysis, the now-largely-discredited discipline that attributes our psychological suffering to our individual and collective history.

Actually the delusion of the APA is that the DSM will resolve this conflict, it’s revisionist editors from the very beginning have been the very people behind ‘the discrediting’, mentioned in the above paragraph, of psychoanalysis.

The American Psychiatric Association has been trying to do just that ever since, mostly by leaving behind ideas about the meaning of our suffering in favor of observation and treatment of its symptoms. In 1980, it hit on the strategy of adopting a medical rhetoric, organizing those symptoms into neat disease categories and checklists of precisely described criteria and publishing them in the hefty — and, according to its chief author, “very scientific-looking” — D.S.M.-III.

The pathologizing of human suffering, and not suffering symptomatic of any known physical disease, but rather that suffering which can be said to have arisen from emoting and thinking. Types of suffering are seen as disease manifested through a variety of symptoms.

Previously I stated that this process was a matter of normalizing medicalization, and this is so, what we’ve got here is medicine’s incursion into areas that, strictly speaking, are specifically not medical, and specifically not science.

In this Op-Ed piece we read the following, “And as any psychiatrist involved in the making of the D.S.M. will freely tell you, the disorders listed in the book are not “real diseases,” at least not like measles or hepatitis. Instead, they are useful constructs that capture the ways that people commonly suffer.” I wonder why does so much of the mental health industry rhetoric and literature insist then on stating that “mental illnesses” are real, that they are real diseases, and not only that they are real diseases, but that they are diseases of the brain. We’re stuck with an either/or that would be a both/and, but…Hey, whatever stretch you can come up to resolve that one has got to break on close examination.

My feeling has always been that this clamor is going to fizzle to a uncomfortable grumble once the volume is released in 2013. If such is the case it will be unfortunate indeed. For years now we’ve been uncomfortably enduring the fruits of the DSM-IV. Those fruits are these growing epidemics of autism, bipolar disorder, ADHD, and depression. My feeling is that as the DSM usually works by division and addition rather than subtraction (starting with 28 mental disorders, now you’ve got something like 374) the 20 % USA labeled “mentally ill” rate is likely to go up rather than down.

The DSM has been referred to as the psychiatrists’ bible. The bible is the number 1 best selling book of all time. The DSM is doing none too poorly itself.

On the other hand, given that the current edition of the D.S.M. has earned the association — which holds and tightly guards its naming rights to our pain — more than $100 million, we might want to temper our sympathy. It may not be dancing at the ball, but once every mental health worker, psychology student and forensic lawyer in the country buys the new book, it will be laughing all the way to the bank.

‘Laughing all the way to the bank’ together with drug company executives riding piggyback on this volume of sheer non-sense. The mortality gap for people in treatment labeled with psychosis is widening, not narrowing. This mortality gap is the direct result of our societies over reliance on the quick and chemical fix. The quick and chemical fix is one of the results of using this balderdash to treat people who suffer. At one time we as a nation were a lot better off where our emotional stability was concerned, and at that time there was no DSM. We could be a lot better off again if we were to chuck the present volume into the trash heap now, and call off any future revisions. The internal national enemy of a rising “mental illness” rate is not going away anytime soon as long as this book is used to alienate, marginalize, and disempower an increasingly large segment of the American populace.

Putting Up With The Antics Of Rebecca And A Couple Of Other Crazies

Oh no, I found another one! Here’s an article from Kansas, from The Topeka Capital-Journal to be exact. The heading of this article reads, Topekan talks about living with schizophrenia.

A Topeka woman is sharing what it is like to live with schizophrenia in a 30-minute documentary that will air Sunday on Topeka’s public television station.

I wonder why people so seldom talk about living without schizophrenia? Ditto, bipolar disorder? Why don’t we have stories starting, ‘I once had a pet schizophrenia, but I got rid of mine. I Just didn’t care for it that much.’

Oh, I know…because they’ve got a drug to help people manage the symptoms now.

