Archive for September, 2009
British PM Asked By BBC If He’s Taking Anti-Depressants
Apparently the British blogosphere is nuttier than the American one, because rumors began circulating round the Net recently that Gordon Brown, the Prime Minister of Britain, was coming unhinged in private, had OCD and depression and was allegedly taking anti-depressants. The hubub on the issue became so great that an interviewer for the BBC pressed him on it during a radio show.
Here’s the Guardian’s account of what went on:
“Marr [of the BBC] said this morning: ‘A lot of people in this country use prescription painkillers and pills to help them get through. Are you one of those people?’
“Brown replied: ‘No.’ And when Marr asked him about the issue again later in the interview, he said that he had already dealt with the question.
“The prime minister seemed to object to Marr raising the matter, saying this was ‘the sort of question that is all too often entering the lexicon of British politics.’”
Standards at the BBC have sure gone into the tank. I can’t see where a bunch of half-baked Internet rumors should lead to a legitimate journalist pressing a public official about what pills they take. Unless there’s something else going on that I don’t know about. But it’s basically no one’s business I would think.
It all kind of reminds of lefty bloggers painting a psychological profile of President George W. Bush a few years ago. One psychologist even wrote a book about the President and his alleged maladies. I did not like Bush 43 much at all, but this sort of thing is just out of hand and is wildly disrespectful of the office and I hope that right wing bloggers and others don’t attempt to play DSM game with President Barack Obama.
Posted in Jaycee Dupree, Sexual Abuse and Stranger Danger
The story of Jaycee Dupree is a sad and tragic one. Stories of children being abducted from their homes are often seen in the news and sometimes recounted in movies or mini-series. The alarm is raised and parents frequently worry themselves and warn their children about “stranger danger”. What is rarely, if ever, discussed is a much greater danger to our children - their own families.
I am reading The Assault on Truth: Freud’s Suppression of the Seduction Theory
Having worked with numerous clients struggling with sexual abuse I have found the majority of their perpetrators are not strangers but family, or friends of the family. Fathers, mothers, brothers, uncles, grandfathers and mothers’ boyfriends have been the predominant threats to clients with whom I have worked. Yet the issue of child sexual abuse is still a clouded one. When a claim of sexual abuse is made it provokes all kinds of reactions, many no better than those of Freud’s Victorian era. If a mother reports that her child is saying the father molested her (the daughter), the mother may be accused of being a vindictive ex-wife. The father’s rights may be invoked. People may tell the mother to keep quiet and not embarrass the father. People may deny that the father could do such a thing, since he is a prominent member of the community. (Freud discovered this was a common argument against claims of child sexual abuse.) They may call into question the mother’s sanity for making such a claim.
Freud discovered this in the 1900’s and tried to make the public aware of it but was shouted down by the psychiatric community. It seems we have made very little progress in the past 100 years.
Depression Management
My guest author today is Ashley Jennings.
Depression is a serious condition that affects many teens. Teenagers have a lot going on in their lives and they may sometimes appear depressed when they are perfectly healthy. This can make it difficult to diagnose depression in teens. After being diagnosed with depression, there are many methods available. Finding the best depression help for an individual's specific situation is a great first step.
It is important to catch this condition as soon as possible, because it can lead to many other significant problems. Some common causes of depression are the death of a loved one, divorce, or even medical conditions that can affect the chemical balance in your body. Common symptoms of teen depression include:
· Feelings of guilt, anxiety, hopelessness, pessimism or sadness
· Lack of sleep
· Excessive fatigue
· Rapid weight gain or weight loss
· Reduced concentration and attention span.
· Bad memory or inability to make decisions
· Sudden risky or rebellious behavior
A psychological evaluation is the best way to diagnose teen depression. A doctor can determine the severity of the depression and this can lead to the best possible treatment. Self-help tactics are a great way to help reduce the symptoms of depression between visits to the psychologist. The specialist often provides depression help and it may consist of self-help techniques along with medication.
