Psychiatrists Cast Doubt On Biomedical Model of Mental Illness 329
jones_supa writes "British Psychological Society's division of clinical psychology (DCP) will on Monday issue a statement declaring that, given the lack of evidence, it is time for a 'paradigm shift' in how the issues of mental health are understood. According to their claim, there is no scientific evidence that psychiatric diagnoses such as schizophrenia and bipolar disorder are valid or useful. The statement effectively casts doubt on psychiatry's predominantly biomedical model of mental distress – the idea that people are suffering from illnesses that are treatable by doctors using drugs. The DCP said its decision to speak out 'reflects fundamental concerns about the development, personal impact and core assumptions of the (diagnosis) systems', used by psychiatry. The provocative statement by the DCP has been timed to come out shortly before the release of DSM-5, the fifth edition of the American Psychiatry Association's Diagnostic and Statistical Manual of Mental Disorders. The manual has been attacked for expanding the range of mental health issues that are classified as disorders."
Would most people be better off undiagnosed? (Score:2)
Would most people be better off undiagnosed? When it comes to mental "illness", often the only (or at least the best) treatments are behavioral therapy, in which the "illness" is trained away.
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And medications are rarely, or at least are supposed to only be rarely, the only prescribed treatment, usually initially medication and behavioral therapy, medication being largely used to aid behavioral treatment at the start, unless I am mistaken.
Re:Would most people be better off undiagnosed? (Score:5, Interesting)
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If you got 15 minutes you were lucky. I got ten, a scrip, and a followup cancelled by the doctor.
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Your lucky then, I've had two friends come back from the doctor in worse condition than they were in the first place after they got medicated. In one case my friend got better when the doctor took him back off the meds but in the other they doubled down on the meds and he ended up not being able to function on how own (or even hold a conversation) and in a group home.
Re:Would most people be better off undiagnosed? (Score:4, Funny)
they doubled down on the meds and he ended up not being able to function on how own (or even hold a conversation) and in a group home.
Post hoc, ergo propter hoc.
quidquid Latine dictum sit altum videtur
Every time I see this pointlessy show-offy use of latin, all I can think of is telling the OP is caput tuum revelle tuo e culo.
(And now we get an endless debate about whether I should have used clunes, and velle rather than revelle, and that's the real reason for the fall of the Roman empire, not the inability to terminate strings but the fact that they spent most of their time arguing over grammar).
Re:Would most people be better off undiagnosed? (Score:5, Funny)
Would most people be better off undiagnosed? When it comes to mental "illness", often the only (or at least the best) treatments are behavioral therapy, in which the "illness" is trained away.
I agree. And so do I.
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That sounds like just like me!
Jesus, it's past your bedtime!
Whoooooo!
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Re:Would most people be better off undiagnosed? (Score:5, Insightful)
A diagnosis may also be less useful when the problem is a natural reaction to a social environmental situation and lead to attempting to 'cure' the patient rather than fix the problems causing the reaction. Trying to treat of depression or anxiety caused by stress with long term use of medications is likely to lead to eventual failure of the medication or in the case of anti-anxiety drugs lead to addiction and problems from that, leaving the patient in an even worse situation than before.
Doctors and depression (Score:5, Insightful)
It may be that diagnosis and treatment would be theoretically beneficial... IF THEY IDENTIFIED THE ACTUAL CAUSE! I don't know about anxiety, but a typical doctor dealing with depression will just throw SSRIs, SNRIs, TCAs, or even MAOIs at the problem. They don't think, they just prescribe. They make no attempt to understand the underlying pathology.
You brought up stress induced depression. The average doctor won't consider stress related disorders when dealing with depression, even if you ask him to. Tell a doctor you have depression and fatigue, and most of them wont even think about hypothyroidism. Tell a doctor you have depression and have trouble sleeping, and they'll tell you that it is a symptom of your depression*. They won't wonder about sleep apnea.
*(This is from the "depression is a disease not a symptom" philosophy. At the very least, there's a high chance of co-morbidity, or that the depression has been exacerbated by a sleep disorder.)
The medical profession really needs to wake up and understand that depression is not a disease. It is a symptom. There are many known causes, and probably many that are unknown. When dealing with a chronic condition, you can't just assume that it is idiopathic and treat the symptom, hoping that it will go away. That's unethical.
(You must make a true, good-faith effort to show that it really is ideopathic first. Just because you don't know what it is off the top of your head is no excuse to slack off.)
The problem seems to be made worse because doctors seem to like depression. Depression, as a diagnosis, is popular. It's almost as if doctors are hoping you'll be a depression patient.
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Re:Would most people be better off undiagnosed? (Score:5, Interesting)
Would most people be better off undiagnosed?
In a word, yes. Since "most people" would not be ill, neither physically nor mentally. This new edition of the DSM risks to change that, as in it provides a convenient way to slap "diagnostic" labels on quite a few people who're today considered pretty much normal.
Cue the observation occasionally voiced that what today is called "ADD" (and but yesterday called "ADHD") and results in prescriptions of ritalin, only a few short decades ago was called "being a kid". We are going a little bonkers with the mental, yes.
Re:Would most people be better off undiagnosed? (Score:5, Insightful)
But with more people being diagnosed as mentally ill, and thus more people receiving prescription medicines, the profit margins of Big Pharma (tm) will only go up!