“Living with Schizophrenia: A Call for Hope and Recovery,” featuring Topekan Rebecca Phillips and two other people diagnosed with the chronic brain disorder, will air at 3 p.m. on KTWU, Channel 11.

“The chronic brain disorder”, say people who want to sell you a drug “treatment”.

“It’s been a long journey,” Phillips, 37, said of her recovery.

What kind of “recovery” can there be to a “chronic brain disorder“? Isn’t this sort of like talking about seeking the “cure” for “incurable insanity”?

“Someone with schizophrenia can be active in the community. They can make a difference in other people’s lives,” she said. “There’s hope for people with schizophrenia. The end doesn’t have to be bad. They can be just like anyone.”

Anyone? Even people without a pet schizophrenia? Now here comes the scary part…

Phillips said she was asked to do the film in 2010 by officials at Janssen Pharmaceuticals Inc., which funded and produced the film. She previously had taken part in a shorter film about schizophrenia the company made for its sales representatives.

Jenssen Pharmaceuticals, if you don’t know, is owned by Johnson & Johnson. They are the not so wonderful people who brought you the neuroleptic drug Risperal.

Uh, considering the following, this isn’t the accident you might think it is, is it?

The years that followed were a mix of hospitalizations and medications to try to control the schizophrenia. That changed when she went to The University of Kansas Hospital and was prescribed risperdal consta, a drug she takes by injection every two weeks.

Living with Schizophrenia, the documentary, brought to you by Johnson & Johnson, the makers of Risperal.

This is the same Johnson & Johnson that just got sued for fraud to the tune of 158,000,000 smackeroos by the state of Texas for ‘off label’ prescription practices, notably of their neuroleptic drug Risperal.

I’m thinking about making my own film, Living without Schizophrenia. A film of which it could be said that no drug company, neither Eli Lilly, nor Johnson & Johnson, nor Pfizer, nor Bristol-Myer Squibb, nor Asta Zeneca, had any hand in the production.

Madness At The Top

Three statistics pertaining to the “mental illness” label in the USA that have recently come to light stand out. As I reported, the Medco report showed that 1 in every 5 Americans are now on a psychiatric drug. What I didn’t mention is that the rate of women to men on these prescription drugs is much higher, and so actually 25 % of women, or 1 out of every 4 women, are on a psychiatric drug at the present time. Then there was the recent study showing, as of a couple of years ago, fully 11 % of the population is taking an antidepressant drug. These statistics, of course, apply only to the USA, the current epicenter of the worldwide epidemic in “mental illness” labeling.

This is one more reason why I’d be irked by any article with the heading, as the article I ran across at Psych Central does, Do You Have “Complete” Mental Health? This article was published in the Adventures in Positive Psychology column, and positive psychology just happens to be one of my pet peeves.

The absence of mental illness does not necessarily constitute complete mental health. Someone may not have any mental illness but they may not be satisfied with their life or striving to reach their potential. They may be surviving but not thriving.

I’m offended by any definition that would equate completeness in mental health with satisfaction and an abstract potential. I feel that such a definition tends to serve the rich and powerful, and that it is based primarily upon falsehood and misconception. Given such a definition, the most “mentally healthy” people in the world are also going to be the richest and the most powerful people as well. People in impoverished situations would, by this definition, of course, be the most afflicted.

Someone who is flourishing is living with optimal mental health and may be experiencing subjective well-being in most or all of three general domains.

We are then given 3 general domains: Emotional well-being, psychological well-being, and social well-being. Emotional well-being is described as having “positive affect and a high-level of positive emotion”. Psychological well-being is described as having “a sense of purpose and meaning in life”. Social well-being is described as having “a sense of belonging and accepting the world around us”.

Well-being is further broken down, by a certain theoretical model, into 4 further divisions.

Flourishing – Someone who are high on subjective well-being and low on mental illness.

Languishing – Someone who is low on subjective well-being and low on mental illness.

