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Future Psychiatry

Make way for the DSM-6 1/2 & 3/4. Some Oxford University mad shrink, a certain Kathleen Taylor, she calls herself a neurologist, thinks that religious fundamentalism and cult group membership could become a disease in the future.

Don’t look now, but religious fundamentalists and those whose ideological beliefs border on the extreme and may be potentially harmful to society could soon be called crazy—in a medical sense.

Remind me to stay way clear of the border of extreme.

Taylor also warned against taking “fundamentalism” to mean radical Islamism.

The story/review, Is religious fundamentalism a mental illness?, is to be found at GMA News Online, ‘the go-to site for Philipinos’.

I’m encouraged by all this potential broadening of commitment criteria in a way.  Just imagine, in the future maybe we could lock up members of the Church of Biological Psychiatry. As is, they do an inordinate amount of injury while everybody just looks the other way.

Kathleen Taylor has written a book, “The Brain Supremacy”, on the dangers of brain technology, but, oh, I don’t know…

“What we perceive from our perspective as our legitimate self-defensive reaction to the psychosis of the enemy, is from the perspective of the same enemy our equally malignant psychotic self-obsession,” it [Digital Journal] added.

Here it comes, here it comes…World War III!

This just goes to show now that, beyond intoxicating substances, behaviors have been found to be addictive, the bag is open, and anything can crawl in. Should psychiatry be your career choice, I hope we can find a cure before it’s too late, and the bombs start falling all around us.

More Or Less Biology In Psychiatry–That Is The Question

Much newsprint has been wasted recently on the split between the APA (American Psychiatric Association) and the NIMH over the revision of the DSM (Diagnostic and Statistical Manual of Mental Disorders)  that is going to be called the DSM-5. In my view, letting the 100,000 manuals bloom is not going to be any better of a solution than letting the 100,000 diagnoses bloom in the long run. If we are going to treat every patient as an individual, for the sake of the individuality of his or her condition (and genetic makeup), that’s going to make for a whole lot of variation in disorder (and/or order) expression.

The New York Times covers the story, regarding the NIMH APA divide, in a story with the heading, Psychiatry’s Guide Is Out Of Touch With Science, Experts Say. Of course, it always depends on which experts you ask. The experts the mass media is still slow to consult, and the New York Times is no exception in this regard, are those experts with lived experience on the receiving end of mental health treatment.

While typically critics of the DSM have tackled the subject from one side of the political psychiatric spectrum, here comes mob boss Thomas Insel, godfather of the NIMH, attacking from the other. In the first instance, you have people who object to the biology in biological psychiatric theory, (Theory, now there’s as important a word as any.) in the second, you have a group that doesn’t think the APA is biologically grounded enough.

The expert, Dr. Thomas R. Insel, director of the National Institute of Mental Health, said in an interview Monday that his goal was to reshape the direction of psychiatric research to focus on biology, genetics and neuroscience so that scientists can define disorders by their causes, rather than their symptoms.

The DSM focuses on symptoms precisely because we don’t know the causes. Dr. Thomas R. Insel, apparently, thinks otherwise.

Precision seems to be a big part of the problem. In psychiatric diagnosis, theoretical speculations aside, there are no precision tools.

The creators of the D.S.M. in the 1960s and ’70s “were real heroes at the time,” said Dr. Steven E. Hyman, a psychiatrist and neuroscientist at the Broad Institute and a former director at the National Institute of Mental Health. “They chose a model in which all psychiatric illnesses were represented as categories discontinuous with ‘normal.’ But this is totally wrong in a way they couldn’t have imagined. So in fact what they produced was an absolute scientific nightmare. Many people who get one diagnosis get five diagnoses, but they don’t have five diseases — they have one underlying condition.”

Or, a possibility not considered here, we’ve got five misdiagnoses floating around for which there was no underlying condition in the first place.

Solution. The NIMH is developing it’s own manual, Research Domain Criteria, or RDoC.

About two years ago, to spur a move in that direction, Dr. Insel started a federal project called Research Domain Criteria, or RDoC, which he highlighted in a blog post last week. Dr. Insel said in the blog that the National Institute of Mental Health would be “reorienting its research away from D.S.M. categories” because “patients with mental disorders deserve better.” His commentary has created ripples throughout the mental health community.