Teen depression self-help generally consists of lifestyle changes that build confidence and interest in their favorite activities. If diagnosed with depression, it is important to eat nutritious meals, spend time with loved ones, exercise, and enjoy the time spent with family and friends. These are all excellent methods of controlling the effects of depression.
Ashley Jennings
The Homeless are not Black
I work as a therapist in a homeless shelter in Texas and I'm astounded by some of the serious misperceptions of the homeless which are held by the public. A recent donor asked that we photograph families in the shelter receiving items which had been donated and specifically requested that we please "include some people who are not Black". I was appalled.
I also watched the movie, "The Soloist", recently and couldn't help but notice that as they panned the homeless community within a social service program they presented them as being predominantly Black as well. I have not worked with Los Angeles' homeless population, nor studied their demographics, but I highly doubted they were largely Black. A Wikipedia article discusses the demographics of Los Angeles' Skid Row: "The racial makeup of the neighborhood was 25.5% White, 16.7% African American, 0.4% Native American, 5.8% Asian, 40.7% from other races, and 2.0% from two or more races. Hispanic or Latino of any race were 51.4% of the population."
The demographics of people in any given homeless shelter reflect the demographics of the area in which the shelter is located. They are not "Black". In Texas, the residents of our shelter are largely a mixture of White, Hispanic and Black, with an occasional resident of another race, ethnicity or culture. By contrast, look at the residents of a homeless shelter with different demographics. Look at the Boulder Shelter for the Homeless. Boulder, Colorado is 84% White. You see this reflected in the faces of their shelter residents, who are primarily White.
Homelessness, like most other social ills, is colorblind.
Building Self Esteem through Self Care
Many people ask me how to build self esteem. I think one of the most important aphorisms I've heard was spoken many years ago by Dear Abby, "We teach people how to treat us." So this is where you begin, with good, healthy self care. When you care for yourself you communicate to yourself and others that you are worthy of care. What constitutes good self care?
Several years ago I wrote a checklist for childhood trauma survivors who needed to learn how to reparent themselves in healthy ways, as opposed to the neglect and abuse they had received at the hands of their parents. These same rules apply to all of us. That article is below and applies to anyone, whether you have been abused by others, or neglected by yourself.
Self Care 101
A lack of self care can be the first indicator that the trauma is getting the best of us. Many survivors of abuse are taught to sacrifice their own wellbeing to satisfy the needs of an abuser. As adults some survivors act out the abuse they suffered as children by repeating the abuse over and over. In order to fully heal you have to rewrite the script that was handed to you. You are no longer a victim of abuse. You are not longer an object to be used for the pleasure of others. Replace the hurt that was inflicted upon you with loving, nurturing self care. This will communicate not only to yourself, but to others around you, that you are worthy of respect and kindness.
1. Sleep
Sleep is more important to your body’s ability to function properly than food or water.Your body repairs itself when you are sleeping deeply. Failing to get enough sleep impairs your body’s ability to function and, if severe enough can actually result in your system starting to break down. Your thinking and emotions are particularly susceptible to lack of sleep. Sleep is often a very big problem for trauma survivors, especially survivors of childhood sexual abuse. Many children are abused while they are sleeping. Making your world safe enough for you to be able to sleep is crucial.
2. Eat
The eating habits of the modern human are often deplorable. How many times have I been working with an anxiety ridden trauma survivor only to find that they are downing coffee and energy drinks all day? Caffeine and anxiety often don’t mix well! Neither do high sugar products. Sugar and caffeine will temporarily boost your energy and make your neurons fire a bit faster, but they both end with a crash. The crash can often leave you feeling worse than before and you may resort to more coffee or candy bars to boost you back up. Caffeine and sugar also artificially boost you way up. This boost can also boost your anxiety or your hypervigilance and may increase the changes of a panic attack.
For energy it is better to mix quality proteins with complex carbohydrates and quality fat so your body has a steady source of fuel throughout the day instead of a massive jolt, then a crash. The neurotransmitters your brain makes to calm you (like serotonin and dopamine) and to provide you with energy (like norepinephrine) are made from amino acids which are in proteins. Providing your body with enough water to be properly hydrated also insures that all systems are firing properly since dehydration results in clouded thinking and fatigue. Good self care requires a good healthy diet so your body has the nutrients it requires to function well.