Struggling – Someone who is high of subjective well-being but also high on mental illness.

Floundering – Someone who is low on subjective well-being and high on mental illness.

The only thing I think this model serves is an arrogant and deluded sense of smug self-satisfaction. I don’t think it has a whole lot to do with reality. When “complete” success is judged by some stock exchange figure flashed over Times Square, relative success is going to be relevant in other places. I certainly wouldn’t measure success in terms of material accumulation in this fashion, and even spiritual accumulation doesn’t quite cut the grade.

I, for example, don’t think it a good idea to praise people for flourishing when those very same people dump oil off the coasts of Alaska, Louisiana, and New Zealand. I don’t think of dumping oil as very healthy, mentally or physically. I certainly don’t think it to be very healthy to wildlife. You dump oil into the ocean, and that’s bad karma, for yourself, for the wildlife you impact so disastrously, and for everybody else. I don’t think it “mentally healthy” to ignore this fact.

99 % of the population is struggling, lanquishing, or floundering, by this definition, while 1 % of population is flourishing in a more objective sense. I want to point out again that there is something wrong with flourishing at the expense of life on this planet, and that apparently we’re still locking up the wrong people for being disturbed and disturbing. Were we to lock up, if not psychiatrists, then maybe a few drug company CEOs, it is my belief that the rate of psychiatric drug abuse in this country would go down appreciably.

Dramatic Rise In Psychiatric Drug Abuse Over The Last Decade

Medco Health Solutions Inc., a pharmacy benefit manager, just released a report finding that psychiatric drug abuse in the USA has risen starkly in the past decade. The Wall Street Journal did a story on this report, Psychiatric Drug Use Spreading. The most startling figure to come out of this report is the fact that fully 20 %, or 1 in every 5 Americans, are on a psychiatric drug at this point in time. That’s a lot of ‘mental illness’, that’s a lot of drug abuse!

Among the most striking findings was a big increase in the use of powerful antipsychotic drugs across all ages, as well as growth in adult use of drugs for attention-deficit hyperactivity disorder—a condition typically diagnosed in childhood. Use of ADHD drugs such as Concerta and Vyvanse tripled among those aged 20 to 44 between 2001 and 2010, and it doubled over that time among women in the 45-to-65 group, according to the report.

A big rise then was found in the use of harmful neuroleptic drugs. Neuroleptic drugs are drugs that change metabolism and they are drugs that cause neurological problems; neuroleptic drugs are known to shorten life spans. Also, it’s not just children and adolescents taking the lion’s share of the ADHD drugs any more, now it’s going to adults. Although there aren’t a lot of seniors on speed, just let these adults age, and see where that lands us.

Overall use of psychiatric drugs grew 21 % between the years 2001 and 2010 according to the report. Despite the increase, declines, probably due to increasing awareness of the dangers, were reported in anti-depressant drug use in children, and in anti-anxiety drug use on the elderly.

One thing this article doesn’t go into is whether this decline in the use of anti-anxiety drugs on the elderly has meant a corresponding rise in the use of neuroleptic drugs on them. Drugs that are, as pointed out previously, known to shorten life spans.

Drug sales speak for themselves with the sale of neuroleptic drugs raking in the most profits of the bunch.

Psychiatric medications are among the most widely prescribed and biggest-selling class of drugs in the U.S. In 2010, Americans spent $16.1 billion on antipsychotics to treat depression, bipolar disorder and schizophrenia, $11.6 billion on antidepressants and $7.2 billion on treatment for ADHD, according to IMS Health, which tracks prescription-drug sales.

When people speak of gains in the mental health treatment, I can only see using these statistics to argue that, no, we haven’t made progress, quite the reverse. The mental health system is getting worse.

Shire PLC, maker of Vyvanse and Adderall, pointed to an increased recognition of ADHD as a lifelong disorder as a main factor for growth in treatment in adults, as well as marketing and awareness campaigns have led to the awareness that this is a real entity, said Jeff Jonas, head of Shire research and development. Johnson & Johnson, maker of ADHD drug Concerta, declined to comment.

