DSM5 in Distress

Absolutely beautiful!

Too bad you're not running for something. I'd certainly vote for you...twice!

Steve Mason
PT Blogger

PS You might find the first paragraph interesting:
http://www.psychologytoday.com/blog/look-it-way/201005/don-t-worry-be-happy

I really enjoy this blog. I have been reading related research about misdiagnosis of mental disorders in the populations of highly intelligent, gifted, and creative individuals. What is actually "normal" for a highly gifted and intelligent person might be mislabled as a mental disorder. And worse - treated as one! Education about this population is lacking in the professionals who are in a position to diagnose mental disorders, and there are fears that this lack of information combined with the trend of overdiagnosis you write about might do a particular amount of harm in these individuals.

The implications of misdiagnosis in a highly intelligent and gifted person are huge for that person's self-esteem and functioning. I understand those implications all too well.

I look forward to reading more of your important work!

I just noticed that Steve Mason left a supportive comment on this blog too. Steve writes one of the only other blogs I follow on this site!

It is so refreshing to hear this perspective being espoused from within the field itself. Not only are external forces promoting normalcy needed but also professionals such as yourself calling your colleagues to task.

Can't argue about too much in this post. Lots of good points to ponder. Our field has gone from a handful of psychiatric conditions/diagnoses to a few hundred in a few short decades. We could probably narrow it down to a couple of dozen disorders and not lose much.

I look forward to the days when much more is added to the DSM. As Depressives /Bipolar's search for new ways to express their dysfunction, so will change or grow the list.

I don't feel like anyone is coming after me.

Do you feel like someone is coming after you?

I want to unofficially add infidelity to the psychotic list.

Psychiatry: No Cures No Science [4 mins]
http://www.cchrint.org/videos/mostviewed/nsnc/
Psychiatrists openly admitting at the 2006 APA convention that they have no scientific tests to prove mental illness and have no cures for these unproven mental illnesses.

What’s Wrong with Psychiatry? A Psychiatrist Explains… [2mins]
http://www.cchrint.org/videos/experts/whats-wrong-with-psychiatry-a-psyc...

I couldn't agree more with this blog post and Dr. Frances' point of view. We get hung up on labels and forget that there are human beings attached to them! I think a better way of accounting for individual differences in human beings is to utilize the neurodiversity concept that has been floating around the autism community for the last ten years. In my recent book Neurodiversity: Discovering the Extraordinary Gifts of Autism, ADHD, Dyslexia, and Other Brain Differences, I suggest that the mental health labels that are all too common these days, focus all the attention on the negatives and neglect the positive dimensions of these disorders. People with autism have enhanced perceptual functioning. Those with ADHD are novelty-seekers. There's a strong link between bipolar disorder and creativity. Dyslexics often make great entrepreneurs. What would happen if the positive aspects of these and other disorders were included in the DSM-V along with the regular diagnostic criteria? Perhaps then we'd have a more balanced picture of individuals who struggle with mood, attention, sociability, and other dimensions of being human.

"Could it be that the surge in mental disorders is caused by our stressful society? I think not. There is no particular reason to believe that life is any harder now than it has always been-more likely we are the most pampered and protected generation ever to face its inevitable challenges."

I disagree on this point in that certainly I think the death of community, the increasing isolation, in the TV/automobile and internet age (where we're now 'alone together') does constitute an increase in stress, compared to times in the past where people may have been more likely to lack adequate food to eat, etc but at least didn't feel as isolated.

Are We Being Unkind To Psychiatrists [1 page article]
http://www.rehabilitatenz.co.nz/pages4/psychiatrists.html
We—the taxpaying public—have hired just such an expert. He is psychiatry. And he claimed to be the expert who would take care of society's drug problem, crime and violence problem and education problem. He also said he would take care of our mentally ill and cure them. And we have paid him not millions but billions upon billions of dollars to perform these functions.

His results?

In the United States, there has been a more than 370 percent increase in violent crime since 1960. Today, a violent crime is committed every sixteen seconds. 26

The rehabilitation of criminals has become a forgotten dream. Instead, we are building more prisons, knowing that in addition to the new criminals, about 80 percent of the old ones are going to end up back in jail.

