• Top Posts

Let’s look at the terminology

Some of the terms defining the role of the person who has had experience in the mental health/illness system are:

Mental patient

I don’t like the term mental patient. Cage one has a cage two. This is the cage of words. The patience of saints might never be rewarded. This is a role without an end unless you end it. Desperation won’t end it. Desperation is often its source and substance.

Mental health consumer

Mental health consumer seems the refuge of every last treatment junkie in the world. I’m not any fonder of the term mental health consumer than I am of the term mental patient. The presumption is that said person has an illness. This illness is a matter of emotional and mental distress. If the truth be told, perhaps distress isn’t an illness, but we don’t have the time or inclination to cover that one at length. People who think themselves well don’t buy mental health services. They don’t need to do so. More and more mental health consumers are getting jobs as mental health workers. Getting a job in mental health services is no way to wean oneself of the mental health/illness system. In fact, advancing to a job in mental health services might be seen as a further indication of a person’s addiction problem.

Note: Prisons have trustees, mental health services have peer support specialists, and governments have traitors and double agents. One has to wonder about prisoners who become guards. Bribery and corruption are rife in the mental health/illness system, and since human rights are so slack there, sell outs aren’t hard to find. Co-optation happens.

Mental Health Service User

Service user is a term more favored for mental health consumer in many parts of the world outside of the continental United States. It has its points. Survival, after all, is survival. User is perhaps more honest in that many of the people consuming psychiatric services don’t have a steady income, and so the money they use to consume those services comes from tax payers. User invites corruption in the same way that consumer does.

Psychiatric inmate

This term used to be more frequently used than it is today. The reason for the endangered nature of this expression I attribute to the popularity of mental health consumer. A mental health consumer is an addict, and anybody with any experience in substance abuse knows how difficult, some would say impossible, addictions can be to overcome.

Psychiatric prisoner

When people are not at liberty to leave a facility or a unit, those people are prisoners. When people are held in facilities against their will and wishes, those facilities are prisons. Calling a hospital a prison does not make a prison a hospital. Toxic substances, restraining devices and electroshock machines are torture instruments. Such devices don’t serve any medical purpose unless it is to supply medical hospitals with maimed and wounded psychiatric prisoners and ex-prisoners.

Psychiatric survivor

A psychiatric prisoner or ex-prisoner who has survived imprisonment, physical assault, toxic substances, restraining devices, solitary confinement, electroshock torture, etc., mistreatment, in other words, masquerading as medical treatment, alone or in combination. A psychiatric survivor is a person who has had his or her human rights violated by the mental health/illness system.

Former mental patient or ex-patient

Recovery from a severe mental illness is often more a matter of recovering from an oppressive mental health/illness system than it is anything else. People who consume mental health services are said to have not fully recovered from their “illnesses”. Many of these people have serious mental health service consumption addictions or habits. People who work in mental health services are the pushers that keep these treatment junkies supplied. A former mental patient or an ex-patient, strictly speaking, is a person who has left the mental health/illness system entirely. A person who was in the mental health/illness system, but who has not left that system, is a person who cannot be said to have fully recovered his or her mental health.

In Recovery

The term “in recovery” has become a euphemism for mental health treatment consumption. There is no end to this recovery unless a person gets out of recovery (i.e ceases to consume mental health treatment). Partial recovery is not complete recovery. There is more involved in this recovery process than the recovery of one’s mental and emotional stability alone. Institutionalization disrupts lives. There is also economic, situational, and social recovery to consider. Recovery that is not recovery is why we have a mental health ghetto.

Mad Folk

A gifted few might actually be a gifted few despite the lack of regard and understanding they have received on the part of the general run of humanity. Given the rapid advance of medicalization, madness is no longer the stigmatizing insult that it once might have been. No, mad describes professional athletes and entertainers of an exceptional calibre in this, our more enlightened, day and age. That dishonor now belongs to the term “mental illness”. If you’ve got a special talent, perhaps that talent is a madness, in which case, I should be very careful in whose presence you choose to reveal it. You don’t, after all, want just any old John or Jane who comes along handed the power to nip your madness in the bud.