Drug company marketing campaigns have helped make adult ADHD a “real” entity. Of course, they’re giving new meaning to the word “real” when they make these claims. In a similar fashion, utilizing a similar sleight, Monopoly boardgame play money could be said to be “real” money, too.

One quick way to lower the psychiatric drug abuse increase rate, and with it the ‘mental illness’ increase rate, would be to outlaw the practice of direct to consumer adverterising. Direct to consumer advertising is legal only in the USA and New Zealand now, and certainly it has had more than a little to do with the extent of this epidemic in psychiatric disability that we are weathering at the current time.

You, too, can acquire a psychiatric diagnosis!

If the sun has set on the age of Sigmund Freud, it certainly hasn’t set on the age of therapy. The Wall Street Journal just published a “how to” article about the quest some people have made to get, uh, whatever it is they offer. This article bears the heading, Help Wanted: a Good Therapist. Just think…Heaven forbid that one should be caught without a therapist.

Therese Borchard went through 6 shrinks before she came to the one she must have been looking for all along.

Finally, No. 7 diagnosed bipolar disorder, found medication that was effective, helped her to be less hard on herself and “salvaged the last crumb of my self-esteem,” says Ms. Borchard, who writes the popular “Beyond Blue” blog on Beliefnet.com.

Wow! Therapist No. 7 diagnosed her with the immensely popular bipolar disorder! Why am I not at all surprised by this development?…

Next question, is it possible that what she was really looking for was a “disease”? We used to have a word for this sort of thing, a word that has fallen into relative disuse, and that word is hypochondriac.

Patients who aren’t sure what’s wrong with them can be stumped about the type of therapist to call and ill-equipped to evaluate what they’re told during treatment. How well a therapist’s personal style matches a patient’s individual needs can be critical. But experts also say that patients shouldn’t be shy about pressing their therapist for a diagnosis and setting measurable goals.

What’s wrong with them is the big question some patients have, a doctor answers this question by justifying their role, as patients. He gives them a diagnosis, he writes them a prescription, and usually an insurance company takes care of the rest of the deal’s details.

What perfect other might an individual be looking for besides a therapist, and why is the individual more likely to be disappointed there than on the couch? Uh, excuse me, I digress.

If anything has changed, I imagine it’s that the talking cure has given way to the chemical fix.

About 3% of Americans had outpatient psychotherapy in 2007—roughly the same as in 1998—although the percentage taking antidepressants and other psychotropic drugs rose sharply, according to an analysis in the American Journal of Psychiatry last year. The same study found that the average number of visits dropped from nearly 10 in 1998 to eight in 2007.

Then, as I indicated, you’ve got people searching for the right “disease”, I mean, therapist.

By some estimates, one-quarter of the U.S. population has some kind of diagnosable mental illness. But many don’t believe they need help, don’t know how to get it, think they can’t afford it or that it won’t be effective. There’s also the lingering stigma attached to seeing a “shrink.”

Apparently somebody is estimating a large number of nut jobs, but my question is what’s in it for the estimator? One thing I know for certain is that when a lingering “stigma” is attached to seeing a shrink, the shrinks business should do a lot better when it is “eradicated”.

Note we’ve got 2 interesting “stigmas” in the new contemporary treatment lexicon now, and I happen to think they are related. We’ve got the “stigma” attached to having a “mental illness”, and we’ve got the “stigma” attached to seeing a shrink. Few people mention the other 2 “stigmas” affecting contemporary mental health treatment. There are also “stigmas” attached to losing a “mental illness” and not seeing a shrink. I feel certain that many more people would recover from their disabilities, and their shrink tasting habits, if it weren’t for these further “stigmas”.

Some clinics and university mental-health centers offer consultations to help evaluate which treatment might be best. “Patients shouldn’t have to decide this by themselves,” says Drew Ramsey, an assistant clinical professor of psychiatry at New York’s Columbia University, who says he loves to play “shrink matchmaker.”