3. Exercise
Exercise releases dopamine and endorphins which calm and soothe. However, I have found that different kinds of exercise work differently for everyone. Some people do best with high energy cardio workouts. The extra endorphins and the fatigue which results is very calming for them. Others are only agitated more by high energy workouts and find it increases their anxiety. Calming workouts like yoga, tai chi or qi gong work better for them. Some people like to workout best in the air conditioning, while others don’t like to be around other people and/or prefer fresh air and sunshine. Experiment with them all and see which works best for you. Whatever you choose, it should be enjoyable and pleasant and should calm you in the long run.
4. Socialize
Developing a support group is essential to good self care. Having people around you with whom you can confide and lean on during those difficult periods is important. It is also important to foster relationships built on honesty and trust. Having a friend or loved one who will pull you out of your shell and take you to a movie when you need it or confront you when you are not taking care of yourself is crucial. Friends and loved ones should be there when you are sad, help you see the light when you are lost and let you vent when you are angry. You should be able to get a “reality check” from them. They should be able to tell you the truth, with compassion. Cultivate relationships with people who give as much as they take – and be sure to reciprocate!
5. Play
Learn to play. Experiencing trauma is learning to see the world as a dangerous place. But the world can also be a tremendously fun place. Garden, play games with your kids or your dog, go to an amusement park, enjoy a special movie, play, opera or concert with a special friend or loved one. Take time to entertain yourself. Laughter is especially therapeutic. I once had a client in the throes of a devastating divorce. He purchased the entire DVD set of an old comedy sitcom he enjoyed and watched a few shows every night. In order to be healthy it is important to exercise your sense of humor. Laughter can truly be the best medicine.
6. Soothe
Touch is a very basic human need and it deeply affects us. Most survivors of abuse have experienced some form of violence against their bodies. Learning to enjoy the sense of touch again is crucial. Whether it is a massage, a yoga workout or a warm bath, take back the good feelings your skin and body are capable of generating.
7. Think
Minds need stimulation in order to be happy and content. Boredom is a killer to a healthy human mind. Expose yours to things which stimulate your five senses in a positive way and stimulate you to think. Computer programmers have a saying, “GIGO”, Garbage In Garbage Out. Be aware of what you put into your mind. I had a client who was having nightmares every night. Granted, she had experienced a lot of trauma in her life, but her nightly habit of watching a horror flick right before going to bed did not help. Graphic movies, violent music, loud or stressful work environments, working in a place with a nasty stench. Be aware of what you are exposing your mind to. People who have an endless string of complaints and are negative and draining? People who are violent, abusive or manipulative? Garbage In, Garbage Out. Go to an art gallery. Listen to beautiful, soothing music. Learn to cook beautifully prepared and healthy foods. Try foreign films instead of horror flicks. Attend a lecture on something that fascinates you.
8. Chill
Learn to take things in stride. So much of what we experience depends on our viewpoint. Be patient with yourself and with others. Allow for foibles, mistakes and human error. Address negative thought patterns that cause you to be frustrated, annoyed, irritated or angry with yourself and others. Look at perfectionistic attitudes which cause you to be too hard and unforgiving with yourself and others. Slow down, take things as they come and focus on living in the moment. Many abuse survivors are control freaks with relentless schedules. Learn to trust yourself, those you love and life just a little bit more as you get stronger and safer in your world. Trauma is about being out of control. There was a moment in your life when you were out of control and you got hurt. Being a control freak is your attempt to make your world safer, by insuring that you are never out of control again and therefore are not so vulnerable to being hurt. Learn to recognize this tendency if you have it and take back your ability to trust.
9. Feel
Get in touch with your feelings – and trust them. So many abuse survivors were told that what they experienced wasn’t real, it didn’t happen, they misunderstood it, or they were lying. They often grow up not trusting their own five senses. Get in touch with your five senses. Trust what you see, hear, feel (as in touch), smell and taste.