Mental Illness, The Redefinition

I got that “oh, no” feeling when I came across this very short piece in The Atlantic entitled What is mental illness? It was alluding to a blog post about efforts among the American Psychiatry Association committee revising the DSM to redefine “mental illness”. That’s right, these guys want to take the mental out of “mental illness”. The current view is that there is a physiological basis, if undetected, behind what is commonly referred to as “mental illness”. Webster’s Dictionary is still way too good for them. I see serious semantic complications arising from redefining something as something other than what it is defined as being. It’s sort of like we must be dealing with a secret code here. The fact that we are getting an entirely theoretical argument presented in this snippet is not dealt with at all. I know that such notables as Dr. Thomas Insel, the current director of the National Institute of Mental Health, are pushing for this kind of view. I take the contrary view; I don’t think the evidence supports the brain disease hypothesis. The crevasse between the psychiatrist and the neurologist is still broader than these psychiatrists would choose to admit it is. I had to go to the original blog post, A Consensus Emerges, in Seed Magazine to see what was actually up.

Last week, psychology graduate student (and Research Blogging Psychology / Neuroscience Editor) Jason Goldman held a mini-carnival, an online forum inviting some of the top psychology and neuroscience bloggers to weigh in on the question “What Is Mental Illness?”

British psychologist and editor Christian Jarrett answered the question by citing an editorial published in January in Psychological Medicine. The editorial’s writers, led by Dan Stein, argued that a “mental disorder” has five primary factors: It’s a behavior or pattern occurring in an individual, causing clinically significant distress or impairment, reflecting an underlying physical dysfunction, and is not primarily the result of social deviance or conflicts with society. It’s also not just a response to a stressful event like a friend or family member’s death, where it’s normal to expect someone to appear “depressed” or otherwise disturbed for a period of time. Stein’s team is part of the working group for the DSM-V, so clearly their arguments will carry significant weight in forming the new definition.

Dan Stein’s 5 primary factors of “mental disorder”

1. behavior or pattern occurring in an individual
2. causing significant distress or impairment
3. reflecting underlying physical dysfunction
4. not primarily the result of social deviance or conflicts
5. not a response to a stressful event

The idea is to take any strictly unmedical factor out of the equation, and to assume that by so doing psychiatry has become a legitimate branch of the medical sciences way up there with cardiology and endocrinology. The problem with this view is that it is primarily an abstract fabrication based entirely upon bias. We haven’t ruled out, in other words, social deviance and conflicts, or reacting to some traumatic happening, merely by stating that this has nothing to do with that. Proof is called for, and it is not forthcoming.

Looking for a mad gene does not make genes the source of madness. When the source of what some people call “mental illness” is still up for grabs, we can’t say for certain that madness is biological. The psycho in psychobiological, in fact, indicates that all is not of a biological origin. The extent of the biological cause is still, and will continue to be, a matter of depute for some time to come. Social and environmental factors cannot be ruled out entirely, until they can be ruled out, after the evidense comes in, even if theory has blinded researchers researching the subject regarding this matter. If it’s a “brain disease”, find the “brain disease”. This is something researchers have simply not been successful at doing. Alright, if you have not been successful at proving your hypothesis, perhaps it is because your initial premises were just plain wrong.

Personal accounts of liberation and bondage

Regarding recent study results showing that despite more of a biological approach to serious “mental illness” issues, the “stigma” had not appreciably lessened, Patrick Corrigan, an Illinois Institute of Technology psychology professor, had a few good remarks to offer on the subject. The report I’m referring to, found in Bloomburg Businessweek, bears the headline For Many, Stigma of Mental Illness Lingers.

Corrigan believes the answer — or at least part of it — lies in stories, “having people with a condition tell their story. This, he said, might include a “way-down story” and a “way-up story”: “the way-down proving you are a person with a mental illness and the way-up proving that you have recovered.”

Reading the news, you catch more way-down stories than you do way-up stories. I’d definitely like to see more way-up stories out there, many more.

“Most people with serious mental illness do recover, so that’s why way-up stories are so important,” he added. “We would suggest that [these stories] be told to key power groups — instead of trying to change popular opinion, trying to change important power groups like landlords [and employers].”