Today, drug abuse is ravaging society, particularly our young. The illicit drug trade moves more money through the world than the economy of some nations.

There has been a drop of almost 80 points in SAT scores and more than 90 million Americans, including many high school graduates, are too handicapped by illiteracy to function effectively.

As for mental illness, according to census takers, last century one in a thousand people were mentally ill. After World War II, psychiatrists promoted the figure as 1 in 10. Then we heard that it was 28 percent of the population, and now some psychiatrists say that 50 percent of us are suffering from "mental illness."

Psychiatry is still doing more studies. And still asking for more money. And still promising that the problems will soon be under control.

Unbelievably, governments still fund them.

Drug Addiction [1 page article]
http://www.psychosomatic-healing.co.nz/drug.addiction.html
So before any government strikes too heavily at spreading drug use, it should recognize that it is a symptom of failed psychotherapy. The social scientist, the psychologist and psychiatrist and health ministers have failed to handle spreading psychosomatic illness.

This is an excellent article. We're still pushing drugs though. And that's not cool. I help women get off toxic, dangerous medications that they are put on WHILE they are pregnant! Or while they are in their Post-Partum period NURSING! Anyone see a problem with this situation? Class C drugs being prescribed left and right, to expecting and nursing mothers. Women being labeled, and made to feel completely alienated during one of their most vulnerable periods of their life?
I hope this starts a wave of sanity- from the field, and all their cooperators, EVERYONE needs to learn how to recognize sanity. Not only psychiatrist, but anyone who refers patients to them!
Concerned- Advanced Doula & Midwifery Assistant

Dr Frances says it's "too bad that there is no advocacy group for normality that could effectively push back" against the mistaken ideas of his profession. Can you imagine a cardiologist saying this about other cardiologists, or an orthopedist about other orthopedists? What on earth is wrong with the psychological professions, that they can't police their own foolishness, but want "advocacy groups" to do it for them??

The Psychiatric Industry has been abusing the population for decades in America. Not enough is being done to stop them because they hide behind the veil of "The Authority" but they are not. All you have to do is LOOK and ASK for RESULTS and you will see they can not cure anyone and they even admit that. Their domain historically was that of the insane but for the need of money,they branched out to the normal population and with invented "diseases", duped them into thinking there was a quick fix for the natural problems of life. Now we have an epidemic of people that are addicted to the harmful substances and chemicals that they create and push and listen to their psycho-babble.

There will come a day when they are banished from society and the medical field. What a glorious day that will be for all of mankind!

The Psychiatric Industry has been abusing the population for decades in America. Not enough is being done to stop them because they hide behind the veil of "The Authority" but they are not. All you have to do is LOOK and ASK for RESULTS and you will see they can not cure anyone and they even admit that. Their domain historically was that of the insane but for the need of money,they branched out to the normal population and with invented "diseases", duped them into thinking there was a quick fix for the natural problems of life. Now we have an epidemic of people that are addicted to the harmful substances and chemicals that they create and push and listen to their psycho-babble.

There will come a day when they are banished from society and the medical field. What a glorious day that will be for all of mankind!

For 30 years I've been representing SSD/SSI claimants. I used to get clients who had serious, distressing symptoms without objective findings. They had diagnoses of conversion disorder, somatoform disorder. I still get clients with serious distressing symptoms and no objective findings. But I have not seen a somatoform diagnosis in 10 years.

What's the dynamic? Does the psychiatrist or psychologist give way to the patient's perception, the likelihood the patient will go shopping for another diagnostician?

Same thing goes for schizophrenia. I realize some people have schizoaffective disorder but there is no accounting for some of the diagnostic switches from schizophrenia to bipolar disorder -- except for the psychiatrist giving way to the family's lobbying for a diagnosis that is more socially acceptable.

For years no one identified sensory issues as causing any of my child's complaints about loud noises, strong smells, scratchy clothes, or bright lights hurting her eyes. No one understood how hard transitions were for her either. She was told she was being ridiculous and made to feel guilty for things that she could not control. We were given poor advice by well-meaning parents and friends as well as by doctors who did not understand and some even judged her and/or us. BTW, I consider her diagnosis to be neurological not psychiatric.