Will no one think of the major pharmaceutical companies?
I don't think its a vast conspiracy, so much as generations of doctors being educated that drugs are the solution to mental problems, and that all mental illness can be treated by some drug treatment. Also this wacky idea that we all have to match some theoretical norm of some sort. "When all you have is a hammer..." etc.
Re:Would most people be better off undiagnosed? (Score:4, Insightful)
How about another way of looking at things: These are devastating illnesses. Non medical treatment hasn't been shown to be terribly effective. What the hell else do you do?
While I'm one of the first people to dump on Big Pharma, we've gone to a biopsychosocial model because chaining people up in asylums and beating them just didn't get the job done. The brain is clearly chemical in nature and at some point reductionist medication SHOULD point the way to detailed understanding and treatment. We just aren't there now. Doesn't surprise anyone in the field. We use the SAME drugs for many "different" diseases. How's that supposed to work?
Yes, by limiting discussion to just a certain framework of diseases you can inappropriately narrow thinking and treatment. You can make it so that it's hard to come up with a different paradigm.
The DSM was the first attempt to come up with a reasonable framework and language. It's not very accurate but you have to start somewhere. Everyone is open to suggestions.
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The principle of first do no harm comes into play. If someone in a position of medical authority is going to offer you a treatment we need good evidence that the benefits of that treatment outweigh the harms.
This is almost impossible to do if the very definitions you have of mental illness aren't meaningful. And the evidence that backs the DSM is very very weak.
Re:Would most people be better off undiagnosed? (Score:4, Interesting)
Psychiatrists take the Hippocratic oath? Considering their treatments and "remedies" they don't seem very good at upholding it.
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The brain is not just chemical in nature. Many of the important properties of the brain come from the physical arrangement of neurons. If the neurons are connected in the wrong way, you can't fix that by bathing the entire brain in some chemical, so there are almost certainly problems that can occur in the brain that cannot be fixed by just administering a medication.
Re:Would most people be better off undiagnosed? (Score:5, Insightful)
You may not be able to fix the brain, but you can use drugs to put a cap on runaway processes that are the result of a miswired brain.
The problem with mental illness is that the brain gets caught in a feedback loop which manifests itself in various ways. This is probably the price we have to pay for the level of intelligence we have - our brains are unusually complex. Many very creative persons are also known to have had a history of mental disorder of some kind. The balance between genius and madness is always close.
Salvador Dalí was from some perspective a bit crazy, but he was also a very smart and creative person. Franz Kafka was riddled with depressions but nevertheless an important author.
As for experiencing depression/anxiety myself - without the drugs I would be stuck in a bad loop most of the time.
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Still, seeing a symptom and treating it with a drug, skipping "thinking", probably misses an enormous chunk that needs to be built back into the model.
Freud-type stuff has been largely shot down, but the brain, when thinking, builds and reinforces thought and memory pathways. If the thinking thinks odd things, it's going to reinforce odd things. What's the mental problem rate of farmers working all day keeping their brain busy vs. poorly-employed people sitting around brooding all day?
Brooding, thinking,
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You're skipping right over numerous known causes of depression, including several endocrinological, nutritional, and even oncological causes.
Not faulting you. Most doctors overlook them too (to their fault).
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The brain is clearly chemical in nature and at some point reductionist medication SHOULD point the way to detailed understanding and treatment.
[just an example below]
I have a problem with my Windows computer. Now and then Firefox crashes when I visit a certain site. Since the computer is clearly electrical in nature, I'm considering taking this here 120V AC wires and sticking them into various places on the motherboard. Random places, actually - because I have no idea how the motherboard works. Will t
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Your example's wrong. Back in the olden days when they still repaired computer boards rather then simply throwing them out, the way they figured out which chip needed to be replaced was by using electrical equipment to test circuits. It took forever even back then, with much simpler circuits, but if you had the right tools you could still do it today. It's not a great way to solve every computer issue, but for some extremely severe problems this is the only solution besides throwing out the hardware.
This is
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That was actually a very good computer analogy. Top notch researchers are almost at the oscilloscope level. They don't really know what's going on in there, but they've found ways to get glimpses. The average doctor treating (for example) depression? Just randomly connecting wires. That doesn't work? Let's put some voltage behind them.
Re:Would most people be better off undiagnosed? (Score:5, Interesting)
CBT is a wonderful advance in psychology.
but most honest practitioners of it will concede that a short course of (the correct) meds will make CBT a lot more effective.
how do you tell someone to calm down when they can't hear you above their own screaming? sometimes people get into a state where they're simply not going to be receptive of any talk-based therapy. if this happens to somebody in your life, you'll be glad that drugs exist, and in enough variety that one of them is quite likely to be just the ticket.
an analogy i've heard is that the patient is like someone walking through snow wearing nothing but underwear. giving them meds is like handing them a coat and scarf. it'll work, but eventually that person has to get themselves out of the snow because it's pretty damn cold.
Re: Would most people be better off undiagnosed? (Score:5, Interesting)
I suffer from major depression. When I go off my mess I feel like crap. I stop being able to concentrate and I feel overwhelming hopelessness. On the wrong medication I was failing basic courses at uni. On the right medication I got credit/distinctions on average and have not only held down a job for 3 years but excelled at it.
