Everyone is now officially disordered
Re: Emily's post on depressed Californians - according to this, they're inordinately happy.
LONDON (Reuters) - An updated edition of a mental health bible for doctors may include diagnoses for "disorders" such as toddler tantrums and binge eating, experts say, and could mean that soon no-one will be classed as normal.
Leading mental health experts gave a briefing on Tuesday to warn that a new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is being revised now for publication in 2013, could devalue the seriousness of mental illness and label almost everyone as having some kind of disorder.
Citing examples of new additions like "mild anxiety depression," "psychosis risk syndrome," and "temper dysregulation disorder," they said many people previously seen as perfectly healthy could in future be told they are ill.
"It's leaking into normality. It is shrinking the pool of what is normal to a puddle," said Til Wykes of the Institute of Psychiatry at Kings College London.
The shrinking pool, the puddle, the leaking - sounds like someone has hydrophilic simile fixation. But I agree: "Temper dysregulation disorder" used to be known as "being a hothead," and "mild anxiety disorder" is also known as "an occasionally sensible reaction to the human condition."
So what's behind this? A) trying to drum up new business; B) trying to mitigate the stigma of serious disorders by making everyone feel as though they're noggin-bonker in their own special way; C) boffins gone wild looking for new things to write about; D) all of the above.
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Comments :
Re: Everyone is now officially disordered
Big pharma must be having a field day -- now they get to sell drugs for "temper dysregulation disorder" and "binge eating."
Jul '10
Re: Everyone is now officially disordered
Emily, with all due respect, knock off the "big pharma" nonsense. They give us what we want (and sometimes even need).
No, this is all part of the larger cultural effort to eliminate normalcy. If we are all screwed up, then how can we judge anyone?
Ironically, most conservatives start from the premise that we are indeed all screwed up. It's called original sin. But the lesson we take from that is that we ought to strive for a level of personal achievement despite our weakness. And despite the certainty that we will shall fall short. And that we are better for defining standards to hold ourselves accountable.
The shrinks at DSM see that we are all srewed up, and conclude that we therefore should toss all efforts at mere normalcy - never mind standards - out the window.
It is cut from the same cloth as multiculturalism.
By the way, I am pretty sure that I have some form of Anxiety Disorder NOS coupled with mild alcohol dependency. Don't judge me!
May '10
Re: Everyone is now officially disordered
If I might add an (E) to your list of explanations, James: the folks behind DSM despise the vocabulary and phrasing of the English language, and have hatched a plot to replace the lot of it with pseudo-medical jargon. Soon we won't be able to reply to the bank teller's "How are you today?" without referring to a pocket Diagnostic and Statistical Manual of Mental Disorders!
May '10
Re: Everyone is now officially disordered
She's probably not completely off base. Companies of every industry tend to act in their own best interests. Many capitalism-loving companies lobby government to shape regulations. Many form ties with other companies to shoulder out competition. What's remarkable about the idea that drug producers would lobby psychiatrists to use more of their products? We're already familiar with how they've taken to advertising directly to patients on TV and in magazines, thereby putting pressure on doctors to give patients what they want instead of what medical judgment supports.
Whether pharmaceuticals pushed for the extra business or not, Emily's right: they'll get it.
There was already much debate regarding over-diagnosis of old disorders, like ADD and depression. I doubt these changes to the DSM will change much. The good doctors will diagnosis carefully and sensibly, while the bad doctors will squeeze patients into the most common or profitable classifications. Like with physiological health issues, symptoms of different diagnoses often overlap. Nearly all psychological disorders are exaggerations of normal conditions.
Re: Everyone is now officially disordered
If the reports are accurate, this latest revision of DSM sounds fishy to me, for all the reasons Patrick describes. But I also support Emily's dig at Big Pharma. Quick, how many Viagra emails have you deleted from your inbox this week? If I had a dollar for every Viagra spamogram in the past year . . . you get the picture. There's a cost to selling priapic recreation on television during family hour: the audience begins to doubt your claims to scientific seriousness.
Most people in Big Pharma spend endless hours developing treatments for serious, debilitating diseases. But saturation level life-in-a-bathtub marketing is unintentionally effective at conveying the opposite impression.