Then check with your emotions. I call this “checking with your gut”. Abuse survivors are taught to tune out their basic instincts which told them they were in danger or being hurt. Take back this valuable tool. Tune in to your “gut” or your emotions – and learn to trust it as well. Is your gut telling you that this is “wrong”? Then it is. Many survivors attempt to rationalize. “Well I don’t know exactly what is wrong or I don’t have stone cold evidence of what is wrong so I must be mistaken.” You’re not. If it feels “wrong”, it is. Trust yourself. If it feels sad, it is. If it feels infuriating, it is.
Once you tap into your emotions, take time to sit down and feel them. Learn to find creative ways to express them. Write, journal, paint, write poetry, sing, dance. Everyone learns to express themselves differently. Express yours emotions in a way that is comfortable and natural for you. Don’t distrust your feelings or bottle them up. This is what your abuser did to you. Take them back from the abuser and claim them.
10. Maintain a Spiritual Practice
If you are a spiritual person, notice if you’ve kept up your spiritual practices. If you are religious, you may use prayer as a major stress reliever and strategy for emotional health. Going to church may provide a place to socialize and glean support. If you are more spiritual than religious, you may prefer meditation, visualization, music, yoga, tai chi or qi gong for spiritual comfort. Not everyone is spiritual, but if you are, revive your spiritual practices to calm your mind and emotions.
Power in Relationships and the Scapegoat Role
. It’s a bit outdated, originally published in the 1970’s, but still has some real gems. Here is one about power in relationships, “The exercise of power over people for the purpose of harming them seems to have two basic sources.”
Steiner says the first source is “scarcity” or lack of resources. If there isn’t enough of a commodity to go around, a few people will exercise power over the others to acquire the resource for themselves. Steiner posits that this power may not always be physical, but can be psychic. Those in power can actually convince the powerless to give up their fair share by accepting the deceptions used by the powerful to justify the oppression. I think we can all relate to that in the modern world where genocide, racism, religious fundamentalism and sexism is justified to dominate certain resources. But you can also see this in families. If mother only has a limited amount of affection to go around she may favor one child at the expense of the others. She may justify ignoring the other children by convincing them they are undeserving or convincing them the favored child is more deserving.
Steiner then talks about another kind of power which Fanita English calls the “hot potato”. This use of power is “done as a defense against accusations of worthlessness from within oneself or from the outside”. This negative feeling, or “hot potato” is tossed to someone else. If the tosser of the hot potato ”can make another person feel less O.K. than he does, then, relatively speaking, he is O.K.”.
I see this a lot in scapegoating families. They are usually a very hypercritical and intolerant lot. Constant criticism and fault-finding are the norm. In order to keep people from seeing their own faults (and we all have them) they join together to heap their collective “sins” upon the scapegoat, magnifying that person’s faults (or inventing them outright) and elaborating on them ad nauseum. If they can keep the scapegoat as the target for the family’s negative energy, they avoid having it directed at them. You can see this in the recent movie I wrote about, “Pieces of April”. All of the family’s criticisms and negativity are directed at April, leaving the rest of them unscathed. Their own flaws are quite clear to outsiders, but by magnifying April’s they lessen the impact of their own by comparison. It’s interesting to note that despite their heaped on criticisms, April seems to be better balanced than her family.
Major Depression Overdiagnosed?
A recent article at Sciam.com discusses the possible overdiagnosis of Major Depression. I agree with the authors that this diagnosis seems to be applied to normal reactions to typical life stressors; the loss of health, the loss of a job, the loss of a relationship.
We seem to be a culture afraid of feeling our feelings. We also seem to have been indoctrinated with the belief that we should always be happy. This is simply not true. Normal human beings living normal lives have normal mood swings and one of them includes grief and sadness. By diagnosing someone struggling with real ife problems as having depression we are saying they are dysfunctional in some way and in need of treatment. They may be told they have a “chemical imbalance” that they will have for the rest of their lives and placed on mediications they are expected to stay on for the rest of their lives. All of this because they are expressing normal grief.