Consider, ripples sent throughout the mental health community, ripple throughout the “mental illness” community (i.e. the mental health ghetto). Now whether “patients with mental disorders” are going to get “better” treatment thereby is a big leap. Too big a leap in fact to make. So sorry, my poor victims of standard psychiatric malpractice!

Whatever you call it, my guess is that this switch still represents a way of billing insurance companies, the most important role for patient consumers a psychiatrist assumes. Of course, given that this paradigm change is all about biological explanations, I expect the treatment the insurance companies will be paying for is a chemical fix. Given this situation, the extent to which pharmaceuticals damage patients is still the great unasked question biological psychiatrists do their best to avoid asking.

Pre-psychosis In The News

Attenuated psychosis syndrome, alternately called psychosis risk syndrome, pre-psychosis and prodromal disorder is going into section 3 of the DSM-5. This is the section for disorder labels that need more review, and which will not be reimbursable. The bad news is that it is in the DSM at all, and being in the DSM, it’s going to be considered as a disorder. The good news is that it is not an “official” disorder label, insurance companies are under no obligation to pay for it, and so its not likely to explode into an epidemic next year.

Researchers, it seems, much less fastidious than DSM revisers, are intent in studying people afflicted with this fictitious and elusive label. The latest rage in pseudo-scientific discoveries concerns this nebulous early stage in the development of psychosis. An article in the Detroit Free Press, Schizophrenia may give early warning signs, is typical.

Researchers in Chapel Hill looked at brain scans of 42 children, some as young as 9, who had close relatives with schizophrenia. They saw that many of the children already had areas of the brain that were “hyper-activated” in response to emotional stimulation and tasks that required decision-making, said Aysenil Belger, associate professor of psychiatry at the UNC School of Medicine and lead author of the study.

Now whether psychiatrized families actually think differently from non-psychiatrized families is anyone’s guess, and it could always be the topic for additional research should anybody choose to go there.

People who have a parent or sibling with schizophrenia are about 10 times more likely to develop the disease than those who do not. Signs of the illness typically begin in the late teens to mid-20s. These include declines in memory, intelligence and other brain functions that indicate a weakening in the brain’s processing abilities. More advanced symptoms may include paranoid beliefs and hallucinations.

Perhaps this sounds like an astonishing figure until you realize that it actually means 1 in 10 people rather than 1 in 100 people.  This is to say that among the 1 in 100 people that get described as psychotic, 1 in 10 of their closest relatives could also be so described. Unlike in the rest of the world where the rate stays more or less at 1 %. 1 in 10 means that chances are, if you are in a family haunted by the phenomenon of psychosis in one of its members, 9 out of 10 of it’s members most probably wouldn’t be described as psychotic anyway.

“Of all the people who seem to have compromised circuitry in their brain, if we come back and image them in later years, some may be moving toward the cluster of symptoms for schizophrenia while others may have other types of deficits,” such as bipolar disorder or attention deficit disorder, Belger said.

The article goes on to add, “Still others may avoid serious disorders altogether”, but the damage has been done. If you were an agent of the inquisition, let’s say, looking for witches, you are not going to be questioning the existence of witches. If you want to find fault in anyone, or anything, no problem. Just conduct a fault finding mission. If you are out to praise those people, well, hunting for future “mental illnesses” is just not the way to do so.

I think these researchers have better things to be doing with their time. We really have a problem when the DSM starts predicting disorders in people.  Ignoring any fork in the pathway that may lead to dysfunction, from functionality, is a major shortcoming, I would imagine. Ditto, in the case of paths that lead to folly from reason and wisdom. You are postulating that mental and emotional disturbances are a matter of predestination, and I imagine such leaps of faith belong in the realm of superstition rather than in the realm of scientific inquiry and skepticism.

This doesn’t mean that pre-psychosis isn’t going to make it’s way as a reimbursable disorder in a future edition of the DSM. I imagine, if things continue going the way they are going, it will. There is a lot of nonsense in the DSM. I would say maybe 100 % of the DSM is sheer nonsense. All the same, quite literally, even a listing as a category for diagnosis won’t make future psychosis a real disorder in present time.

