DSM 5: Changes to psychiatry manual: Problems in mental health

I think that anyone with common sense knows by now that this DSM thing is just a way for a professional group to seem more knowedgeable and expert than they are. You can't just lump people into predesigned categories. Any treatment with a competent therapist involves them getting to know you and understand you and deal with you as an individual. People are not machines. BTW, if you ever need help, don't go to a psychiatrist for obvious reasons. The only thing they can do that other therapists can't, is prescribe medication. If you really need it, your therapist can send you to one for occassional consultations for that. But for doing therapy, psychiatrists are the last ones I would ever go to. I trust them the least to really know anything about human nature. I say that from experience.

reply to post by Hillarie


Interesting anecdote. Opposite of mine. The only person I trust is my psychiatrist. I don't trust others much, though. But my psychiatrist also is a counselor and we have regular sessions. At this point it's about 3 times a month for 20 minutes. He respects my decision not to use medication, but I will always keep that option there. He encourages me to educate myself on mental health, medications, and reactions. He welcomes new knowledge. He supports me. He helps me find better ways to cope. And most of all, he understands the psychology of chronic pain.

I consider myself lucky because I am aware there are not many psychiatrists like mine. He inspires me to become a psychiatrist myself, but of course am too afraid because of my mental health history. People with mental illness are still people who should be treated with the utmost compassion and empathy. We usually seek help in our most vulnerable state, and it's unfortunate that there are doctors more focused on the bonus for prescribing psychiatric medication instead of focusing on his patients well being. I wish I could change it, that this would stop.

reply to post by InnerTruths

You are the boss of your health, and know yourself better than anyone. If you have a problem with your doctor, let them know, and find a new one. Your health care is your business, so fire your Dr if he isn't good enough, and find one who is.

Very well stated. Thanks for the (perhaps unintended) support.
It's your practitioner that makes the difference!

reply to post by Hillarie

this DSM thing is just a way for a professional group to seem more knowedgeable and expert than they are. You can't just lump people into predesigned categories.

I am in agreement with your post, and applaud you for your recommendation that a person should carefully choose a practitioner!

I am NOT, however - and must protest it - in agreement that "this DSM thing is just a way for a professional group to seem more knowledgeable and expert than they are."

Did you read my other posts here?

It is CODING TOOL for BILLING PURPOSES. It does not contain "treatment recommendations" or "meds" or anything like that. Any practitioner who leads a client to believe it is some sort of voodoo cure-list book is misleading the client.

Ah well. I'm trying.

Thanks to those of you who have "lightened up" on me. I'm only trying to dispel misconceptions about how the system works, and what the actual therapists (NOT THE PSYCHIATRISTS) are doing. The psychiatrists go with what Big Pharma reps tell them.

So do GENERAL PRACTITIONERS, and FAMILY DOCTORS. Hence my separation of the real therapists from the MD's with the scrip pad and the power to sign off on meds.

I hate when people view complex scientific materials without proper knowledge, and then make it out to be something it's not....

Psychologists and Psychiatrists usually only see patients who have symptoms that are causing problems in their life....so in other words, some of the symptoms in the DSM may be present in normal people, but that doesn't matter.
The symptoms will only be treated when they are causing problems.

Psychiatrists don't just analyze every single person and when they have one symptom, they are given a label for a disorder and given meds.
They only treat people who come to them looking for help, unless the court send them(in which case there is still a problem, or parents send their kids, and while there may be some misdiagnosing, most are treated successfully and without meds).



The brain is the most complex thing in the universe! You probably know next to nothing about it! Yet you're sitting here judging this book for being a little flawed?
Sorry they can't make a perfect book that categorizes all of the potential problems with the most complex thing in the universe!

Originally posted by Wrabbit2000
34%? Just to add something to this.... When I was in school in the 80's, the Nurse's office had a plastic tub .... a small one...with controlled substance type meds for students. When I was at my Son's school earlier this year to drop something off, I had to see the nurse for some issues as well. The Nurse in HIS school has a stand up, full size Mechanics chest like the red Snap-On chests you see in a well appointed car shop. It's full...every tray from top to bottom...with controlled substance meds for the kids at the school.

In the 80's when I was in high school, I had to take heart medication and simply carried it in my pocket in one of those plastic "dose dividers" that you can buy at the drug store. There was no rule about it and most of my teachers were quite aware that I had to take medication and that I did so as necessary.