Life cannot always be full of hearts and roses. We cannot always be happy. Life has its ups and downs, laughter and sorrows, fears and tears.
I would like to thank David Ray at his blog Dare to Dream for sharing this article.
The Man of the House
Once again I watched as an 8 year boy (with a 10 year old sister and a 6 year old brother) was told he was now “the man of the house” and “you have to look out for your mom, brother and sister now”. His father and mother have divorced and this advice was coming for a seemingly well-intentioned adult, but it made my hair curl. Why?
Children Take Responsibility Seriously
Children assume a tremendous amount of responsibility for things which are not their fault. I’ve written before about little girls who were molested as young as 5 and completely believed they had seduced the molester into doing it to them. Dr. John Breeding wrote in his book, The Wildest Colts Make the Best Horses
So what happens when we make an 8 year old boy “the man of the house”? He takes this designation very seriously. Children tend to blame themselves for their parents’ divorce anyway. They often feel that they did something wrong to cause it, even though they had nothing to do with and no power over it. This is without being told they are responsible and often in spite of being told they are not responsible.
A little boy who is made responsible for the “house”, his mother and his siblings will take no less responsibility or blame, though he has absolutely no power over any of them. This can lead to serious problems. A newly divided house is often chaotic. What was once done by two parents now has to be done by one. Mom is now a single parent. She may be stressed and depressed about the divorce and raising two children alone. The 8 year old now feels responsible for this. He’s been told to “take care of his mother”. If the house experiences added financial difficulty because the father has left, the mother’s income is substantially less, or the father fails to pay child support, the 8 year is going to blame himself for this. He’s the “man of the house” now.
It Compromises the Relationship Between the Boy and his Mother
Putting an 8 year old child in this position seriously compromises his relationship with both his mother and his siblings. If the 8 year old is the “man of the house” how does the mother discipline or parent him? How is their relationship as parent and child forever changed? What kind of power struggle will ensue between them as a result of this role change?
And imagine what are we communicating to young boys about women when we tell them to look after their adult mother. She is an adult who should be looking out after him, yet he is told to look after her. How can an adult woman be so incompetent that an 8 year old has to be entrusted to “look after” her? This is absolutely backwards the boy is intelligent enough to know this. If mom goes along wtih this, what kind of resentment will this cause him to feel toward her for failing to be a mother to him and making him responsible for her?
It Compromises the Relationship Between the Boy and his Brother
What are well meaning adults telling little boys when we put an 8 year old in charge of taking care of a 6 year old? And what does this say to the 6 year about himself and his competency when someone only 2 years older than himself is “in charge” of him? It communicates to him that he is in some way inferior.
If the younger brother starts to have trouble in school and disobeys mom at home because he is acting out the stress of losing his father, is the 8 year responsible for this? If the 8 year old is put in the position of disciplinarian and father figure for the 6 year old, what happens to the comradery they share as brothers? There is a natural alliance between siblings against parents that happens in families. The assignment of the 8 year old boy to the role of “man of the house” totally changes this dynamic.
I’ve also seen cases where the 8 year old is made responsible for the 6 year old’s behavior. Mom leaves them chores to do and the 6 year old refuses to “obey” the 8 year old. The 8 year gets in trouble if the 6 year old’s chores are not done. This causes a great deal of animosity between them and a power struggle ensues which will likely last into adulthood, and perhaps for the rest of their lives. The younger brother may have gained a “father”, but lost a brother. And what kind of “father” can an 8 year old be? The 8 year old may also resent the 6 year for continuing to be nurtured as a child by the mother while the 8 year old is held to a different standard. The animosity which results may destroy their relationship forever.
It Compromises the Relationship Between the Boy and his Sister
Imagine being an older sister to this boy who has been put in charge. If the sister is 10, she is now taking orders from an 8 year old. This is preposterous. (Well the entire situation is preposterous, which is the point.) She is going to rebel against this, like the 6 year old. If the 8 year old is also held responsible for her behavior, animosity and power struggles are sure to result. Once again, this compromises the natural alliances between siblings. And once again, this conflict will probably persist throughout adulthood.