Here I wouldn’t neglect popular opinion. I think that’s in large measure a big part of the problem currently. The education the general public receives at the hands of mainstream media and the entertainment industry in cohoots is atrocious. Your average person in mental health treatment is by no means a slashing serial murderer. In fact, people who have received no “mental illness” label are more likely to commit a violent crime than the typical person who has had experience in the psychiatric system.

Give us more way-up stories, and I think you’d see a slight shift in public opinion. The psychiatric industry is full of way-down stories. These way-down stories serve as a justification and rationale for the medical model of psychiatry (i.e. psychiatric pessimism). Give us a few more way-up stories, and even your conventionally minded mental health professionals might begin to see that there are different ways to approach the subject of problems in living.

A related but unmentioned story is the way-out story. One shouldn’t automatically assume that everybody who gets sent to a state hospital is “mentally ill”. It just isn’t so. People get locked up because somebody wanted to get them out of the way, in some instances, as in custody disputes and inheritance battles. Some people enter the mental health system as children, too, and this is often a case of guardians over reacting to the stresses involved in child rearing rather than to any case of actual derangement.

One damper to this situation is that when the bureaucratic maze gets too clogged with red tape, or the system presents itself as too “broken”, even the way-out story can cease to find that way-out.

Two Species Of Mental Disorder

There are two separate species of those life crises that have come to be dubbed mental disorders. I think that a closer scrutiny of what separates these two species might well eventually play a role in debunking the mythology of medical model psychiatry. This cleavage has existed for ages. It roughly parallels the no longer current divide between neurosis and psychosis. This is the division between minor mental illnesses, so called, and major mental illnesses (sic).

The suspicion that these two species are closely related is offset by claims that they are such different animals. Some people, myself for instance, feel that the fissure between them has been breached in a most arbitrary, and therefore questionable, fashion. Theory, posing as ironclad proof, puts forward its own biases and prejudices, and hopes people won’t see through the textual smokescreen. Surveys, with questions such as is the world flat or round, are no way to determine whether the world is flat or round.

Let us look at what are seen as the characteristic differences between these two species of disorders. Professionals have tended to see minor mental disorders as having a non-biological base. Minor mental disorders are thought, in other words, to be predominately caused by stress and stressors, and not by genes. Let’s forget for a moment that mating is a social phenomenon. The situation is reversed with major mental disorder where the disorder is thought to have primarily a biological base, irrespective of environmental and social factors.

One can’t help noticing that while such differences are often seen as merely a matter of degree, such a view doesn’t jive with prevailing theory. Defining these two animals by their relative significance, minor or major, severe or mild, and so forth, would indicate that this difference was merely a matter of degree. If it’s a matter of degree, then either minor mental disorders are more biological in nature than previously thought, or major mental disorders are less so.

When professionals talk about the percentage of people who have a mental disorder but who are not receiving treatment, usually they are referring to people labeled with minor mental disorders. A fear exists that if left untreated your minor mental disorder will develop into a disorder of much more calamitous proportions. I feel there is an equally valid suspicion that if your minor mental disturbance was left untreated it would resolve itself naturally without intervention. Certainly, there is every reason to look more closely at this division of disorders in the interests of making sure that our preventive measures don’t end up being propagation errors.

Nope, Not Even A Smudge

I challenge anybody to prove to me that any mental illness exists. I have never seen a mental illness in my life. I have seen people, and I have heard other people talk about behaviors as symptoms, but that’s not saying much. Have I seen people with mental illnesses? No. I’ve seen the people, but I’ve had much trouble making out their mental illnesses. When I can’t discern this mental illness, or that, as far as I’m concerned, it’s a figment of somebody’s imagination.

Viruses and bacteria can be accounted for under a microscope. Although there have been theories attributing mental illnesses to germs, those germs have never been found. All indications are no germ ever put anybody in the state hospital. Looking for mental illness in chromosomes has become even trickier, and equally dubious. Especially when you consider that we’re supposed to be dealing with a genetic predisposition. Given a predisposition then, somebody is saying maybe a good portion of people with these genes aren’t mentally ill. Okay, if a number of people with these genes don’t have a mental illness, these genes aren’t mental illness genes.