Today, if a kid were to do it the way I did? He'd be expelled for possessing "drugs" on school property. Also likely arrested for not having prescription medication in it's original container.

That probably is at least part of why the school nurse went from a storage bin to a file cabinet.

~Heff

reply to post by PatrickGarrow17


I've been very open about my psychiatric issues on ATS. I am diagnosed with Bipolar, PTSD, and five additional, lesser issues, most of which are sub categories of the "big two".

I take a very small dose of Xanax and a small dose of an older SSNRI each night. On paper the doses are insignificant enough that, when I have to see a new medical doctor for any given reason, it causes them to doubt the sincerity of my problems. It takes quite a lot to try and convince them that my doses are that light because I have put decades of work into getting them that way. Once upon a time I was on much, much stronger medication and at much higher levels. I made the personal choice to become accustomed to my symptoms and to adapt to them, rather than to spend my life on strong medications.

Still. Take away those minor doses? Within 48 to 72 hours not only can I feel the difference, but others, around me, can see it. I become much more emotional and highly aggressive. This is a function of my Bipolar disorder. In my case, my manic state is not very pronounced and went undiagnosed for years. I am atypical. My manic state manifests in behaviors that don't stand out in our society too strongly. I tend to just get very flirty and promiscuous with women, and aggressive with males. I also become highly jovial.

Thus my manic state would seem to most people like I was just some slightly arrogant guy at a bar, trying to blow off steam by picking fights and trying to pick up every cute female in sight. Much of this got overlooked, though, because I also bought rounds, picked up bar tabs, and my nature is to joke around a lot. So my "isms" were accepted by the group. I was considered a great guy. Fun at parties and always entertaining.

I spent more than two decades of my life in this state.

Beginning in 2003 a person I trusted and cared for very much urged me to start going to therapy. She and I lived together and she could see the less "shiny" aspects of my illness. She could see the nuanced compulsions that haunt my life ( ATS is a perfect example. When am I NOT here? ). She could also see that, beneath the happy exterior, I was miserable. My coping mechanism was to make everyone around me happy - and not to worry about myself. I honesty don't know why this was - and still don't get it. But it was true. As long as those around me were smiling? I was smiling. If they stopped smiling? I did whatever it took to make them start again. I never focused upon or worried about myself. Which is, in itself, strange - because much of my behavior during those years had the appearance of being selfish. Go out with a guy who insists upon paying, who insists upon telling jokes and guiding the conversation, who insists upon making sure everyone else is having a blast. It ends up being seen as ego and self-absorption. A control freak.

In 2007 I, finally, had a total breakdown. I've discussed it before on ATS and don't care to do so today.

Since 2003, however, I have been "in the system". Not an inpatient ( ever ) but very participatory in the county mental health clinic. Upon request, I have even attended Q&A sessions with local police to help them better understand mental illness and to demonstrate that it doesn't have to be obvious to be legitimate. I also attended and helped to run weekly group therapy sessions for 8 years.

I am friends with and am acquainted with literally hundreds, if not thousands, of mentally ill people. Some, very, very obviously so. Others get better and disappear.

There are people diagnosed who are never put on medication. I have known many. In fact the doctors I deal with are often hesitant to prescribe medication. It all depends upon how obviously troubled a patient is. There are many people who fake mental illness as a means of trying to get prescription medication. That, in and of itself, is enough to dissuade good doctors from going straight to meds as an answer.

There is no doubt that psychiatry is an evolving science. It is not, IMO, an exact one yet. One of your OP examples shows that grief is now being listed as a depressive state. IMO this is good. It allows doctors to prescribe medication, temporarily, if the grief or separation anxiety in a person is strong enough to warrant it. And they can do so without fear of being sued or having their right to practice taken away for "prescribing off label".

In the end, some here will say "I can relate" - and others will post that mental health is BS and that it's just an excuse or a lie, based upon a myriad of motives. All I can say in reply is to restate what I said above... Without my medication? I can feel the difference and the people around me can see it. Without it my life would be much less fulfilling and enjoyable.

~Heff

reply to post by wildtimes


Sorry, I came across pretty harsh bit I did more than lose 3 months of my life, antidepressants changed how I felt from the point on I never felt the same again. When I said incarcerated against your will I meant involuntary commitment to a mental institution.