Bringing the war in the classroom home to your doorstep

Did somebody say it’s jungle out there? It isn’t a jungle, it’s a war zone, especially in the public school system. Among the new disorders in the DSM-5, such as adult ADHD (attention deficit hyperactivity disorder) , you will also find childhood PTSD (post traumatic stress disorder) listed.

Just read between the lines on the first paragraph of this ABC News report, Psychiatry ‘Bible’ DSM-5 Will Add PTSD for Preschoolers, and imagine millions, perhaps billions, of shell-shocked kiddies returning home from their school day.

 When the new Diagnostic and Statistical Manual of Mental Disorders, DSM-5, is published in May, a small section could alter the lives of millions of children.

Not to be alarmed, despite this potential sharp rise in the number of children labeled ‘off their rocking horses’, mental health professionals tell us they’ve got treatment, and that this treatment can be effective.

Small children develop PTSD at the same rate as adults — one in four — and the number of potential sufferers is vast, said Dr. Judith Cohen, a psychiatry professor at Drexel University’s College of Medicine.

I imagine we could just give children signs on their first day of class, basing children numbers on adult numbers, of course. Numbers, you know, don’t change. 1/4th of the students would receive a sign that read PTSD, and 3/4th of the students would receive signs that read NORMAL. The students with the signs that said PTSD could then automatically be enrolled in a treatment plan.

And yet because existing DSM criteria doesn’t apply to young children, and because of society’s tendency to idealize children as resilient, pre-schoolers aren’t getting the diagnoses they desperately need, [vice chairman of Child and Adolescent Psychiatry at Tulane University, Dr. Charles] Zeanah [Jr.] said.

Children are idealized as resilient. Oh, that explains it! We don’t have the time to offer classes to parents, teachers, and children in ‘how to be more resilience’ then I guess. Notice, they desperately need diagnoses, too. You think so?

If you will excuse me, I think I’ve had enough of this nonsense, and so I think I’m going to return to my bunker for a little blissful shuteye. The prospect of a nation of shell-shocked children is just a little much for me to face head-on alone at the moment. I’ve got my own patch of green pasture that needs tending.

Policing Mental Health In The Schools

If you want to erase the “stigma” of “mental illness”, stop labeling people nutzoid. All the discrimination and harm that comes of “mental health” treatment has to start somewhere, and that somewhere is with the diagnostic tag.

The sad part is that now children are being labeled “mentally ill” at incredibly young ages, 2 year olds, 3 year olds, 4 year olds, 6 year olds, 8 and 9 year olds. I’ve got news for you people. Psychiatric drugs are no replacement for good parenting practices.

If folks knew this, perhaps they would be less inclined to label their toddler a problem toddler. All 2 year olds, for instance, are a world of trouble, as are all teenagers, and I’d think more than twice about labeling them, too.

I know it’s not bad parents, it’s ‘bad’ children, but all the same. I remember when we used to think of children as innocent, and when we used to put a great deal of emphasis on child rearing. If I remember correctly, there was much less childhood “mental illness” back then as well.

The problem we’ve got now is a big part of the Obama administration solution to violent school massacres.  Primary and secondary school workers, from principals on down to the janitorial staff, are being turned into mental health police. That’s right, the idea is to bust children for “mental illness”.

Well, the only thing we’re likely to get out of making our educationalists mental health cops is an increase in troubled peoples. When troubles are pathologized, hey, that’s a cinch for compounding them. The big tab for Obama care, as a result, is likely to get much much bigger.

This Year’s ‘Disease’

According to my doctor
I don’t know what to do
I’ve got binge eating disorder
It’s kind of like the flu

Sometimes I have to feast
Beyond any need to survive
Releasing my inner beast
As listed in the DSM-5

Psychosis Risk Weasels Its Way Into The DSM-5

Allen Frances in his ten worst changes to the DSM list misses one psychiatric label that has got to be as bad as many of those that did make his list.

Remember “psychosis risk syndrome? “Psychosis risk syndrome” is still there, only now it’s called “attenuated psychosis syndrome”.

