We turn everyday problems into mental disorders

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And I’m not the one saying it. It’s Allen Frances, Professor Emeritus of Duke University, who for years edited the DSM, the publication that all psychologists and psychiatrists in the Western world (including the United States and Spain, of course) use to diagnose mental illnesses. In other words, any psychologist or psychiatrist who diagnoses someone with ADHD (attention deficit hyperactivity disorder), bipolar disorder, depression, anxiety disorder, etc., uses the DSM to find out if the person has the “illness” or disorder.


So I was thrilled when I read the interview (in Spanish) that was done by “El País” newspaper with the same title as this article. Since I moved to the United States it has never ceased to amaze me the number of people who tell me that they’re diagnosed with this or that disorder. The words “depression,” “bipolar,” “anxiety” are on many people’s lips, and unfortunately they all feel weighed down by their supposed illness and experience it with a certain impotence and resignation. It seems like people don’t get sad anymore, but skip right to being depressed. People don’t have mood swings; it’s that they’re bipolar. People don’t go through stressful periods; it’s that they suffer from anxiety. And the list goes on. And I’m not saying that there aren’t people who get those disorders, because there are bound to be some. What I mean is that, the way the system works in the United States, people have to be diagnosed in some way, in order to be able to use their insurance. That is, if you feel bad, need psychological help, and want to use your insurance (which you’ll surely want to do, because that’s why you pay for it), they have to put a label on you and diagnose you with something. The big disadvantage that comes along with that is that no one has everyday problems anymore, as Dr. Frances said in the interview. They have mental illnesses or disorders. And that makes everything take on an air of seriousness that affects the person negatively. The person believes that what is wrong with them is referred to as a mental illness!


The parts of the interview that I consider most interesting are copied below:


Dr. Frances: The DSM IV turned out to be a dike that was too week to stop the aggressive, devilishly cunning push of the pharmaceutical companies to introduce new pathological entities. We were unable to anticipate the power of the pharmaceutical companies to make doctors, parents, and patients believe that psychiatric disorders are very common and have easy solutions. The result has been a diagnostic inflation that’s causing a lot harm, especially in child psychiatry


Q. Are all of us going to be considered mentally ill?

A. Something like that. . . . I see myself in many of those disorders. I often forget things, so I probably have predementia; from time to time I eat a lot, so I probably have the compulsive eater syndrome, and seeing that since the death of my wife, I’ve been sad for over a week and it still hurts, I must have fallen into depression. It’s absurd. We’ve created a diagnostic system that turns normal, everyday problems of life into mental disorders.

Q. With the collaboration of the pharmaceutical industry…

A. Of course. Thanks to them being allowed to advertise their products, pharmaceutical companies are deceiving the public by making them believe that problems are solved with pills. But this is not the case. Drugs are necessary and very useful for severe, persistent mental disorders that cause severe impairment. But they don’t help with everyday problems, quite the opposite: The excess of medication causes more harm than good. There’s no magic treatment for discomfort.


Q. In 2009, a study carried out in Holland found that 34% of children between the ages of 5 and 15 were treated for hyperactivity and attention deficit. Is it believable that one out of every three children is hyperactive?

A. Of course not. The actual incidence is around 2-3% of the child population, but then again, in the US 11% of children are diagnosed as such, and in the case of teenage boys, it’s 20%, and half of them are treated with drugs. Another surprising fact: Among the children in treatment, there are more than 10,000 who are less than 3 years old! That’s somewhat barbaric, inhumane. The best experts, those who honestly have helped define the pathology, are horrified. It’s gotten out of control.

Q.And is there as much Asperger syndrome as indicated by the statistics on psychiatric treatments?

A.That was one of the two new disorders that we incorporated into the DSM IV, and soon afterward the diagnosis of autism tripled. The same thing happened with hyperactivity. We estimated that with the new criteria, diagnoses would increase by 15%, but there was a sharp change beginning in 1997, when drug companies launched new, very expensive drugs on the market and on top of that were able to advertise. The diagnosis multiplied by 40.[…]First, there is no long-term evidence that medication will help to improve scholastic outcomes. In the short term, it can calm children, even helping them focus better on their schoolwork. But in the long term these benefits have not been demonstrated. Second: We’re doing an experiment on a grand scale with these children, because we don’t know what adverse effects these drugs can have over time. Just like it doesn’t occur to us to prescribe testosterone to a child so that he performs better in football, it also doesn’t make sense to try to improve school performance with drugs. Third: We have to accept that there are differences among children and that they all don’t fit into a mold of normality that we’re making increasingly narrower. It’s very important for parents to protect their children, but it’s from the excess of medication that they need protection.


Q.And doesn’t it also have consequences to be labeled as someone who suffers from a mental disorder?

A.Many, and in fact every week I receive emails from parents whose children have been diagnosed with a mental disorder and are exasperated by the harm that the label causes them. It’s very easy to make a misdiagnosis, but very difficult to reverse the damage that comes with it. Both socially and in terms of the adverse effects that the treatment can have.

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