I don’t think we’re talking a dating service for shrinks here. No, that could get a whole lot of shrinks in a whole lot of trouble, and in more ways than one, of course.

Even close relationships sometimes fail to get at the right issues. Victoria Maxwell, 44, an actress and blogger from Half Moon Bay, British Columbia, says she worked with a therapist for 2½-years as a teenager and liked her enormously. But she never made much progress, because the therapist didn’t recognize Ms. Maxwell’s underlying bipolar disorder. “I became a really insightful depressed person. But it wasn’t helping my depression,” she says.

Remember, if a wrong diagnosis has been made, no matter what it is, its probably bipolar disorder. We call this wrong diagnosing misdiagnosis because “well” people don’t visit shrinks.

Fishing In The Stream Of Ambitions, Profiteering, and Genomic Research

Biological psychiatry is abuzz with news of 2 big research studies recently undertaken. HealthCanal.com ran a story on these studies bearing the heading, Researchers in ‘most powerful genetic studies of psychosis to date’. These studies involved some 50,000 patient volunteers.

The problem with some of these mad gene chases, and these two studies are a case in point, is the presumption that often underlies the whole undertaking.

Professor David Collier from the Institute of Psychiatry at King’s College London, who was involved in both studies says: ‘Although we have known that psychiatric disorders such as schizophrenia and bipolar disorder have a strong genetic basis, it has proven very difficult to identify the genetic risk factors involved. This is because the causes of these illnesses are highly complex, with many different genes and environmental factors involved. In order to try and solve this puzzle, hundreds of scientists researching schizophrenia have pooled their research results resulting in a major and unprecedented research cooperation, involving tens of thousands of volunteer patients.’

Psychiatry is not hard science. These researchers are not actually searching for a mad gene, or even cluster of genes according to the revised theory, they are actually searching for a propensity to go mad gene. This means that a large number of the people with these genes are not going to go mad at all. It also makes the search much more elusive than it would be if there was, let us say, a mad gene. I imagine one could say that the search for the proverbial needle in a haystack would be as productive as any ole’ mad gene hunt.

We have known belongs to the province of religion. We have known because the good book tells us so for instance. We have known doesn’t mean we have proven or we have disproven, the objective of scientific research, anything. The scientific method is not nearly so self-assured, valuing independence of mind and, in particular, skepticism quite highly. If we know then why are we conducting research? We should be conducting this research precisely because we don’t know, because we are unsure, but I suspect something else is going on here, and I will presently indicate what that something may consist in.

‘Our findings are a significant advance in our knowledge of the underlying causes of psychosis – especially in relation to the development and function of the brain. Unraveling the biology of these disorders brings great hope for the development of new therapies – we can attempt to develop therapeutic drugs which target the molecules in the brain involved in the development of psychosis.’ [Emphasis added.]

Funny that these new therapies should translate into chemical compounds, and that these chemical compounds should be making mega-bucks on the stock exchange. I’m talking drugs here, or the researcher’s chemical oil field. Since drugs have been the primary modality of treatment for psychosis since the mid 1950s, I don’t see what the heck is so new about this therapy at all. Drugs are rapidly becoming the only kind of therapy that psychiatrists permit and that their clients receive. If psychosis is not as biologically determined as theory would have it, then perhaps a drug is not the only way to fix it. My suspicion is that this kind of research is tainted by serious conflict of interest issues from the get go.

Dramatic Child Drugging Increase Investigated In Great Britain

The United Kingdom’s Channel 4 News headline spells out the problem succinctly, Number of children on antipsychotic drugs doubles. Channel 4 News is doing an investigation on children prescribed neuroleptic drugs, and they found that over the course of 10 years the numbers of children prescribed these drugs has doubled.

As many as 15,000 children and young people under the age of 18 were prescribed this medication last year. But these figures are only from GP surgeries and primary care trusts and do not include hospital prescribing, which suggests the true number could be far higher.