I have gone off my medication in the past because I wasn't convinced that the problem was chemical rather than environmental. When I go off my medication I'm sometimes fine for months. But eventually things get worse. I've been on the same medication for 4 years now, I've yet to have any issues.
I explored several options before settling on medication. Even then I explored the possibility that the depression was environmental or situational. I've been proven wrong each time.
Are some people incorrectly medicated? Definitely. But the idea no-one needs this medication to live a fulfilling life is reckless and ill informed.
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Would most people be better off undiagnosed?
In a word, yes.
In a word, no. The people most likely to benefit from treatment are also the least likely to be able to afford it. Not many companies actively recruiting schizophrenics for high paying jobs these days. Additionally, insurance companies would love to deny medical claims for the mentally ill as psychiatric treatment and medications do not come cheap. Without a diagnosis there is no way in hell any insurance company will honor a claim for treatment.
Re:Would most people be better off undiagnosed? (Score:5, Insightful)
It's a pretty crappy headline. My apologies for the length and tangential nature of this post. This is a very personal subject for me.
The problem is that we really don't have a decent understanding of the brain (or its abnormalities) at all. We have collections of symptoms appearing in varying severities with varying results, and we have treatments that alter those symptoms. As far as medicine goes, that's really about it.
The problem with a diagnosis is that it's a label. Someone who says "I'm bipolar" can expect that every action will be judged harshly as to whether it's actually their intended "normal" action, or the manifestation of their depression or mania, whichever happens to be the case that day (or hour). A child who's inattentive in school may just be bored, but the diagnosis of ADD opens the door to differently-structured classes that may help - as well as opening the door to ridicule for being different. Sometimes, yes, it's better to stay undiagnosed, and sometimes it's better to get the diagnosis and do nothing with it.
On the other hand, diagnosis is necessary for any treatment. Someone can understand "I'm sad all the time, and don't like it", but without the term "depression", it's very difficult to find information about how to improve. I've met several people who, in the 90's when depression was highly stigmatized, had traumatic experiences that they couldn't talk about and couldn't do anything to recover from, partly because they wouldn't consider the possibility of actually being "depressed".
To make matters worse, there are still an enormous number of people who simply deny the existence of any mental illness. They assume that kids with ADHD are just being active children, or people with depression are just sad, or people with bipolar disorder are just moody. The illness isn't what's visible from the outside, though. The illness is what's happening in the brain to cause the outward symptoms. The ADHD child can't calm down and focus - his mind always jumps to doing something else. The depressed people can't cheer up - even happy times are often plagued by a sadness that's always present in their minds. The bipolar person can't control their mood - the emotions are overwhelming.
What's happening now, albeit slowly, is that the stigma is being countered by awareness programs. This story is in a similar vein to the one a few days ago [slashdot.org] decrying DSM-5 for not being valid regarding mental health. As our understanding and openness about mental illness improves, we're starting to recognize that typical Western medicine may have done some serious harm to our society. A recent Broadway musical [wikipedia.org] explored this question well.
In next to normal, a woman who grieved four months for a dead child was diagnosed as "depressed", and began 16 years of treatment. One of the questions explored is whether her illness was really because of the loss, or whether it was because of the trauma of ongoing treatment. There is no answer. There is no happy ending. There's only the promise of a next-to-normal life, where everything is perfect except for when it isn't, and there's always some new treatment to try.
That's the ongoing problem with our current handling of mental illness. We have collections of symptoms, and drugs that treat them, but we don't really understand how. The DSM-5 is so vague and imprecise that a particular symptom is painted with a wide brush to be a whole set of disorders. With no testing for suitability, medications are tried that aren't fully understood, in the hope that it's the right drug to set everything right quickly. When it doesn't work, another regimen is proposed, also with little or no testing for suitability. As the patient's treatment drags on, whole classes of drugs are ruled out for their side effects, then brought back be
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The problem with a diagnosis is that it's a label. Someone who says "I'm bipolar" can expect that every action will be judged harshly as to whether it's actually their intended "normal" action, or the manifestation of their depression or mania, whichever happens to be the case that day (or hour).
And any person who says that needs some behavior modification anyways. No one walks around saying "I'm heart disease" or "I'm the flu" when they are suffering from those disorders or illnesses. Only mental health and diabetes have that distinction. And it's a bloody stupid one that continues to allow people with mental illnesses to continue to blame their illness for everything, because they treat it as a label. It's stupid for the reason you bring up as well, because it allows others to blame that one thi
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Yes, I did write that. And yes, the stigma is still pervasive in areas dominated by the old ideology, including law, medicine (sadly), religion, and news media. Fortunately, mental health awareness is indeed spreading through the public. Help agencies are advertising suicide hotlines and informal discussion groups, and hanging up posters saying that "mental illness is an illness", highlighting how it's a condition affecting an otherwise-normal person. Then there are the many more popular artistic works like
Re:Would most people be better off undiagnosed? (Score:5, Insightful)
Would most people be better off undiagnosed? When it comes to mental "illness", often the only (or at least the best) treatments are behavioral therapy, in which the "illness" is trained away.