Is not the goal of psychiatry to help people adjust to the world they live in? What if the world they live in is corrupt and people succeed by using unethical behaviors? That is pretty much the situation we find ourselves in today.

I know that most people involved in the mental health field honestly desire to help people become happy and well adjusted. My contention is that the government uses every institution to further goals and engender attitudes and beliefs that are for their benefit rather than for the individual's. Sanity is an elusive goal, especially when they keep moving the goalposts on you.

Eta: there are indeed many people who have and who need help from mental health professionals and institutions.
I don't mean to deny or diminish the great work that they have done.

I heard they were getting rid of Aspergers syndrome.

t’s official: Asperger’s Syndrome has been dropped from the Diagnostic and Statistical Manual of Mental Disorders (DSM) which contains the diagnostic criteria for psychiatric disorders and is often called the “bible of psychiatry.” When DSM-V (the next edition of the influential manual) appears in 2013, it will no longer list Asperger’s as a distinct condition, but describe its symptoms under the newly created “autism spectrum disorder” (ASD). Read more: www.care2.com...

reply to post by Hefficide


Thanks for the input Heff.

I hope I haven't sounded too anti-medication. My intent was more to promote minimizing it, and it sounds like you aim to do this. I understand that in many cases medication is warranted, and I can't even rule out the possibility that I may end up being best suited taking some meds daily.

I'm no expert on this stuff, and surely I have some bias in my thinking because of personal experience. I just see us on a slippery slope, and looking at statistics it is easy to infer that medication is being abused. I don't like the trend of expanding diagnosis criteria, because I'm afraid of doctors getting lazy and medicating when other measures would be more beneficial.

A healthier mind can be developed in most cases by living a conducive lifestyle. I fear that as these diagnosis expand, and more people have a minor label, then medication will become a crutch at higher and higher rates.

reply to post by Asktheanimals

Is not the goal of psychiatry to help people adjust to the world they live in? What if the world they live in is corrupt and people succeed by using unethical behaviors? That is pretty much the situation we find ourselves in today.

Yes, and YES! It is very much the situation in which we find ourselves today!
That's why I tried to differentiate between "psychiatrists" (who are Medical Doctors, and think they are superior experts...and are ALSO the only ones who can 'prescribe')........and genuine 'therapists', who recognize the adjustment problems that occur while dealing with the world we do live in.

The world IS corrupt....and people (for now) DO succeed by using unethical behavior...I'm in NO WAY condoning that.

I hope that you guys understand me. There are very genuine, caring people in the mental health profession. There are also "snake-oil salesmen" (the Psychiatrists and Big Pharma) that make money off of people's suffering.

I'm one of the "I don't care if I get paid or not" type of people.
I just want to help.

reply to post by PatrickGarrow17


Are we sure the big pharma isn't writing this book now?

If I remember right it was just the last few years that they fixed the DSM re, grieving spouses and depression now they are reversing wth?

The system is flawed yes many do need meds however inmho, and experience, when the pharmacies run out of adderal (amphetamine) because they can not meet the demand theres a problem. Controlled substances are easily prescribed often without therapy. This has a negative impact on society. Thank you for the thread-

Thank you
bg

Originally posted by Wertdagf
reply to post by PatrickGarrow17

 

That list was eveloped in the think smell of fear.

Almost all people need to be stabalized with medication first.... then you can get close and start ironing out the details. I think your looking at this from the wrong end. These people are mothers and fathers... they are there to help you... they spent potentialy a hundred thousand dollars to end up in a profession where they watch the worse case senarios everyday.

edit on 8-12-2012 by Wertdagf because: (no reason given)

yep, and those pharmaceutical perks really help pay off that hundred thousand dollars too
biggest pill pushers in the entire industry !!

In a fu##upped world, your response might, in fact, be sane.
There are plenty of forced commitment cases like that. You want a famous one--Frances Farmer. Movie actress in the forties. Her mother and the studio who had her under contract conspired to have her committed, as she wasn't cooperating with anyone's "financial goals." The woman ended up with a lobotomy.

Yes, this is an extreme example, but the DSM is all too easily employed, IMHO, in cases and times where someone is saying things no one wants to either hear or believe, or displaying symtoms that have an etiology that make other's uncomfortable in a historical sense, as to what may have transpired in the past, or even the present.