Apparently the Brits are doing something more about psychiatric over-drugging in some quarters than rustle their newspapers.

The investigation comes as the government announced that GPs could face jail if they are found to be “chemically coshing” elderly patients with dementia. But no mention was made of children and young people in the announcements.

There is also little monitoring of this child drugging.

Of concern to a growing number of experts is the effect they have on developing brains. They said proper monitoring was essential. But Channel 4 News has obtained a confidential report into the way mental health trusts look after children and young people on anti-psychotic drugs. It found there was “no evidence” whatsoever that some young people are being properly monitored.

Awhile back I read about a British director who made a movie shown in the UK on the child drugging craze in the USA. Apparently there is a danger of importing this child abuse to the UK right under the noses of the inhabitants of that country. I have to applaud Channel 4 News for getting wind of the matter. Whatever little may come of this investigation, it has got to be better than complete complicity in crime—-legislated or otherwise.

Notes on the coming “mental health revolution”

Don’t believe all you read, especially when it comes to what is termed mental health treatment and research. Generally speaking, most of this research is coming from the biological medical model school of psychiatry. Biological psychiatry offers an approach that, although pervasive, is notorious for its cynically fatalistic attitude and its astonishingly negative results.

Case in point, the BBC story, On the brink of a mental health revolution.

Dr. Thomas Insell, the director of the NIMH, has become one of the biggest pitchmen for medical model psychiatry of late. He would have us believe that the current research, rather than being misguided by presumption and bias, was cutting edge and is on the verge of major breakthroughs.

“”We can begin to understand which circuits are involved, and how the brain is wired. We have never had a full wiring diagram of the human brain. We are getting that now.”

What wiring!? This is metaphorical gobbledygook carried to an extreme. The brain isn’t an electrical appliance, nor is it a technological device; it’s an organ of the human body. Dissect it, and a living human brain is still more than the sum of its parts.

In groundbreaking research seen by Newsnight, a London team taught computer software to recognise patterns in brain images. Those patterns predict which patients will go on to develop the most serious forms of psychosis.

There is a great and insurmountable rift between the first sentence and the second sentence in this paragraph. I would suspect that this “Cassandra” software is not nearly as reliable as any of these researchers might lead us to believe in their enthused and over-excited states. I have yet to see anything in psychiatry that had anything approaching the 100 % accuracy of hard science.

Then they make a big to-do about ketamine, a substance that is a key ingredient in popular club-drug Ecstacy, and a substance that is used as a street drug. The claim is that it does in 3 hours what it usually takes SSRI antidepressants 6 weeks to accomplish. If I remember correctly, there was also a big to-do about the possibility of using hallucinagens in the treatment of mental disorders a great many years back. Perhaps they felt they were on the verge of some great breakthrough back then, too. This instance seems very similar, if you ask me, and I don’t think it is likely to advance very much farther.

The to-do is followed, in fact, by a disclaimer.

Ketamine itself could not be used, it is not safe, long-term, and people relapse over a week or so. But it worked on the same part of the brain as conventional anti-depressants, and much faster – and it is that that has got scientists excited.

I’ve got what shouldn’t be news for you. SSRI anti-depressants don’t alleviate depression. These drugs work no better than an enhanced placebo at best. Simply put, they don’t do anything beneficial. No wonder any new substance under the sun looks better. The miracle, at least for drug manufacturers, is that they’ve got 11 % of the US population taking them now.

Says a Professor Nick Craddock…

“What I foresee over the next generation is psychiatry becoming like cardiology and other medical specialities, where we have a range of tests – imaging tests of the way the brain functions, blood tests to know about susceptibility factors, other sorts of psychological tests. That will really help direct us to the diagnosis, and crucially – enable us to know how to help people.”

Whereas a heart attack will kill a person, a nervous breakdown never hurt anybody. Self-control might have something to do with both the development of heart disease, and so-called disorders of the nervous system. I suspect that the experts consulted for this piece are more interested in managing disturbing behaviors through the development of chemical compounds for purposes of social control than they are in rewarding responsible behaviors.