Jun '10
Re: Everyone is now officially disordered
You're mixing up your ED marketing messages, George. Pfizer would never stoop to the level of Lily, with the dopey seniors in bathtubs ads. (I still wonder how the seniors get romantic when they are in seperate tubs. And climbing out puts one at risk of a broken hip.) Pfizer used Viva Viagra, and a guy who grew devil horns when he walked by the window display of a lingerie shop. Much classier.
I think the Cialis marketing team decided that it is the woman who will push for her husband to see a doctor & structured their campaign accordingly. Viagra goes right to the guys, and even had a race car driver (Martin?) in the ads who drove a blue car with Viagra logos.
I don't think Big Pharma is a pejorative term. They are big. They do work successfully through their trade organizations to influence the business climate in which they operate. They greatly improve our quality of life, but like any business, self interest is their first motivation.
Jun '10
Re: Everyone is now officially disordered
It took me years before I could accept ADD as a legitimate medical problem. I noticed later in my classroom that the condition is over-diagnosed. Parents are more likely to blame academic failure on some sort of pathology than the obvious: ordinary laziness, lack of discipline, or dope smoking. Such parents will frequently go doctor shopping until they get the diagnosis they want. Once personal responsibility is eliminated, kids quickly catch on that they can use their alleged condition to get a free pass. They graduate knowing nothing on what is essentially a medical waiver. A teacher who even suggests personal culpability for failure runs the risk of a lawsuit
While James rightfully pokes fun at the situation, I would not be surprised to see the following sometime in the future: homework completion failure disorder, low academic achievement syndrome, or misplaced priority addiction. And yes, I think it's all part of the liberal agenda to reduce everyone to a victim of something. What better way to control the populace than to insist that everyone is an inmate in one great psycho-ward. Medicate them all, and let the bureaucrats sort them out!
Jul '10
Re: Everyone is now officially disordered
Patrick,
I think you have valid points, but i wouldn't be so quick to dismiss that there are interests with a stake in the DSM and those interests might be ones who manufacture drugs. I love the free market, but i would shy away from describing our medical market as free. We have regulatory capture on one end, and then we have governmental capture of medical industry interests on the other.
sometimes i wish we had the ability to write our own regulation that would regulate the regulators. govern the government!
Jul '10
Re: Everyone is now officially disordered
Hmmm, I seem to have touched a nerve with my throwaway line. I am not defending "big pharma" per se. They have been delighted to hop into bed with the government when it suits them. They are rent-seekers supreme.
But I tend to instantly recoil from the sort of cloying populism that message echoes: "Greedy Drug Companies" that "Don't Care" and sell us "Unecessary" products. Sounds right out of the progressive playbook.
Balderdash, I say! We're adults. Buy what you wish, use what you need. Delete the spam.
It would be fascinating to see what a society with an actual free market in health care goods and services would look like. I bet we'd have fewer "disorders".
May '10
Re: Everyone is now officially disordered
Zoon Politikon
Patrick,
I think you have valid points, but i wouldn't be so quick to dismiss that there are interests with a stake in the DSM and those interests might be ones who manufacture drugs. I love the free market, but i would shy away from describing our medical market as free.
In defense of Emily's innocuous use of a standard non-pejorative descriptor, I volunteer to participate in any debate regarding Big Pharma (or Little, or Medium), since I work with these folks for about 50% of my job. They are like bankers- absolutely essential to modern life, and providing many vital things. But the regulatory and payment systems have frozen them into a business model that is not terribly well-understood by most, and is totally obsolete in almost every way, in addition to damaging costs and retarding aspects of medical progress.
Neither the "Big Pharma is Eevil" nor the "Big Pharma is a victim" scenarios work- and conservatives need to look at this de novo.
May '10
Re: Everyone is now officially disordered
I think it was the tone, not the message. You just seemed to come down a tad harsh on Emily. :)
But no worries! The last thing we want is for everyone on Ricochet to sound the same. And conservatives could use more forceful speakers.
If Emily's like most conservative women I know, she won't need protection if someone really steps out of line.
May '10
Re: Everyone is now officially disordered
These are separate issues. Sure "Big Pharma" does a whole heck of a lot of good in this world. However it is also true that certain drugs are over prescribed, I did a paper on the increase in use of the earlier popular antidepressants like Prozac and it was shocking how much profit they were making on that quarterly. You can't just blame the drug companies for that though since dispensing Prozac or others is more cost efficient that say paying for therapy so the HMO's really loved it. My issue is how drugs are marketed today. I think it puts doctors into a bad position to have their patients self-diagnosing and self-prescribing.