Before Accepting Mental Disorders…

January 9, 2012

…get a second opinion. While there are tons of benefits to seeing a psychiatrist and talking through problems, it turns out that over-diagnosis may be a little too common, especially in children. Some people go to doctors, psychologists included, looking for a prescription to fix their problems, and that’s great. For the natural crowd, or the side-effect wary, it may be worth two opinions before popping brain-changing pills.

Although there are plenty of mental disorders that need treating, diagnosing them isn’t cut-and-dry, and it used to be that two doctors would not give them same answer. To simplify, and more importantly unite the profession, the go-to diagnosing manual, Diagnostic and Statistical Manual of Mental Disorders (DSM), was formatted to work sort of like online self-diagnosis sites: insert symptoms, output mental disorder.

But it’s not always that simple. Everyone’s different, and there are factors that don’t get weighed that are especially important in psychiatry: like what meta-thoughts and attitude the patient has. For example, if the recession has put you through hard times, you might be diagnosable as severely depressed, due to length and severity of symptoms. However, if you’re aware of the cause, and just need to talk through your woes, that’s not a factor in the diagnosis—even though the feelings are natural to the situation, rather then chemical, a distinction not emphasized enough by some.

Another issue is that diagnosis is required for insurance payments, so if a patient has a more complex issue, they still have to be pigeon-holed regardless of whether the psychiatrist has come to a firm conclusion, which may or may not be a problem, depending on the state of the person.

But the most important problem facing check-list psychology is the over-diagnosis and over-medication of children. In the article at Wired, one of the authors of DSM mentions his regrets in contributing to the over-diagnosis of bipolar disorder in children, a psychiatric fad which started about a decade ago. It eventually came out that one of the doctors advocating for the diagnosis in children (rather than limiting it to adults) was accepting money from a manufacturer of the drug being prescribed.

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