[anecdote ahead]
Well, I am currently on lithium, and it has helped me more than the CBT ever did. How do I know? I haven't tried to kill myself in a very long time. I haven't even given it serious thought. IT is the emotional life equivalent of watching widescreen movies on 4:3. The worst ups and worst downs simply are no more. (I blatantly stole this quote from someone)
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Yeah, I know a couple of people on lithium and it has switched them from attempting suicide to instead kind of just getting on with life.
I think people are better off diagnosed. Just knowing that you aren't an obnoxious anti-social twat but instead suffering from something that makes you an obnoxious anti-social twat makes it easier to cope with. Behavioural therapies can be targeted and ineffective pharmaceutical treatments can be avoided.
Being "different" is far easier to deal with if you're medically ack
Re:Would most people be better off undiagnosed? (Score:4, Interesting)
As someone on venlafaxine, I concur about the ups and downs being gone more than through CBT. CBT requires such an effort that at least to me it seemed that if I could seriously benefit from CBT, I wouldn't need it in the first place since then I wouldn't have the problems I've had functioning. Venlafaxine is not an ideal medication for me but because I have epilepsy, it reduces the options what doctors can prescribe me. Out of curiosity, I ask if you notice the effects some other way? For me, an unfortunate effect has been a lowered ability to concentrate. At first, I noticed that every time I was getting a bad, depressive thought, I just forgot it and thus didn't end up in my depression cycle. It's, however, not a "precision weapon" so other thoughts are often "collateral damage" so I often forget what I'm thinking of even if I try to concentrate really hard. In the past, I instead associated to something negative in my life from almost anything and thus my productivity was lower not because I forgot thoughts but precisely because I didn't - I was able to constantly make jumps like "I heard this unusual word the first time when I saw movie X and there was a poster for movie X in location Y which was where I met girl Z for the last time" and even much more far-fetched associations to anything that made me feel sad and I just couldn't stop those associations from being constantly formed. Now that i no longer do that, I'm also a lot less angry with myself and that might have harmed my productivity in a different way, I'm more forgiving to myself if I skip exercising, do a shitty job and so on (although I know that prior to my medication, my perfectionism was quite extreme by most peoples' standards). So how has your productivity level changed on lithium?
And to "normal" people, i.e. those few that have never gone through depression or had to take antidepressants: If you're curious to find out what it can be like, you can first think about what it's like to suddenly be reminded of something by making an association Then imagine that you constantly associate things with something negative - as if you had had e.g. pictures of all bad things you've ever experienced and all people that have hurt you placed all over your room/cubicle/house...
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There are a few things that should be taken into account, specially regarding other, more physical medicine fields like the placebo and nocebo effects that could be triggered by the treatment or diagnosis, and the tendency on overmedicating that is having medicine now. Probably in overall is doing more damage than good right now as it is being used. As any tool, it should not be misused, only used where really is needed.
Re:Would most people be better off undiagnosed? (Score:4, Interesting)
When it comes to mental "illness", often the only (or at least the best) treatments are behavioral therapy, in which the "illness" is trained away.
For mild forms of mental illness (bearing in mind that what we call "mild" mental illness can be crippling and painful from the perspective of the individual), perhaps. I'm not sure I agree with the way you phrase your position, but it is at least a valid position.
But behavioral therapy supposes that patient has enough function to engage with the therapist; even in the days before neuroleptics, it was recognized that some forms of mental illness did not respond well to talk therapy. A severely disorganized schizophrenic will turn even the simplest statements into jumbled hash; a catatonic depressive might not have sufficient volition to even reply.
Therapy is pretty advanced when dealing with patients who can't function enough to take care of their basic survival needs -- I'm not talking about acceptance of particular choices or values (by society or by self), or even whether they fit in well enough to hold a job. Rather, individuals rendered unable to attend to basic functions like "avoid freezing to death in winter" or "obtain and prepare sufficient food to maintain life, without endangering others". In such cases it is often a useful adjunct, but supposes that the patient can improve enough to be establish some level of meaningful communication.
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Would most people be better off undiagnosed? When it comes to mental "illness", often the only (or at least the best) treatments are behavioral therapy, in which the "illness" is trained away.
You know not what you speak of. I'm not a doctor and know you're wrong. CBT does not work with untreated schizophrenia spectrum disorders, and can make them worse.
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Would most people be better off undiagnosed? When it comes to mental "illness", often the only (or at least the best) treatments are behavioral therapy, in which the "illness" is trained away.
Perhaps not. I think the point they are trying to make is that the traditional diagnoses do not reflect any deep insight into the nature of the disorders - they merely describe a set of symptoms, and trying, like the American manual, to pin it out in ever more specific categories does little to help in that respect.
There is some research to suggest that the actual underlying disorder in the brain may be essentially the same for at least several of the common diagnoses (like schizophrenia and depression), wh
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Primal therapy is pseudoscientific hogwash. And you are deluded and/or a charlatan.
See rebirthing therapy, crystal healing, and pyramid power for additional examples.
Car Analogy (Score:5, Insightful)
If mechanics understood cars as well as we understand brains, then dealing with car problems might work like this:
After having cut apart and ground up thousands of working and non-working cars, mechanics would know that a lack of gasoline, oil, or water was a common factor in many common car failures. Thus, whenever a broken car was brought into their shop, they'd pop open the hood and pour a bucket of gasoline, oil, or water over everything (depending on the symptoms) to try and fix the problem.