In addition, what message are we sending to young men and women when an 8 year is placed in charge of a 10 year old just because he is a boy and she is a girl?
It Compromises the Mental Health and Well Being of the 8 year old
An 8 year child, male or female, is emotionally, mentally and physically incapable of handling adult responsibilities. And to be told to do so is totally unfair. It holds them responsible for things totally out of their control. It places a unfair burden on them to be something for which they are totally unequipped. It gives them power in the family they should not have and prevents them from being the child they were meant to be. It cheats them out of their childhoods and creates tension and frustration among the family members.
It’s important to stop this pattern which has been handed down through the generations. Children must be allowed to be children and parents must be the adults in the household.
DSM V and the Diagnosing of Human Behavior
A recent story in U.S. News and World Report states, "The Diagnostic and Statistical Manual of Mental Disorders, as it is known, is hugely influential because it determines what is and is not a mental disorder. In turn, it is responsible for much of the sales growth in prescription drugs." In a recent article in Psychiatric Times Dr. Allen Frances discusses his concerns about the way the next version of the DSM is being formulated and the possibility that formerly normal human behaviors will be become "medicalized".
The DSM is the "Bible" of psychiatrists. It is used to define what is and is not abnormal behavior. Psychiatrists like it because it is definitive and descriptive. Identify the mental illness, name it and medicate it. Instead of a weekly, one hour psychotherapy session they can do a quarterly, 15 minute "med check" for about the same price. They also don't have to do the work of actually having a therapeutic relationship with the client or facing a problem they don't know the answer to. The answer to every problem is "take a pill" and no therapeutic intervention is required. Just a discussion of symptoms and a prescription. If the symptoms persist despite medication, the dose is adjusted or the medication is changed. No matter how many times a patient comes back complaining that they are not getting relief from the symptoms, another pill is the answer to every complaint.
Insurance companies like diagnosing because it provides a coding system that makes it easy to approve or decline coverage and determine the approved treatment based on the diagnosis. They too like the fact that weekly psychotherapy sessions are reduced to quarterly med checks.
Pharmaceutical companies like it because it promotes a line of thinking that is very profitable for them. Have a problem? Take a pill. No, take their pill. The latest greatest pill. The one with no generic, of course.
Scientists and researchers like it because it is said to be based on empirical evidence.
Patients like it because they are convinced that taking a pill is going to fix everything and they won't have to do the hard work of psychotherapy and actually address their issues, change their behavior or change their relationships.
So what's the problem?
Normal Human Behavior is being Defined as "Abnormal"
Previously normal behaviors such as shyness are now being defined as something abnormal (i.e. shyness is now "Avoidant Personality Disorder" or "Social Anxiety Disorder") requiring intervention and treatment, typically with a medication. Grief is now described as depression (instead of a normal reaction to the loss of a loved one) and treated with an antidepressant. Anxiety caused by living a very stressful lifestyle is now classified as abnormal (instead of a normal reaction to poor lifestyle choices) and treated with anxiolytics. Even Posttraumatic Stress Disorder is viewed as abnormal and medicated though this is clearly a normal reaction to an environmental stressor. Instead of working through our problems, feeling our feelings and working through this stress or pain, we medicate ourselves into oblivion, often for the rest of our lives. Since we do not work through the real issue we do not come out on the other side, we are never healed.
Normal Human Behavior is being "Medicalized"
"Medicalizing" is the process of defining human behaviors as medical conditions to be treated by medical means. It is the application of the medical model to human actions and reactions. The medical model views "abnormal" behavior as a disease. This was a great leap forward at a time when mental illness was viewed as demon possession. Redefining insanity as an illness instead of a weakness of character or demon possession allowed patients to be treated with more compassion and understanding. However, in the 21st century it may hinder more than help.