What these guys have yet to find is any “illness” in the brain. Lacking any “illness”, they’re going ahead, and starting to look for the genes behind what they are calling “illness”. A lot of good those genes will do you when you don’t necessarily have any “disease” in the first place.

I recognize spin when I see it, and what I’ve been getting here is just that, spin.

Critics of the DSM-5 Revision Process Draft Petition

The farsical DSM 5 revision debacle continues. The situation has grown even more comical than previously as members of the American Psychological Association have drafted a petition expressing alarm about some of the current prospective disease categories and calling for changes.

MedScape Medical News, repeating the need for tempering the blunders of the recent past, published a news piece on the matter bearing the heading, Petition Calls for Critical Changes to Upcoming DSM-5.

The disease making process behind the DSM was always very unscientific. This is what neither the American public nor the American Psychological Association seems to understand.

Allen Frances, one of the drafters of the DSM-IV, has become one of the most vocal critics, not opponents, of the process involved in the drafting of the DSM-5. What position he will take when the DSM-6 is being formulated is anyone’s guess.

Divisions of the American Psychological Association have created an online petition addressing “serious reservations” about the upcoming Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Launched October 22, the petition has already garnered more than 3000 signatures from mental health professionals, students, and organizations.

I, having serious reservations about the DSM-I, the DSM-II, the DSM-III, the DSM-IV, and the current revisions under review, am not one of the signatories.

One of the issues, although by no means the only issue, for the petitioners is the matter of attenuated psychosis syndrome, the linguistic loophole by which what was formerly referred to as psychosis risk syndrome gets back off the chopping block.

“There’s this idea that if you identify people early, somehow you’ll be able to prevent a full-blown psychosis or full-blown schizophrenia. But research has shown that only up to 20% to 30% of identified people actually went on to develop psychosis, meaning up to 70% or 80% of these people received treatment for a disorder they never ended up developing,” said [Fordham University doctorial candidate] Ms. [Sarah R.] Kamens.

This is not the only proposal these psychiatrists have made for increasing business, and for pushing pharmaceutical products. They also want to reduce the criteria needed to make a diagnosis of attention deficit disorder, and they want to reduce criteria needed to make a diagnoss of generalized anxiety disorder as well.

“We believe we have tapped into a growing frustration with the DSM-5 process. And the groundswell has been quite overwhelming. It’s important to realize, this is not some fringe group that is anti-DSM-5 or antipsychiatry in any way. It’s a group of all kinds of professionals.”

Minor objections to this document are okay, professionals make them; major objections, on the other hand, are made by members of fringe groups. Maybe we need to ship a few more people off to Guantanamo Bay, huh? Assuming they are amateurs, of course.

Unfortunately, once this DSM-5 becomes psychiatric gospel in 2013, the debate will probably die down until we reach the debate on the revisions for the DSM-6. These dead sea scrolls we leave to some archeologist from the post-psychiatric distant future. “Why post-psychiatric”, you may ask? Well, for starters, our very survival is at stake. As you may have noticed, the creeping medicalization of society is now beginning to creep at a cheetah’s pace.

Anti-depressant use in the USA soaring

The % of people on anti-depressants in the USA is at an all-time high at 11 %. (Funny, it only seems to go up, and not down, don’t you think?) This according to an article in Medscape Today, Antidepressant Nation: Use Tops One in Ten.

Eleven percent of Americans ages 12 or older use antidepressants — usually for at least two years but 14% have been taking antidepressants for a decade or longer, according to a CDC analysis of data culled from the National Health and Nutrition Examination Survey (NHANES) 2005-2008.

We’ve got an unemployment rate of 9 %, and I’m just waiting for that one to enter the double digits, too. Obviously, running charities for big businesses run by wealthy Americans is not getting people hired either.