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You forgot WD-40 (although you could argue that it really is a mix of gasoline, oil and water).
What? (Score:2)
Jesus, and how long ago were predominately PSYCHOLOGICAL models being attacked?
Re:What? (Score:4, Funny)
About three hours? It's currently 3:30 on the east coast of North America so everybody there is still daydreaming off the lunch stupor. The Europeans are home from work or sleeping, and the west coasters are high so they're not attacking anything.
Replacement needed (Score:5, Interesting)
If they want a replacement they will need to provide one. Until then, people are being treated, with varying degrees of success, with the current model. Even if the model isn't actually an accurate description of what is going on, it is still a fairly useful guide to approaching the problems. Sort of like classical physics versus relativity. A real breakthrough in understanding would be great - and maybe with all of the brain imaging and various other things going on, that will emerge. But so far it seems to mainly be individual studies that aren't producing a cohesive theory or useful guide to treatment. They will need to find their equivalents of Einstein and Dirac.
Another problem with the recent releases of the DSM is that what is considered a disorder sometimes seems to be a question of politics or political correctness.
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Which model? After all we wouldn't want to break the psychiatrist's business model, would we.
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Why are people (including you) so incapable of differentiating between classification and treatment.
Classification of mental abnormalities: Good. For so many different reasons.
Abusively using that classification to extort money from potentially vulnerable people through application of potentially unnecessary treatment: Bad.
So your comment on psychiatrists' business models is totally fucking irrelevant to the efficacy of DSM-V
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Even if the model isn't actually an accurate description of what is going on, it is still a fairly useful guide to approaching the problems.
Some operating thetans might disagree.
Replacement available (Score:4, Insightful)
Mental health is a large subject, let's take a smaller slice for discussion: depression.
Depression meds work no better than placebo [thedailybeast.com]. Depression meds have lots of unpleasant side-effects, so being treated for depression is - on average - worse than going undiagnosed.
Depression is a symptom of many diseases - at least 18 of them commonplace. Many cases of depression are the result of 1) underactive thyroid (40% by one accounting), 2) Low levels of vitamin D [mayoclinic.com], and 3) sleep apnea [wikipedia.org].
And yet, the symptom is treated as a disease in and of itself. Prescription meds which do more harm than good are commonly prescribed under the flimsiest of circumstances:
Patient: "doctor, I feel tired and run down"
Doctor: "It sounds like depression. Try this and see if it goes away".
After all is said and done, a casual reading of the research would suggest that the scientific method used in psychology research is crap. That's a strong statement, but not completely without merit.
Psychiatrists need to stop worrying about publishing the next trivial follow-on paper, and need to stop theorizing by making up stories. Get your evidence first, make theories to explain the evidence, and then throw out theories which have no testable predictions.
Go back to basics, and stop making money from giving people false hope through increased suffering.
(Grrr! A close friend got chewed up and spit out by the medical profession because of depression.)
Re:Replacement available (Score:5, Insightful)
"Depression meds work no better than placebo [thedailybeast.com]."
Beware the weasel words. What your link actually says, and what the research shows, is that antidepressants in general have about a 25% effect over and above placebo. They do work. However, you can get 75% of the effect by taking a sugar pill, without all the side effects.
Antidepressants are undoubtedly overprescribed, but they do work.
"the scientific method used in psychology research is crap."
You've shown no evidence for that. Psychiatrists have gotten pill happy, probably at the behest of their patients, just like antibiotics get overprescribed, but that has no bearing on whether antidepressants or antibiotics actually work (both do). It also isn't relevant to whether biologists, psychologists and pharmacologists are doing good science or not.
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Depression meds work no better than placebo [thedailybeast.com].
Since they don't cite which study they are talking about, I can't begin to pick apart it's actual problems. In 2010, there was a study (damned if Scholar isn't finding it right now) about SSRI treatment of 'mild to moderate depression'. It showed, and was widely quoted at the time, that placebos were as effective as SSRI and tricyclics. Sure, sounds damning, except that the definition of 'mild depression' is as vague as the rest of your post makes it sound.
Severe depression, on the other hand, is not vague
Re:Replacement available (Score:4, Informative)
I can confirm anti-depressants work fine if you're correctly diagnosed with depression. I can feel the pills wear off. And if you read your link, you'll note the actual paper you quote says they work better then placebo, too. Only 33% better, but better is better.
Being misdiagnosed is not unusual. Strokes also have the same symptoms as many other diseases. Women having heart attacks are frequently told they're having a panic attack. That doesn't mean that the numerous diseases that look like strokes are complete BS made up by some idiot, it just means that you have to have a Doctor whose smart enough to tell a stroke from a migraine.
Re:Replacement available (Score:4, Insightful)
My husband has suffered from severe chronic obstructive sleep aponea for a number of years. It initially presented as hallucinations, nightmares and mood swings - he was diagnosed as bi-polar and put on lithium. When that didn't help, in fact he got worse and start to have fits and seizures (both convulsive and vacant) he was diagnosed as epileptic and put on high doses of epilium which did nothing but cause him to massively gain weight due to the way it messed with his satiation triggers and he felt constantly hungry.