Although I’ve seen websites saying, oh, “attenuated psychosis disorder” was thrown out of the DSM. (Allen Frances says as much in his post, DSM-5 Guide is Not Bible-Ignore It’s Ten Worse Changes.) This is untrue. It’s still there, and it’s still a problem.

“Attenuated psychosis syndrome” will be in section 3 of the new revision. Section 3 is for diagnoses requiring more research.

It won’t be reimbursed by insurance companies, but it will be there, and this is ominous. It means the possibility that it will be reimbursed by insurance companies in a future edition of the DSM is extremely high.

75 % of the people tagged pre-psychotic never go psychotic, and so this diagnostic label is extremely dangerous, and potentially contagious.

“Attenuated psychosis syndrome” is in the same section that includes “internet addiction”, the “behavioral addiction” some professionals want included so badly.

If it’s in the DSM at any place, from page one to the appendix, it is going to be applied to living human beings. Given this reality, the danger of increasing the “serious mental illness” rate substantially through the use of such a bogus diagnostic tag is very real, and it should be a major cause for concern.

The DSM-5 is only a dead sea scroll and not the fully approved Allen Frances version

I hear a constant buzzing. No, wait. It’s only Allen Frances.

The chief editor of the DSM-IV is posing as the chief critic of the DSM-5, if that makes any sense. The problem is that the criticisms this retired psychiatry professor applies to the DSM-5 apply to the DSM-IV as much as they do to anything, and I’m still waiting for a major display of remorse over that document.

If we look at his latest in a catalogue of complaints against the upcoming DSM revision, DSM-5 Is A Guide, Not A Bible—Simply Ignore Its 10 Worst Changes, some of his criticisms are right on target.

His numero uno is a real humdinger, Disruptive Mood Dysregulation Disorder (DMDD) or temper tantrum disorder. This is the DSM revision teams way to try to deal with an artificially created epidemic that isn’t even in the DSM. A Harvard psychiatrist developed this notion that a number of these kids diagnosed ADHD were actually bipolar, and thus began the pediatric bipolar disorder boom. The DSM revision team has simply created a third diagnosis with which to compound the prior two diagnoses. When ADHD and bipolar disorder are at epidemic proportions, this is certainly paving the way for a third wave. Just wait, perhaps in 10 or 20 years they will come up with an adult DMDD diagnosis.

His second and ninth complaints we can skip over. Sadness, grief, and anxiety aren’t illnesses, or diseases, or disorders, or whatever you want to call them. They are emotions known to all of us. The distinction between clinical and “normal” is a distinction between the everyday and the psychiatrized. If you want one, go about your business, it will come. If you want the other, see a shrink. He or she has their “help” to contribute.

Number 3 is Neurocognitive Disorder or old folks disease. Oh, yeah. Age happens to everybody. I kind of think it redundant as when the brain breaks you have dementia or Alzheimer’s. If we had a ready trash can we could scrap number 3, too, but, of course, psychiatrists must to make a…I dunno…Is it a living, or is it a killing? Anyway, it’s bread, bacon, and a big house in an upscale neighborhood.

Number 4 is adult ADHD. I think I covered the subject sufficiently with number 1. There was a time when there was absolutely no ADHD. A few unruly children popped up, and the editors of the DSM-III put it in the DSM. ADHD babies grow up. 30 years on and, it’s epidemic among children, while the revisers of the upcoming edition are making it an adult “disease”. Pill popping babies grow up to be pill popping adults. Although the drug companies know this, they aren’t letting on. Why nip a good thing in the bud.

Number 5 over eating isn’t a disorder any more than over drinking is a disorder. Alcohol poisoning, with attendant headaches, on the other hand, bellyaches, diarrhea, and vomit, are major concerns. If you’re going to over indulge, learn to under indulge, er, or moderate your appetites. If you need a shrink to do so, well, you’re probably pretty gullible when it comes to a number of these other disorders. Excess in anything could be “co-occurring”, lay talk for “co-morbid”, with any human trait, negatively labeled a disorder, under the sun, moon, and stars. Psychiatrists tend to think “mental disorders” lead to “substance abuse” and vice versa. What a racket!