Let’s back up a little bit. I mentioned symptoms earlier. Some people think they have found a mental illness when they have found a person displaying a certain cluster of symptoms. These symptoms tend to be little more than behavioral patterns associated with certain emotional states. Persistent sadness is said to be depression. I think a better term for persistent sadness would be persistent sadness. People who don’t respond to the demand “get happy” are said to be depressed. I’m not the person to disapprove of sadness. You can be sad if you want to be sad. It’s NOT a disease.

I know, you can’t get over your negative feelings. You can’t choose happiness. Hello? We’ve just abandoned the hospital unit for the philosophy department. How do you know you can’t choose happiness? Have you ever tried? I’m a great believer in examining all the possibilities. If you haven’t examined all your possibilities don’t blame freedom of choice for the choices you neglected to take. I can’t just make myself happy. You can’t? How do you know? Perhaps all you need is a how to book on happiness. I think there’s a whole book industry built on that kind of thing. Do we need to talk to happiness experts? For your sake, not mine; it’s not all about me. Isn’t that what this mental illness business is really all about? Baby wants something, tend to baby. I’m not saying that something is a booby, but if the blouse fits, bare it.

Perhaps happiness is over rated. Perhaps it isn’t. Happiness isn’t on the table, mental illness is, and it still looks like an empty table. Ahha! So we’ve got an empty table. Then there is no mental illness. The thought police are out to pick people up for deviant behavior. Deviant behavior isn’t wasting a life on some ridiculously boring, futile, and stupid 9 to 5 gig. Sometimes you have better things to do with your life than slaving for the man all the time. Deviant behavior is way up there in the future waiting for the rest of civilization to catch up with it. You can call your deviant mentally ill, but that doesn’t give mental illness a tangible existence. It only makes your deviant an outlaw. Careful what you say, the thought police are zooming in. He or she could be you.

Newly Discovered Psychiatrist Disorder On The Rise

Perhaps you like I are a little more than a little chagrined by the throwing around of ridiculously slanted statistics these days on the part of the Psychopharmaceutical Industrial Complex (PPIC). The Psychopharmaceutical Industrial Complex, just in case you were wondering, “is a symbiotic system composed of the American Psychiatric Association, the pharmaceutical industry, public relations and advertising firms, patient support organizations, the National Institute of Mental Health, managed care organizations, and the flow of resources and money among these groups”. Statistics like this one from a myhealthnewsdaily article, Mental Disorders Strike 1 in 5 Adults, Survey Finds.

About one in five adults in the United States suffered from a mental disorder during the past year, according to results of a national survey released today (Nov. 18).

20% of the population “mentally sick”. I don’t think so. 20% of the population so over burdened and overwhelmed by economic and social difficulties that they might visit a psychiatrist’s office, perhaps.

Statistics like this represent just one more reason why the expression “laughter is the best medicine” exists. Laughter, after all, should keep any “mental disorder” a person might happen to develop from becoming “seriously disabling”.

Roll On The Floor Laughing (ROTFL), and maybe not.

Keep reading.

Nearly 5 percent of those adults suffered from a serious mental illness, such as schizophrenia or bipolar disorder, that substantially disrupted their daily life, according to the 2009 National Survey on Drug Use and Health, conducted by the Substance Abuse and Mental Health Services Administration.

We’re still on the laugh track apparently.

Barring a literal translation of “those adults” [emphasis added] into 5% of 20% or 0.01 of the population, this means that 1 person in every 20 people has been tagged with a “mental illness” label characterized as “serious”.

This 1 in 5 statistic then means people who were not so seriously disturbed as to need any sort of long term treatment. Many of these people probably could have managed satisfactorily enough without visiting a shrink had they found any other convenient means of working out their problems and dealing with their issues.

I know that psychiatrists and mental health workers want to drum up more business. I also know that if this profession manages to get more than 1 in 5 members of the public into their offices, that 1 in 20 figure of the so called “majorly disturbed” is going to go up as well.

I would like, at this time, therefore to propose the creation of an additional psychiatrist disorder. The disorder I’m referring to statistitis syndrome, or the applying over much weight to, and the jockeying and juggling of, research data in the interest of advancing trade interests. One important thing to remember is that the presentation and display of these statistics must be kept sufficiently slanted so as to deceive large numbers of the general public as to their true nature and the professional’s less than magnaminous intent.