Unsurprisingly this led to severe depression.
Due to a serendipity we ended up seeing a different specialist because his regular doctor was off sick which led to him getting a real diagnosis, effective treatment (firstly a CPAP machine and more recently surgery to open up the airways further) and for the first time in years he is feeling better and is nearly off all the medication.
Ironically I just had my thyroid out due to thyroid cancer and am on heavy doses of Vitamin D.
We're generally a happier household than the previous paragraphs would suggest.
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But in many cases, it doesn't solve the problems. Psychiatry is even less effective at treating disease than other forms of medicine.
Re:Replacement needed (Score:5, Informative)
Pardon me for pointing out that DSM-5 is the replacement. Currently they're using DSM-IV, which is a lot smaller.
The larger point, exposed by this "update", is that the categories are essentially arbitrary and apparently not based on anything falsifiable, ie not anything resembling science.
Yes, I know. That is why it need to be replaced, preferably with something systematic, as indicated above.
As it stands, brain imaging can identify psychopaths [reuters.com], and is showing useful things about Post Traumatic Stress Disorder [sfgate.com]. I expect there will be more to come in that regard. Then there is also the fascinating feedback that can occur between behavior and brain function and activity. Good and bad behavior can become self-reinforcing. Then there is the role of nutrition [usda.gov] in various aspects of brain function and behavior. Biochemistry is continuing to provide new insights, and new approaches. We are continuing to learn important lessons about something so seemingly common as sleep [wsj.com] and its disorders that effect people's memory, attention, and behavior. Even classic psychology and psychiatry have insights that will have to be considered. It all plays a part. On the other hand, in a lot of ways it seems like we are still groping in the dark there is so much to learn. One thing seems likely to me is we are likely to find more conditions that will end up requiring a multidisciplinary approach to treat.
Another interesting question will come when various aberrant behaviors are scientifically identified as such, but they end up being politically protected in either the scientific community, or the political establishment.
Choices, choices.
Psychology VS Psychiatry (Score:5, Informative)
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I was going to post something very similar, but you shouldn't be surprised at the ignorance. My neurologist(who's been treating me for chronic headache, cluster headaches, and chronic migraines for a decade), is also a licensed psychiatrist has nothing but scorn for those "who couldn't cut the coursework." I wouldn't say we're in the dark ages in regards to it. But we're not to the enlightenment period yet either, we understand a hell of a lot more about the brain including how to treat issues then 20 y
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My neurologist(who's been treating me for chronic headache, cluster headaches, and chronic migraines for a decade)
I used to have a car mechanic that I thought was great. Always very pleasant, always explained what needed doing and why. Car was always good when I got it back. Used him for years. Recommended him to my brother. My brother used him once, but didn't go back. I asked him why. He said he replaces parts that don't need replacing. I didn't believe it. Then my brother said, OK, when did you have the car in when it didn't need some parts. And I realised I hadn't a leg to stand on. He may have been gouging me, and
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How do you know you've been getting the best treatment from this neurologist you respect? How do you know you wouldn't have got better results elsewhere.
8 neurologists later...
Re:Psychology VS Psychiatry and BPS==morons! (Score:5, Informative)
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I completely agree with you. In fact, the rambling statement by these psychologists (which does not appear to be scientific) is readily disproven by the biggest and most successful example of medical treatment of a mental health disorder: schizophrenia ( http://en.wikipedia.org/wiki/Schizophrenia#Medication [wikipedia.org] ) and the 1950's discovery of an antipsychotic medication [wikipedia.org] which greatly improved the hallucinations and psychotic breaks undergone by schizophrenic patients: chlorpromazine [wikipedia.org] was found while looking for anti-histamines (for allergies).
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The wikipedia article on chlorpromazine points out:
Chlorpromazine largely replaced electroconvulsive therapy, psychosurgery, and insulin shock therapy.
In other words, chlorpromazine actually worked so well that the psychiatrists no longer had to resort to ECT, brain surgery, or screwing with the patient's sugar and insulin levels.
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You'd have to be a complete moron to claim that there is no evidence for medical and pharmacologic treatment of schizophrenia: the evidence is almost 60 years old. The only conclusion to draw from this is that the British Psychological Society is, in fact, composed of vast groups of complete morons who do not believe in science or the scientific method.
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You'd have to be a complete moron to claim that there is no evidence for medical and pharmacologic treatment of schizophrenia: the evidence is almost 60 years old. The only conclusion to draw from this is that the British Psychological Society is, in fact, composed of vast groups of complete morons who do not believe in science or the scientific method.
You can only draw that conclusion if the BPS were claiming such a thing; are they?
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When properly used in the right cases, Thorazine was great! Unfortunately, you have too many idiots over prescribing it and you have issues like Tardive dyskinesia and the "Thorazine shuffle". And the newer atypical anti-psychotics are dangerous as well(ie: Abilify). I swear they get kickbacks on prescribing these newer and very expensive medications.
I'm not knocking the meds, I think they are great when properly prescribed for the right people, but most of these quacks haven't a clue and the repercussions
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So of course once something has been defined there's a greater likeliho
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You what's interesting?
I had the exact same teachers as my sister. She ended up being diagnosed with Dyslexia, I didn't.