His complaint number 6 is a little weird coming from a psychiatrist. This has to do with the switch from Autism and autism related disorders to a general Autism Spectrum Disorder.

School services should be tied more to educational need, less to a controversial psychiatric diagnosis created for clinical (not educational) purposes and whose rate is so sensitive to small changes in definition and assessment.

Alright. Should you be talking to the nation’s shrinks or the nation’s educators on this score, and then how does this effect other controversial juvenile diagnoses (say, ADHD, conduct disorder, etc.)? If your talking about the collusion between this nation’s educators, law enforcement officers, government officials, mental health workers and psychiatrists that is an even bigger issue than we’ve got time to cover right here and now.

Number 7 is certainly a valid complaint, and number 8 follows close behind. If recreational illicit substance use is abuse, habit and indulgence equals abuse, too. Although hypersexuality was not included in the upcoming revision, internet addiction is going to be there, and internet addiction is a behavioral addiction. Behavioral addiction opens up the flood gates for any fad or trend to be classified an addiction. If internet addiction makes this edition, you can bet other behavioral addictions are coming, and sexual addiction, however you spell it, is way up there at the top among the candidates for inclusions in future editions.

What he ignores is that these “worst changes”, as he puts it, are the result of a process and an idea that is thoroughly unscientific from beginning to end. You don’t find real diseases by inventing them, and voting them into common parlance. You only find fanciful diseases that way.

DSM-5 violates the most sacred (and most frequently ignored) tenet in medicine—First Do No Harm! That’s why this is such a sad moment.

We, in the psychiatric survivors movement, have been something similar for decades. What follows from this sacred tenet is my next question directed at Professor Frances. Why, given this basic tenet, do you need a guide book for doing harm to people at all?

This harm starts with the psychiatric label. The label is a category in the DSM. All further harm follows from this labeling of human beings as flawed or pathologically affected or unworthy. This labeling represents the beginning of a downward slide in perception from discourse between equals to that of discourse between designated authorities and sub-human second class citizens. Even if you’re using a bamboo pole and string rather than a rod and reel, a few of us still aren’t taking the bait.

Showing the proper disrespect to elected diseases

Mental disorders are not like other disorders, they are…mental. This is why it should come as no surprise that, following the 2012 election, some proposed mental disorders are candidates for entry into the 5th edition of the Diagnostic Statistical Manual of Mental Disorders (DSM-5) slated for publication in 2013.

You aren’t a real mental disorder unless you’re in the DSM. Anybody can come up with a prospective mental disorder, but only a committee of American Psychiatric Association members can vote a mental disorder into the DSM. Once a mental disorder has made its way into the DSM, Pandora’s box is cracked, there’s absolutely no way to keep it out of the world.

If you Google DSM-5 news sometime you can get an idea of the great lengths some people will go to in order to get mental disorders listed in that manual. These mental disorders are up for election, and they’ve got their own press crews, and their own sham-paign committees.

4 candidates are currently scrambling on the news search page for election into shrink’s gospel.

Number 1 is Hypersexuality or Sex Addiction. UCLA conducted a research study recently that concluded Hypersexuality was a “real” disorder. Alright, that’s a first step to convincing the psychiatrists on a DSM-5 revision committee that Sex is a legitimate Addiction, isn’t it? I suppose we will be looking for Hypersexuality DNA in the future. Anybody want to see if they can get Hair Disorder into the DSM-5, too?

Hoarding is set to take a seat rather than simply being reduced to serving as an underling of Obsessive Compulsive Disorder. This has got to be another big lift for Hoarding who recently was fortunate enough to land his own television show on the A & E channel.

The next candidate up for office is the new category, Autism Spectrum Disorder. Asberger’s Syndrome has gotten the boot, and Pervasive Developmental Disorders are being replaced by ASD. Okay, no problem. Asberger was a shmuck. Some people still want him to serve out a few more terms nonetheless.

Prolonged Grief is trying to get her own space along this hall of infamy. I think the thing could be covered under Major Depressive Disorder, but, believe it or not, there are actually people who want to make unrelenting Grief a disease category. Who am I to say they should get over it?