Emergency Room Suicide Prevention

Pay more attention to mental health says another article in the Edmonton Journal concerning the Emergency Room suicide of Shayne Hay I reported on yesterday.

Gee, why didn’t that idea occur to the staff working in the emergency room? 12 hours plus is a long time to wait to see someone when you’re having an emergency.

The article then goes on to suggest honoring Shayne’s death by contemplating 3 points. I’d like to add that if we don’t want more deaths of this sort to be the order of the day in the future we’d better be doing a little more than contemplating.

The three points:

1. This death draws attention to the issue of suicide, an attention the issue would have been less likely to receive if Shayne had hung himself elsewhere than in an examination room in the emergency department of a hospital.

What, and no attention to the Heinz Catsup slowness of bureaucratic systems!?

2. Not enough attention is given to the tension between the need to protect civil rights and the need to protect people from themselves.

Moot point when a man dies as a result of emergency room negligence. Had he hung himself anywhere else in the world they’d not have been any more successful at protecting him from himself.

3. People with no experience with emotional problems need to better understand
the amount of trouble emotion problems create for family members and friends.

I don’t think it was any picnic for the man who spent 12 hours waiting for the hospital staff to get around to addressing his EMERGENCY either.

When is anybody going to get the very basic fact that this is not about “mental illness”? This is about emergency room care. Given bureaucracy, waiting to see a doctor outside of the emergency room, with an appointment, might be a time consuming affair. All the same, I think in all likelihood it’s not going to involve 12 + hours at one sitting.

Let me follow the example of the author by offering my own 3 points.

1. When circumstances such as this lead to investigations, changes get instituted, and when they don’t lead to investigations, nothing changes. Let’s try to make an investigation of it.

2. This is about prejudice. This is about how we treat people labeled “mentally ill” differently from people who have not been labeled “mentally ill”. This is about not seeing a non-physical emergency as a “real” emergency. Don’t neglect people, labeled “mentally ill” or otherwise, in emergency room situations.

3. Don’t blame it on a lack of money and resources for mental health. The money is there, and the people are there. You don’t even need psychiatrists if you have paraprofessionals. The psychiatrists are often uncaring people where the paraprofessionals are often very caring people. You don’t need excuses when you do something about the problem experienced (i.e. Shayne Hay killed himself in an examination room of the emergency room of a hospital after spending 12 hours unattended.)

Using Shayne Hay’s death to beg for more money for mental health is missing the point. Were more money thrown at the mental health system it is not likely it would prevent one more death like Shayne’s. It wasn’t the lack of a mental health system that killed Shayne Hay, it was emergency room negligence. If money is to help people like Shayne and his family, this money should go to treating emergencies like emergencies. Shayne felt that he was experiencing an emergency, but apparently the emergency room staff disagreed with this evaluation, otherwise they would have never waited more than 12 hours before getting around to him. If actions speak louder than words, their inaction spoke volumes.

Death From Neglect In A Canadian Hospital Emergency Room

A Canadian reporter, on an emergency room suicide, seems to be blaming a broken mental health system on that death. I, on the other hand, see that as a matter of avoiding the specifics of this case, and I am amazed at how hospital bureaucracy commands the emergency room to such an extent that a completely avoidable tragedy of this sort was allowed to occur.

The story I am referring to, Recent suicide should spark overhaul of a crumbling system, appeared in a recent edition of the Edmonton Journal.

As my colleague Jodie Sinnema first reported on Saturday, the 34-year-old man, who was bipolar and suicidal, arrived at the Royal Alexandra Hospital on Sept. 18. He was lucid and self-aware enough to know he was in trouble. He was placed in an examination room, where he waited for 12 hours for someone to offer him medical treatment. His family’s contact phone number was, it seems, in the hospital file. But no one from the hospital called to notify a family member — presumably because [Shayne] Hay was an independent adult and his legal right to privacy trumped his family’s right to know their son and brother was in crisis.

Not notifying his family is not what concerns me. If Shayne Hay didn’t want his family notified, at least, the hospital staff respected his wishes.