Let’s put this anti-depressant use in perspective by looking at another article on the matter in The New American, CDC: Antidepressant Use Up 400% in Past Decade.

Yes, you read right. In 1 decade there has been a 400 % rise in the number of people taking anti-depressants.

With the development of Prozac and similar drugs, more than one out of every 10 Americans over the age of 12 now takes an antidepressant, according to the findings. Researchers analyzed data collected from 12,637 people who participated in the center’s National Health and Nutrition Examination Surveys, which elicit information from about 5,000 Americans of all ages every year. Antidepressants were the third most common prescription drug taken by Americans of all ages in 2005–2008 and the most frequently used by persons aged 18–44 years. The nearly quadruple rate of antidepressant use was from 1988–1994 through 2005–2008.

I’m going to a Canadian article to help explain this phenomenon, Psychiatrists Urged to Fight Stigma Linked to Mental Illness.

A new position paper, released here at the Canadian Psychiatric Association (CPA) 61st Annual Conference by the association, aims to reduce stigmatization of and discrimination against the mentally ill by mental health professionals, including psychiatrists.

Good enough. What’s the problem?

The position paper suggests a 3-pronged approach to reducing stigma: protest, educate, and contact. It calls on all psychiatrists to lead by example and to protest stigma and discrimination when they encounter it, use education to counteract it, and promote direct contact with people who have lived with mental illness.

Keep reading…

In 2008, the CPA’s Stigma-Discrimination Working Group conducted a survey of its members asking about first-hand experiences of discrimination. Based on 394 responses out of a possible 1083, 79% of respondents reported discrimination toward a patient, 65% reported discrimination toward a mental healthcare provider, 53% reported discrimination against psychiatry as a profession, and 53% observed other medical providers discriminating against a psychiatric patient. At 89%, the survey found that the highest rate of stigma and discrimination was toward people with mental illness presenting to the emergency department.

Notice that this survey was asking whether people were discriminating against mental healthcare providers and the psychiatric profession. Does this mean there is a “stigma” attached to providing mental healthcare or practicing psychiatry? Think, if you can, about all the poor unfortunate psychiatrists and mental healthcare workers there are out there in the world. They need more people (i.e. mental healthcare consumers) to remedy their suffering. A mental healthcare consumer is a person who has been labeled by a psychiatrist “mentally ill”. We’re talking business here, and differences in opinion, surely, but are we talking “stigma”? You be the judge.

Now skip to the bottom of the page regarding this anti-“stigma” anti-discrimination campaigner.

Dr. Blanketyblank reports she is on the advisory board of Eli Lilly Canada Inc, Lundbeck Canada Inc, and Pfizer Canada Inc. She also reports receiving research funding from Lundbeck Canada Inc. Dr. Blanketyblank has disclosed no relevant financial relationships.

No relevant financial relationships, I’d like to point out, is funding from pharmaceutical companies. This fact certainly gives a new twist to the definition of relevance.

The rates of anti-depressant use are going up because drug companies, and doctors in their pay, are doing everything they can do to sell anti-depressants. If you want the rates of anti-depressant usage to go down, you have to resort to preventative measures. Anti-“stigma” and anti-discrimination campaigns directed at mental healthcare providers and psychiatry as a profession are not preventative. If such campaigns are not preventative, they are causative. This business is asking the public to help it sell itself by using some kind of reverse prejudice ploy, and all sorts of people are all too easily taken in by it.

Throwing more money at the problem doesn’t represent a solution unless that money is actually spent on preventing mental health issues from occuring, and on getting people released from current mental health treatment. An expanding mental health system is a broken mental health system. When the numbers of people in mental health treatment is contracting rather than rising, you have a working mental healthcare system. Unfortunately, due to the confusion sowed by conflicts in interests that already exist, some people might not be able to make this connection. The World Health Organization predicts that by the year 2020 depression will be the leading cause of disability in the world, and this prediction would indicate that the selling of anti-depressants is probably not going to decrease any time soon.