I suggest people take these official disorders as lightly as possible. Should they drift off like a butterfly, or a dead leaf on the wind, it would be no great loss. Devotion to a pompous, demanding, and fictitious disease category can have profoundly negative consequences on your overall health and life circumstances. Pretend the DSM had never been written, and you should do just fine.

Saying Yes To Health By Saying No To Labels And Drugs

I don’t have a “mental illness”. I see it as a revolutionary act to proclaim myself free of “mental illness”. It is a revolutionary act because psychiatrists had diagnosed me with a number of different “disorders of the mind” in the past. These same psychiatrists readily give negative prognoses’ for certain diagnoses’, among them some of the diagnoses’ they’d given me. I call it a revolutionary act because I have found that it is an act many people find themselves too cowardly to make. I don’t need a doctor to circumscribe terms for living my life, and I don’t need to pretend I need a doctor to do such.

In a mental hospital setting, where one has been involuntarily committed, by a hearing and not by a trial, one is expected to admit to having an “illness”. If one doesn’t admit to being “ill”, a prequisite for discharge, while one at one time would have been said to be using a defense mechanism, and being ‘in denial’ about the severity of his or her “disease”, now one is more likely to hear that one has ‘anosogosia’, a brain defect, that causes one to ‘lack insight’ into the nature of his or her “disease”. Non-admission of “illness” is seen as a further “symptom of illness”, or a further indication of the more serious nature of the impugned “illness”. This is the game, you go along, or you rot in a psychiatric facility.

It must first be remembered that one has been convicted of acting insane not by a jury, but by a judge, a few psychiatrists, and probably a public defender who was only pretending to defend his client. The suspect, in other words, is presumed to be “sick”, and no proof need be offered, for as long and until a mental health professional declares him or her otherwise. The thing is mental health professionals don’t hand out certificates of mental health or sanity. If they are going to verify anything, on paper, it’s usually to the instability that they would find in their captives. Of course, the appearance of “improvement” can open doors.

I am not a high functioning schizophrenic. I am not a high functioning person with bipolar disorder. I am not a high functioning depressive person. High functioning, in combination with “mental illness”, is an oxymoron. People are gauged by the DSM, the shrink’s label bible, according to levels of functionality, and people so labeled are not expected to be able to function at the level of people who bear no labels. I am, therefore, high functioning precisely because I am not schizophrenic, nor bipolar, nor depressed. The high functioning exception to the rule of low functioning is a ruse.

Much research has stirred up much confusion about so called “mental illnesses” and the direct effects of the drugs used to “manage” so called “symptoms“. When it comes to schizophrenia and neuroleptic drugs, a worsening condition is more often the result of the drugs than it is of the disease itself. Neuroleptic drugs reduce brain mass, induce apathy, and ultimately produce cognitive decline in the individuals who take them. Each of these conditions has been attributed to the progress of the disease. You would have to factor psychiatric drugs into the equation before you begin to figure out whether this is so or not, and this is not done in much research today precisely because it is driven by drug company marketing efforts.

I don’t take psychiatric drugs. I don’t need a psychiatrist to prescribe psychiatric drugs to me. I have recovered from any “mental disability” that I may have been said to have suffered from, and I did so without recourse to excessive psychiatric counseling. Usually this counseling involves little more than a script for a chemical agent to be ingested periodically. I don’t take psychiatric drugs because of the ill effects they have on my person, and because I have some knowledge as to how these drugs actually affect the brain and the body. I, in fact, attribute my continuing physical and mental well being to my aversion to taking psychiatric drugs. I think when you connect the “illness” with the drug you can begin to see the virtue in coming off.

We live in a prescription drug culture that has left many casualties in its wake, and you can read the names of some of the more notable cadavers in the dailies. I am proud, for the moment, to count myself among the survivors of psychiatric labeling, psychiatric drugging, and standard psychiatric malpractice. This survival would not have been the case had I passively concurred with some psychiatrist’s low opinion of myself and my chances. We need to change the predominate paradigm in mental health treatment today from one that relies so heavily on chemical sedation to one that deals with the problems of real people before we can advance. One sure sign that a person is mentally healthy is that they don’t rely upon drugs. I encourage others to do as I have done, in the name of saving lives, and to say no to psychiatry and psychiatric drugs.