A neuropsychologist finally gave us the correct diagnosis about three full days of testing. She was 10 by then. We are among the lucky ones, as we have a select group of friends who support us and who stuck by us during the difficult times. Our child is now doing well and I am sure she can accomplish anything she sets her mind to do. She has already overcome so much including bullying from a group of mean girls who did not understand her.

Her diagnosis gave us insights that allowed us to help her and to get her school to help after she was bullied. My child has not received any taxpayer-funded services nor have we ever tried to do so. FYI she attends a private academic challenging school. The diagnosis of Asperger's did improve her life and ours, so I'm not sure I agree with your decision. Girls are so frequently misdiagnosed as it is.

I do agree psychiatrist can be part of the problem, as when I talked to the psychiatrist after the neuropsychologist evaluation, I was asked, "Why would I want my daughter to have a diagnosis that could not be treated?" I think he meant that he could not medicate. Needless to say we found a psychologist who understood Autism Spectrum and never looked back.

I also know that my child’s sensory sensitivity is real because she can hear my conversations from two rooms away even with the doors closed and even when I whisper. She also can tell me when her dad is almost home as she hears his car from over 1/2 a block away.

I'm concerned that you may make life harder instead of easier for those with loved ones on the high-end of the spectrum. Isn’t it bad enough that lay people already think Asperger’s is just shyness or social ineptitude? I am fighting to get someone to notice my blogs and to understand and to help me fight intolerance, so children get the help and support they need. I fear others will think that you are saying all parents of children on the autism spectrum are just crazy and overreacting. I agree there is some overreaction and misinformation, but many are not overreacting. I have never attributed vacinations as the cause of child's differences just so you know.
Aloha,
Sue
dswalkerauthor.com

Thank You! What I've been saying for years!

It's simple common sense folks!

Dr. Francis, Thank you for stepping forward and using your considerable prestige and relevant experience to explain the nature of diagnosis to laypeople and to address the problems of misdiagnosis. I share your opinion on the uses and misuses of the DSM as well as your apprehension with the proposed DSM V for the same reasons.

As you point out, the general problem has been with us since the dawn of psychiatry (I've been observing it from the early '70s), it does seem to be worsening, and no easy solution suggests itself. That said, it is imperative that the problem be completely described, to professionals and laypeople alike, if an effective solution is to be developed.

Your itemization of the probable contributors is a valuable step in that "factoring of the problem" and I hope that you continue elaboration of the details so that, after decades of ineffective wrangling, a more realistic, stable and defensible framework for defining and treating mental aberrations - from all sources - can be developed. Perhaps, with a comprehensive description of the contributors, a "validity audit", evaluating all aspects of the enterprise including effectiveness, will suggest a solution - or, at least, a better understanding of the problem to be solved.

Hope springs eternal,
John
- an experimental psychologist (comparative learning, neurophysiology, and psychophysics) schooled in the '70s, alongside clinical psychologists with much of the same curriculum, and witness to all of the upheavals in mental-health care since that time.

See the post "Asperger's Syndrome in Girls, Bully Prevention, Forgiveness" submitted by Submitted by D. S. Walker.

She says, "I also know that my child’s sensory sensitivity is real because she can hear my conversations from two rooms away even with the doors closed and even when I whisper." Gte that! 2 rooms away, doors closed, mother whispering but child can hear the conversation?

Later she says, "I fear others will think that you are saying all parents of children on the autism spectrum are just crazy and overreacting".

Let the readers decide.

My grandson can hear a conversation two rooms away with voices lowered. He has been diagnosed with ADHD and is a bit tourette-ish and jittery.

A diagnosis of alcoholism without attention to co-existing mental disorders is overrepresented where the treatment agency is reimbursed for treating alcoholism.

Diagnoses of major depression, borderline personality disorder and posttraumatic stress disorder resulting from sexual abuse are underrepresented in a treatment center for gay, lesbian and bisexual clients.

And whatever happened to somatoform disorder - a legitimate diagnosis that almost disappeared, in my region anyway, about 20 years ago.