Eventually, he asked staff for a pen and paper, wrote a suicide note and hung himself, right in the emergency ward, using the strap of his own knapsack.

No person in a hospital emergency room with a gaping wound, or who was bleeding profusely, would be forced to wait 12 frigging hours in an examination room without being seen by a physician. This case represents a concrete example of the prejudice and discrimination directed against people experiencing emotional difficulties.

I think an apt parallel can be drawn between this case and its handling in the press and the case of Mrs. Esmin Greene who died a few years ago on the floor of King’s County Hospital Emergency Room in New York City. In the case of Mrs. Greene, hospital staff went so far as attempting to cover up the facts surrounding her death.

Why would he have gone to the emergency room if he didn’t think he was in an emergency situation? Emergencies call for immediate attention, and not attention after the lapse of what amounts to an entire day, if not longer.

Rather than using this suicide to make a pitch for more mental health funding in general, as the reporter of the above article seems to be doing, we should be looking at ways for remedying the neglect that people undergoing emotional crises receive in hospital emergency rooms. It is this negligence, and the prejudice behind it, that needs to be addressed, investigated, and corrected. In the absence of corrective measures, you can be certain that this won’t be the last death of this sort occurring in a hospital emergency room.

Talking Back To E. Fuller Torrey

DJ Jaffe’s bigoted Huffington Post blog most recently included an post by fellow bigot and big shot shrink, E. Fuller Torrey. This guest entry blog post is entitled, What should we call people with mental illness? E. Fuller Torrey wants to censor the language of, as it has been put, “people with lived experience” in the mental health system. Dr. Torrey seems to think that about ½ the people receiving mental health treatment are in no condition to speak for themselves and, therefore, people like E. Fuller Torrey and DJ Jaffe must do their talking for them.

His argument concerns how people in and out of mental health treatment should refer to themselves. First, a word this psychiatrist is most friendly with is “client”. “Client” is the word that most conveniently kisses the ass of the mental health “professional”. It helps define a functional and therapeutic relationship. Dr. Torrey would keep this word. “Client” is a good word. “Survivor” is a bad word. Why is survivor a bad word? Frankly, he seems to object to the use of this word because psychiatrists and mental health professionals didn’t come up with it.

”Survivor” is… a term is used by psychiatric patients, not like ”cancer survivor” but in a more menacing sense like ”rape survivor” or ”Holocaust survivor.” It implies survival of a traumatic event, specifically in this case involuntary treatment for a psychiatric illness. A major goal of (people who use this term), is to abolish all involuntary treatment. Such a goal ignores the needs of those individuals with schizophrenia who are unaware of their illness and who, because they are not being treated, are regularly victimized and end up homeless and/or incarcerated. Thus, ”survivor,” like ”consumer,” applies to only some individuals and is not all-inclusive. To use such terms ignores the needs of those to whom it does not apply and is thus a form of discrimination.

Every expatient is a psychiatric survivor, regardless of whether they take to the term or not, by definition. What we mean by psychiatric survivor here is a psychiatric treatment survivor. An even more exact way to express the matter might be to refer to him or her as a psychiatric maltreatment survivor. I’m still waiting for a “treatment plan” that has a “ land of opportunity” feel to it. Most of these “treatment plans” fall way short, to say the least, of a step ladder onto “peak performance”. Some of the practices that pass for standard psychiatric care these days can do much more harm to an individual than good. Some of these treatments can, in fact, even result in death. Any person who has not survived their psychiatric treatment is a cadaver. No amount of jargon is going to change that very basic fact.

Dr. Torrey goes even further in his revision of Websters dictionary.

The latest term being used for people with schizophrenia and other severe psychiatric disorders is ”people with lived experience,”…being increasingly used by groups funded by SAMHSA. …In reading the literature… it is apparent that most of the time the term is meant to imply that the delusions, hallucinations, and other symptoms experienced by individuals with schizophrenia are merely part of a spectrum of human experience. It is thus an implicit refutation of the medical model of disease. …

Most individuals with schizophrenia, including those promoting terms such as ”people with lived experience,” are receiving medical disability benefits such as Supplemental Security Income, Social Security Disability Insurance, and veterans disability pensions. …Logically, if they do not believe that they really have a disease, they should not apply for, or accept, such benefits….