Normal Human Behavior is Now a Permanent Disability
When human behavior is redefined as a chemical imbalance and treated like diabetes or thyroid disorder it dooms the patient to a lifetime illness. If you view "mood swings" as Bipolar Disorder and classify them as a chemical imbalance you doom the patient to a lifetime of "mood stabilizers" and psychiatric treatment. The patient can never be healed and never recover. They will always have to be on meds. They will always be "abnormal" or "ill". Instead of having clients who were treated with psychotherapy and recovered we now have permanent patients.
Normal Human Behavior is being Medicated
Combined with the pervasive influence of the big pharmaceutical companies, any "abnormal" behavior defined in the DSM is typically viewed as a biological problem, a chemical or neurological imbalance, and treated with medication. This is causing serious concerns in the psychological community.
Christopher Lane, author of “Shyness: How Normal Behavior Became a Sickness
See also, Is Social Anxiety Disorder Just a Fancy Name for Shyness?
The Evidence Isn't as Conclusive as the Public has been led to Believe
We are told that the evidence shows that mental illness is a biochemical disorder and that all the research leads to this conclusion. That simply is not so. Research has consistently failed to show the efficacy of antidepressants, but has been suppressed. How? Why?
Research on psychiatric symptoms is heavily funded by pharmaceutical companies and therefore heavily influenced by Big Pharma. They will not fund non-medication studies for obvious reasons. That makes sense. What is not so obvious is that they have been shown to bury studies which show no difference between patients taking a placebo and patients taking their medications.
In addition to the influence of Big Pharma on research, many clinicians are starting to question the efficacy of the medical model in assessing psychiatric symptoms. Clinicians have argued that many diagnoses are not chemical imbalances but reactions to traumas. Depression seems especially vulnerable to external causalities rather than a biochemical cause. In fact, rather than a mental illness, proponents of depressive realism maintain that people with depression are more reality based and perceive life more accurately than people without depression.
See also:
Antidepressant Studies Unpublished, The New York Times
Depression, Helplessness, Hopelessness and External Locus of Control
Depression: New Thinking on Its Causes
Mood Swings are Normal
Depressive Realism
Trauma and Schizophrenia
Childhood Abuse, Depression, Anxiety, Mood Swings, Bipolar Disorder and Trauma
Bipolar Disorder and Trauma
The Effects of Big Pharma on the Medicalized Model are Disturbing
The U.S. News article continues,
"The most recent edition of the DSM, published in 1994, drew controversy because it turned what had once been a thin guidebook into an 886-page tome that significantly expanded the definition of mental illness. Traits once associated with shyness, for example, became symptoms of "social anxiety disorder". And drug companies went on to spend millions promoting medicines for those problems. Eyebrows were further raised in 2006 when a study showed that more than half of the researchers who worked on the manual had at least one financial tie to the drug industry."
Dr. Frances, in the Psychiatric Times states that,
"For instance, a seemingly small change can sometimes result in a different definition of caseness that may have a dramatic and totally unexpected impact on the reported rates of a disorder. Thus are false “epidemics” created. For example, although many other factors were certainly involved, the sudden increase in the diagnosis of autistic, attention-deficit/hyperactivity, and bipolar disorders may in part reflect changes made in the DSM-IV definitions. Note this."
"To promote sales, the companies may sponsor “education” campaigns focusing on the diagnostic changes that most enhance the rate of diagnosis for those disorders that will lead to the increased writing of prescriptions. As I will discuss, there is a great risk of many new “epidemics” based on changes suggested for DSM-V."
"May" sponsor education. I know they will. I have seen them work. This is how antipsychotics became "mood stabilizers". The drug companies come to a doctor's office or clinic and provide elaborate videos, Power Point presentations, brochures and all kinds of information to "educate" doctors.
"Another DSM-V innovation would create a whole new series of so-called behavioral addictions to shopping, sex, food, videogames, the Internet, and so on. Each of these proposals has the potential for dangerous unintended consequences by inappropriately medicalizing behavioral problems; reducing individual responsibility; and complicating disability, insurance, and forensic evaluations. None of these suggestions is remotely ready for prime time as an officially recognized mental disorder."