Re:Psychology VS Psychiatry (Score:5, Insightful)
An interesting point. However I wonder about this part:
While we are certainly still in the dark ages of neuroscience and psychiatry, there is a reason why we can control a ton of psychiatric illnesses with medications.
Now here's the thing. We can alter the behaviour and mood of ANYONE with drugs. Give them more can-do spirit with caffeine, coke or speed. Relax them with cannabinoids. Make them stupid and overconfident with alcohol. Friendly/loving/empathic with Ecstasy etc.
So of course with drugs we can change the behaviour of people diagnosed with a mental illness to better suit societies expectations, or to lift their mood. But that doesn't mean that their problem was biomedical. There's no theoretical reason why a person whose mental problem has an experiential cause, such as childhood abuse, wouldn't benefit from treatment with drugs.
Successful bio-chemical treatment doesn't prove bio-chemical cause.
My own layman's opinion, for the nothing it is worth, is that there's a mixed bag of biomedical and experiential causes, together with a bunch of people that just don't buy into societies current norms, and are wrongly diagnosed as ill. And that you can change anyone, ill or not, temporarily or permanently, with both drugs and experiences.
Re:Psychology VS Psychiatry (Score:5, Informative)
Many mental illnesses are at least partly heritable (including the two examples in the summary) and many are associated with measurable physical (as well as chemical) changes in the brain (including the two examples in the summary). At least some mental illness does have biological causes.
Er (Score:2)
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Derp slashdot, just derp.
Is derp a verb now?
And is slashdot the direct object, or are you telling slashdot to derp?
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Clearly, "derp" is a plural noun, while "slashdot" is the verb, and "just" an adjective. The first clause ("Derp slashdot") has a parallel structure to "Sheep graze". The second clause ("just derp") more narrowly specifies which derp are said to slashdot: the just ones (as opposed to the unjust ones) --- so the overall sentence structure is parallel to "Sheep graze, hungry sheep."
Turf war. (Score:4, Funny)
British Psychological Society's division of clinical psychology says "Psychiatry is bogus"
How much do you want to bet that this is a turf war?
--
BMO
Unfortunate examples (Score:5, Insightful)
Those are some unfortunate examples, considering both schizophrenia and bipolar disorder are at least partially heritable and there's other good evidence both have a big biological component.
Psychologists have a good point that considering all mental illnesses to be biologically caused and solely pharmaceutically treatable is not a good thing, but these ones seem to have gone overboard the other way.
Probabilities (Score:2)
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No more benefit of the doubt--you're a charlatan.
Please go away.
Mod UP (Score:2)
I call bunk (Score:5, Interesting)
I was diagnosed as bi-polar about 6-7 years ago after suffering a serious manic episode with full scale hallucinations. While it was not the first time this had happened to me, it was "the final straw" that led to me being diagnosed.
Since then I've been on Resperidone to control the manic phases, and Effexor to limit the depressive phases. I've had no hallucinations, breakdowns, suicidal thoughts, or any other problems since being put on the medication, except when I've run out of medication, thinking "Maybe I don't need it any more."
But the return of symptoms after 2-3 weeks without medication has me convinced that the diagnosis is valid and the medication effective.
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Your experience sounds similar to that of many who've been treated by reputable mental health professionals, including myself.
But, since you admitted that you're a diagnosed manic depressive, anyone who doesn't want to believe that the meds helped can simply discount what you say as coming from someone who has a mental problem.
And, of course, they can then proceed to "if he only did my particular favored combination of Reiki, homeopathy and an all blueberry diet, he'd really get better, and then wouldn't im
F U Psychiatrists. (Score:2)
"Schizophrenia Experiences and Suggestions?" (Score:2)
There was an article on /. "Schizophrenia Experiences and Suggestions?",
I bookmarked the link as it's such a good read, the experiences of those with, had, or knew others with Schizophrenia.
http://ask.slashdot.org/story/04/05/21/0140239/schizophrenia-experiences-and-suggestions [slashdot.org]
Yes, find out more (Score:5, Insightful)
by spellraiser (764337) on Friday May 21, 2004 @01:04PM (#9217287)
"Wow, who would have thought I'd see this on slashdot? It makes little sense to post this question here, but yet, it was post
So you replace it with .... what? (Score:2)
OK, I'm more than willing to admit we don't have a clue about many neurological disease processes. Schizophrenia and Bipolar disorders may be dozens of different specific diseases that happen to present in a similar way. I get that.
But until we *know* what those diseases are, schizophrenia is useful in that it describes a set of symptoms that commonly occur together, that we can treat.
Theoretical models are never "right" or "wrong." These are meaningless terms. They are only more or less useful in that they
This is simple competition for profit. (Score:2)
The psychiatrists are angry about this statement because it threatens their ability to bilk patients and healthcare systems out of money for pills that cost nothing to produce. The psychologists issued the statement because they're butthurt that the psychiatrists have been edging them out of their own turf and their ability to charge people $100 an hour for a service that guarantees no results at all. The pills carry no guarantee of success either, but at least they don't cost $100 per hour.
The statement
Don't need no DSM, we got brain scans now. (Score:2)
And can read genes.
