The pile of newspapers and magazines next to our bed is not something I am particularly proud of, but it does yield some interesting treasures on a daily basis. Recently, I unearthed a copy of a Fall 2011 edition of U. of T. Magazine, the alumni magazine of my school, the University of Toronto.
The cover story was written in anticipation of what was then the upcoming revision to the DSM, which is a kind of Bible for people in the fields of psychiatric medicine and psychology, that has actually been revised several times before. All I want to do here is isolate six paragraphs that struck me for a variety of reasons.
…[Edward] Shorter’s critique is more general. He thinks that the DSM is both an example and a cause of psychiatry’s wrong turn beginning sometime after the mid-20th century. He says the profession moved from a relatively small, relatively valid list of mental diseases – many of which could be treated effectively by tranquilizers, lithium and first-generation antidepressants – toward a vast list of disorders with no scientific validity. Some of the disorders overlap so much that they are almost impossible to distinguish from one another. Worse, he says, some of the disorders are really descriptions of normal, if difficult, human experience…
…The current American Psychiatric Association task force, comprising 29 psychiatrists and other mental health specialists, wants to recognize that many conditions often overlap – for instance, anxiety and depression – so that a diagnosis of only one or the other doesn’t always make sense…
…“There isn’t any other discipline in medicine that depends on consensus for its scientific truths,” says Shorter. “Consensus really means horse-trading – I’ll give you this diagnosis if you’ll give me that diagnosis. That’s the way they do business in politics. That’s not the way you do business in science. The speed of light wasn’t determined by consensus.” …
…“One of the disadvantages is instilling in people the idea that normal life includes chronic medication. This has been a terrible development in the last 30 years, the idea that you cannot have a normal life unless you’re on pills.” …
…Dr. David S. Goldbloom, a University of Toronto professor of psychiatry, says that Shorter has identified a real issue in psychiatry − the underlying cause of a disorder is often not known. No blood test or X-ray can confirm a diagnosis. That means psychiatrists are left to make diagnoses strictly according to symptoms. But that doesn’t mean the diagnoses are without value. …
… The problem of “diagnostic creep,” in which normal human emotions are classified as pathology is also a valid concern, he says. “Being sad, angry, afraid or joyous − that is part of the normal fabric of human experience. How do we draw a line when sadness becomes depression, when joy becomes mania, when fear becomes paranoia?” he asks. …
[…You can read Kurt Kliener’s whole article here …]
Mental illness is a fact of life for many families. I thought that this article helps to raise some issues that non-academics need to be more aware of.
I don’t want to minimize what is a real challenge for so many, perhaps even people reading this right now. But the line that struck me was, “some of the disorders are really descriptions of normal, if difficult, human experience.”
Life is hard.