When Big Pharma has a new medication, they push it with a marketing strategy that would blow most people's minds. Drug reps will take an entire clinic out to lunch and provide, literally, trunkloads of free samples. They also provide slick, elaborately-executed "educational" programs to doctors on the certain diseases and push the new medication which will magically treat this illness. If you are a doctor, you are human (yes human, not God), and it can be very tempting to interpret a cluster of symptoms as a particular illness which has a new magic pill which will magically fix it rather than an old illness for which there is not a clear treatment protocol or a poor prognosis. We all like to be heroes and save the day. Doctors are no different.
Side effects of the medications are also downplayed. Most patients don't realize that many "mood stabilizing" medications and several antidepressants can cause serious weight gain. Antidepressants are well known to reduce a patient's libido. And "mood stabilizers" can lead to metabolic syndrome when can lead to diabetes. Many other side effects can be caused by various psychiatric medications which are not well publislhed.
Big Pharma and American Psychiatry
FDA Complicit in Pushing Prescription Drugs
The Diagnosing Process is Very Subjective
One of the more prevalent complaints about diagnostic procedures is that they are very subjective and highly dependent upon the background, knowledge and individual prejudices of the clinician making the diagnosis. Currently, many clinicians are complaining that ADHD and Bipolar Disorder are heavily overdiagnosed and indeed it has been my experience that there is a heavy prejudice in favor of diagnosing these two "illnesses". It is interesting that these are also two diagnoses for which there are "new" medications on the market which are being heavily pushed by the drug companies.
A doctor's clinical experience can also color the way they diagnose. A doctor working at the state hospital where the most serious cases often land has seen patients with much more serious symptoms than a psychiatrist in private practice. The state hospital psychiatrist may be less likely to diagnose a patient experiencing mild symptoms with a serious mental illness than the private psychiatrist who is not regularly exposed to patients with more severe symptoms. I see this a lot with Bipolar Disorder. A state hospital psychiatrist will expect to see full blown mania and seriously debilitating depression in order to render the diagnosis while a private practice psychiatrist may diagnose a client with Bipolar Disorder who merely complains of "mood swings".
See also, The Truth about ADHD
Overdiagnosing Bipolar Disorder
Diagnosis of Mental Illness Hinges on Doctor as Much as Syndrome, Seattle Times
Given these serious and numerous concerns about diagnosing human behavior I always urge people to think for themselves. Look up any diagnosis you have been given, look up the medications being prescribed for it and above all think for yourself. Do the symptoms you are experiencing warrant the possible side effects of the medications which have been prescribed? Does the diagnosis make sense to you? Are there situational factors which might be causing the symptoms which need to be addressed?
Some clinicians refuse to diagnose clients at all. Diagnosing is a view of human behavior through the lens of the "medical model". The medical model looks for abnormality and views a diagnosis as something abnormal which needs to be fixed. But it is not the only way to view human behavior or psychiatric symptoms. There are other models which can be utilized without labeling, stigmatizing, disempowering or medicating clients. It's important to consider all possible solutions to the problem and make an informed choice.
With the current state of the psychiatric field, the old caveat for consumers seems especially appropriate. "Caveat emptor" – buyer beware.
Katie Holmes as a Scapegoat
I watched "Pieces of April" last night, starring Katie Holmes as April. The film does an excellent job of demonstrating how a family scapegoats one of its members, and how that person plays into the role.
April is the family scapegoat. She dates drug dealers, lives in a ghetto apartment in New York and comes home to visit with new piercings and tattoos – all of which make her a target of her mother's constant criticism. Her mother demonstrates why the family needs a scapegoat. She is very hypercritical and intolerant and in real life I would suspect that her family of origin was just as hypercritical and intolerant. In a family that looks for every flaw, it's best to have their attentions focused on someone else. Hence the scapegoat is created, subconsciously, to absord all that negative energy. April's sister plays the perfect Hero to April's Scapegoat and her brother is the Missing or Lost Child. If you're interested in seeing a film about family roles, give this one a viewing and let me know what you think.