I imagine he is trying to say here that the schizophrenia label removes a people from their personhood, but I’ve got my own semantic problems articulating that one. Whatever happens in what we refer to as schizophrenia has ceased to be a “lived experience”, and this makes it a term of complete dismissal, if not disparagement. If it represents a human experience, why ignore it?

Dr. Torrey needs to wake up, and look around himself sometime. The results of the recent economic downswing, coupled with Reagonite trickle down economics, are all around us. We call these results homeless people. When you get 5 people applying for every 1 job opening that becomes available, that leaves 4 people out of work. You do not get people working by depriving them of basic necessities. You get people working by providing them with employment opportunities. Realism should tell him that there’s a relationship between chronic unemployment and chronic emotionally disturbance that is not going to be addressed through further deprivation and punishment.

We, people, excuse me, with lived experience in the mental health system have fought long and hard for every word that comes from our own lips and not from some self-appointed mouthpiece for us. Given a chance, some of us can think, act, and speak on our own behalf. Those of us who haven’t developed this knack yet, I suppose you can count many of them among the 50% who are content to let Dr. Torrey speak in their stead. Let me point out that this doesn’t speak highly of their chances for making a complete recovery.

Recovery, there you go! Although Dr. Torrey didn’t deal with the phenomenon of recovery in his article on language, perhaps he should have dealt with the notion of recovery. I’m sure he would have had something to say on the subject even if he thought it was another term whose usage should be discouraged, if not restricted. Myself, I’d like to see more of it.

The Disappearing Disease

Here’s another good joke for you. Much ADHD apparently vanishes before the first year is out. As a headline in Internal Medicine News puts it, Kids Diagnosed With ADHD Often Remit.

In fact, it can be pretty fleeting. Analysis of serial assessments of more than 8,000 U.S. children and adolescents for attention-deficit/hyperactivity disorder (ADHD) showed that the diagnosis often did not persist after follow-up of 1 year or longer, J. Blake Turner, Ph.D., said at the annual meeting of the American Academy of Child & Adolescent Psychiatry.

Has “often” taken on a different meaning from the one it used to have? You mean kiddy ADHD doesn’t automatically lead to adult ADHD in the vast majority of cases? Perhaps your doctors aren’t being scrupulous enough at doing their jobs.

“It troubles me that the [ADHD] phenotype looks so unstable,” commented Dr. Daniel S. Pine, chief of the Section on Development and Affective Neuroscience at the National Institute of Mental Health. “A lot of people are struggling with the threshold for [diagnosing] ADHD. This is a very different conceptualization of ADHD; we don’t usually think of it as something that’s gone in 2 years. If this is [children having] a transient reaction to stress, I don’t want to talk about it [in] the same way as clinical ADHD.

Stress reaction or ADHD, ADHD or stress reaction. Isn’t this a lot like gazing at an optical illusion? Sometimes you see the attractive girl, and sometimes you see the old crone. It’s not an optical illusion though; it’s an illusion of pseudo-science, and speaking of stress reactions, stressed out parents and teachers.

Additional analysis showed that lost ADHD diagnoses usually did not occur as a small change in an initially marginal diagnosis. Patients who changed from having ADHD to not having it lost five ADHD symptoms, on average. And the remitters and nonremitters all had a similar pattern of disease severity at their initial diagnosis. Patients’ age had no association with whether or not an ADHD diagnosis disappeared. And patients who received treatment had a higher likelihood of retaining their ADHD diagnosis at follow-up than did those who did not receive treatment, possibly because the patients who were treated generally had more chronic ADHD.

Either that or the “symptoms” of the “disease” turn out to be “side effects” of the drugs used to treat the “disease”.

If you’re looking for another reason why patients who receive treatment might have a higher likelihood of retaining their diagnostic label than those who don’t receive treatment, well, there is also the investment factor. People without a bill of goods, as opposed to true believers and suckers, aren’t picking up the tab. Ignorance, as the expression goes, is bliss, and this especially true where knowledge is knowledge of personal folly.