Out of sight insight

The situation of the person who shows up in an emergency room wanting ‘help’ for their problems is different from that of the person who is handcuffed and hauled off to psych ward for not wanting ‘help’. I’ve known people who were misdiagnosed ‘mentally ill’, and in need of treatment, who weren’t ‘mentally ill’ at all. Some of these people had to do a little dexterous swiveling of the hips to get out of the clutches of doctors eager to have them doped into zombie land. This is why I have to be very skeptical when it comes to what your typical psychiatrist calls ‘misdiagnosis’.

Usually it’s the situation of a person coming in saying there is something wrong with me, and the doctor says, sure, that’s how I make my living. The doctor finds this wrong with the now labeled patient. If it turns out not to be ‘this’, then the doctor can reach into his bag of tricks, and slap on a different label. It wasn’t ‘this’, it was ‘that’.

About.com would fill people in on ‘the problem’ of misdiagnosis then in another one of their disinformational articles, Reducing Misdiagnosis of Psychiatric Disorders.

Psychiatrists who reconsider diagnoses in overlapping areas of bipolar depression, major depression and other disorders are more likely to make correct diagnoses, according to the study, which suggests that between 15% and 40% of patients with bipolar disorder are misdiagnosed. Bipolar disorder is characterized by episodes of a major depressive disorder with manic tendencies.

The person who comes to a psychiatrist, and then doesn’t have this disorder, must have that disorder. Psychiatry just cannot as a rule comprehend the possibility of no disorder. The fly buzzed into the spider’s parlor, obviously it’s the flies’ fault.

Because the Diagnostic and Statistical Manual, Fourth-Edition requires a manic episode to make a diagnosis of bipolar disorder, many patients are initially diagnosed and treated as having major depression. A manic episode involves a distinct period of abnormal, irritable moods, characterized by inflated self-esteem, sleeplessness and other traits.

So the patient may not be merely depressed, the patient may be bipolar. You’ve just passed from one level of severity to another. No longer is the patient merely to receive antidepressants that work as well as a placebo, now the patient is also getting antipsychotic drugs that damage the brain.

Even murkier is the business of assigning multiple diagnoses to a person as in the case of so called ‘co-occuring disorders’. Gee, you really are a ‘sicko’, chum, what with this, this, and that. The article here began by saying that if you go for 2 disorders you are more likely to have a ‘correct’ label than if you go for 1 label. When you’ve got multiple labels, hey, these guys have multiple pill bottles to deal with them.

Polypharmacy or the prescribing of multiple psychiatric drugs is one of the worst treatment practices around. Recovery is never the result in polypharmacy, and permanent disability is the rule. ‘Co-occuring disorders’ are merely an excuse to magnify the significance of any disturbance found, and to offer polypharmacy as the solution. The treatment here is just going to exasperate the disorder but, hey, psychiatrists make their living on the severity of the disorder.

In some cases, misdiagnosis is a function of symptom overlap, while other patients may truly have more than one disorder. In the past, bipolar disorder was often misdiagnosed as schizophrenia, but this problem diminished with the realization that psychosis is common in both disorders, rather than specifically to schizophrenia.

Uh huh, and now you hear of people labeled both ‘bipolar’ and ‘schizophrenic’. This is an example of killing multiple birds with one stone. If it’s not specifically this, maybe it’s this, and that. We can’t rule out any possibility, so we will take both possibilities, thank you, please. And if there’s a third possibility, we will take a little of that, too.

I just wonder how long a person can take this kind of shoddy treatment without figuring out that there is something a little phony about it all. If some of these people showing up in the emergency rooms could figure out that maybe they don’t want the kind of ‘help’ they would be receiving, if maybe they would get the idea that they need not go onto the psych ward without a fight either, I’d call that a major turning point.

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2 Responses

  1. If I’m discussing the subject of psychiatry I might occasionally utter the word “misdiagnosis”. But only so that at some time later I can say that to misdiagnose might be to choose the wrong item from a long list of false (null) diagnoses.

    Psychiatrists could say, and they probably increasingly do say this, that they never “mis”diagnose a patient. They can say that any diagnosis they make is preliminary and therefore valid. They can say that they are never wrong because they are well intended.

    • Well, there have been people who have escaped the labeling power of the psychiatrist by the skin of their teeth, and there are perhaps no more appropriate words to be used in those instances.

      I came up with one instance of a man in New York City who was locked up after he tried to save a cat that had fallen behind a wall. The police didn’t believe him, and he was sent to the psych ward. Last I heard he was trying to sue the hospital that held him. This cat man story was covered more fully in a Brooklyn Paper article, Trapped cat drives man to psych ward.

      The problem is, as you have indicated, once in the psychiatrists office a person is psychiatrized. There is a whole bill of goods that goes along with that profession, and its a profession that has been under pressure to legitimize itself. Certain members of that profession would like to keep the profession above public scrutiny or questioning. When some members of that profession are responsible for harming a large number people, there can be a great deal of good to come out of calling that profession to account for itself.

      On the subject of misdiagnosis, mental health consultant Pat Risser has a page up on psychiatric symptoms caused by medical illnesses. Many of these physiological problems are routinely ignored by hospital staff.

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