"How to spot a murderer's brain"
http://www.guardian.co.uk/science/2013/may/12/how-to-spot-a-murderers-brain [guardian.co.uk]
Yep, just scan everybody's brain, then jail those who fit the pattern, or are the carrier of one particular set of genes.
Crime prevention at it's best.
Psych, Feynmann and Cargo Cults (Score:2, Insightful)
Stuff that isn't science that is sure it "knows" is prejudice. By pretending to be science such "stuff" gets to deprive you of you liberty in a court based on prejudice because you're a bit socially eccentric and someone else doesn't like that for "moral" reasons or whatever and wants to "straighten you out" whatever that means to them. Do you dress funny? Have sex? The wrong skin colour? These kinds of things...
Stuff that isn't science that pretends to be so usually results in evil of the worst, most unciv
nope (Score:2)
The summary says psychiatrist when it is clearly the: British Psychological Society's.
Funny most people in here are whining about big pharma and psychiatry. There is another field which in most states cannot prescribe drugs.
Wait a sec...Scien...tology! (Score:2)
Talk therapists bashing real scientists (Score:3)
According to Wikipedia [wikipedia.org], "Clinical psychology is an integration of science, theory and clinical knowledge for the purpose of understanding, preventing, and relieving psychologically-based distress or dysfunction and to promote subjective well-being and personal development. Central to its practice are psychological assessment and psychotherapy."
In other words, clinical psychologists focus on the "soft" stuff – talk therapy, Rorschach test, Myers-Briggs and all that crap. So it's not surprising that they would consider the efforts of real scientists to be an intrusion on their turf. We don't use talk therapy to treat depression any more; SSRIs are far more effective (not to mention much cheaper). The only type of talk therapy that has been shown to have any positive effects is cognitive behavioral therapy. All the rest is just crap, and most insurance companies won't pay for it any more because it's basically unproven pseudoscience.
This is not news. (Score:3)
Well... I have to say it's not news to me, but maybe I've just been lucky. My son was diagnosed as bipolar (which didn't exactly come as a surprise to me considering his mother is schizophrenic) last year. Combined with his behavioural issues as well, this was actually a bit of a relief. As far as treatment I have not encountered the "turf war" between psychologists and psychiatrists at all. In fact, my son has sessions with both a psychiatrist (monthly) and a psychologist (weekly) and the two of them talk once or twice a week about his case and work together to try to figure out an holistic solution to his issues.
The psychiatrist has also been really clear from the outset that the medications aren't to treat the problems, rather to make the problems and perceptions of the problems more manageable so that behavioural modification can be developed to combat the issues long term. She has been fantastic in helping us deal with his issues.
Maybe I've just been really fortunate with the group I have been working with here. While his medication is still a bit "hit or miss" there is no doubt in my mind that it has made it a lot easier for him to cope with his issues and put focus into working on his problems that would otherwise be focused elsewhere. While it's still incredibly difficult, it's definitely made things better.
While I agree with the article in that psychiatric drugs do not fix any problems, I think it's a little inflammatory in the way it approaches the statement. Then again, it's "newsworthy" when it's inflammatory I suppose.
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If I was in the doctor's chair I'd call it an unfortunate case of "justified".
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Slashdotitis?
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I heard if you hold a person under water long enough the evil spirits will leave them. I don't know where they go, maybe into a fish?
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A psychologist can't get you locked up for life with no possibility of release based on a dodgy "assessment" that doesn't require an independent review.
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Psychologists have PhDs. Some of them treat patients, These are called Clinical Psychologists.
Psychiatrists have MDs. So do general practitioners, and in many cases psychiatric drugs are prescribed by non-specialists.
Re:s/Psychiatrists/PSYCHOLOGISTS (Score:4, Insightful)
Um, he's absolutely correct. The British Psychological Society is the one making the statement. It's the first three words of the summary. The British Psychological Society is full of psychologists. Unlike the Royal Psychiatric Society, which has a lot of psychiatrists as members and is obviously a little peeved.
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The entire field of Psychiatry was created by the pharmaceutical industry with the express purpose of selling more drugs.
Actually, psychiatry was created by people who wanted to explain everything as the consequence of feeling guilty about jacking off. The pharmaceuticals came along later.
And pace the whiners, drugs *do* help a lot of people. It's hit-and-miss, and not much more scientific than "let's try this and see if it works", but at least that's an approach based on evidence rather than theories about wanking off.
Also, we've made a *lot* of progress in finding effective drugs over the past decades. If you think our m
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Yes. I will certainly consider joining, should I ever be interested in becoming a slave.
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When your poor, you're are nutty: when you're rich; it's called "eccentric".
When you're poor, you're called an asshole. When you're rich; you're called forceful and driven.
Actually, in both cases if your behavior is causing you harm, you are not nutty or eccentric, you are mentally ill. The qualifier of the DSM has, and remains, that the behavior is causing harm. Hear voices that aren't there, but they just are normal conversations or Jesus/Batman telling you to do good deeds? Not a problem unless you want it to go away. Same voices telling you that people are after you and that you need to hurt other people? That's a mental illness. Same for behavioral problems, like narcis
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Are you off your meds?
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You obviously have never known a schizophrenic person. Please tell me how exactly are hallucinations, paranoid delusions and a complete inability to make rational decisions an appropriate biological response to environmental and psychological stressors?