Sorry, I regard much of what happens with the DSM as politically and socially motivated, with a price tag attached. Surely no one can deny that there is a HUGE financial gain centered around the diagnoses, forced commitment and treatment, etc....

I'm sure many of us have anecdotal stories supporting that. Nothing, to me, is much more abhorrent than questioning the sanity of someone voicing an uncomfortable, inconvenient truth and silenced, and forever branded using the DSM and forced commitment. It renders that person totally unable in the future to voice anything that happens to them after that whatsoever, without that question looming, if they are sane, if they really can be taken seriously about what even just happened to them, themselves. Think about it, this is serious business. It is the ultimate in shutting someone down forever, and also, just in defending themselves and/or protecting themselves, because they will never be believed thereafter, leaving them "open season" to anyone.

reply to post by tetra50


do you know the scene in "2001: a space oddessey", at the beginning, with the monkeys?

they really are a terrified bunch and although they do not speak words, it is perfectly clear that their collective sanity is held together by a fragile web of self-affirming social rituals. they come in contact with the "great and terrible" monolith, and......

.....fastforward to "the future". the monolith still exists, and an enormous social structure has been erected by "professionals" whom check and verify one another's "credentials", just to speak about, view, and gain knowledge the monolith. and despite their professional stature, their response to the monolith is the same as the monkey's:

terror and awe of an ineffable nature.


my point is this: sanity is ONLY self affirmed. every single moment of your life is lived on the very edge of the unknown. the DSM-5, and other credentialing institutions such as religion, are a weak scaffolding in an attempt to "declare" a foundation upon which to build society.

but IF our own professionals, right here in this thread, were come to face the monolith, I assure you that they too would revert to terrified monkeys.


mental health care professional?! pffffffft.

Originally posted by tgidkp
reply to post by tetra50

 

do you know the scene in "2001: a space oddessey", at the beginning, with the monkeys?

they really are a terrified bunch and although they do not speak words, it is perfectly clear that their collective sanity is held together by a fragile web of self-affirming social rituals. they come in contact with the "great and terrible" monolith, and......

.....fastforward to "the future". the monolith still exists, and an enormous social structure has been erected by "professionals" whom check and verify one another's "credentials", just to speak about, view, and gain knowledge the monolith. and despite their professional stature, their response to the monolith is the same as the monkey's:

terror and awe of an ineffable nature.


my point is this: sanity is ONLY self affirmed. every single moment of your life is lived on the very edge of the unknown. the DSM-5, and other credentialing institutions such as religion, are a weak scaffolding in an attempt to "declare" a foundation upon which to build society.

but IF our own professionals, right here in this thread, were come to face the monolith, I assure you that they too would revert to terrified monkeys.


mental health care professional?! pffffffft.

Exactly. Agree with you completely. And so glad you referenced that particular scene in that movie. Absolutely fits what we are saying. Not only that, but then they built tools, and for what? To make war, against, about, and for the monolith, whatever came next......and this applies to the end of your assessment, as well. It cuts any way the powers that be wish it to, at the given moment, for whatever is most needed by the populus or those in charge, then.
what a pity. and we haven't come very far at all, have we?

reply to post by tetra50


nope. all we have are a bunch of damned prophets and doctors who are every bit as insecure as anyone else drafting volumes of specialized jargon and rituals, hoping to opiate the masses.

you have to be willing to stand out there and face "it" alone and unflinching.

otherwise, its just bibles and pills (and Santa!) for everyone.

reply to post by tgidkp


"prophets and doctors" that really got me. Can see them, both, clinging to their volumes of explanations, with the wind swirling around them as they look to the sky for answers.

Not that psychiatry does not help some people, and that there are folks who may need it. But, the whole subjectiveness of it is the problem. Of course, when we are supposed to be crazy, we don't recognize we are so. And it's all about getting everyone else to agree that we are, when in fact, that just may be a convenience for all those others. I am not even talking anecdotally; it has happened many times for many people, and should be scary for all, in giving too much power, legally and medically, to others.

reply to post by tetra50


yes! the "vision" you describe is the same as mine. but i don't think the "sky" has the answers either. (although, I could be persuaded otherwise.)

I'm not saying "bring it all down". even an anarchist can see the value of a well-structured society. but yeah. it can be a difficult experience, holding "alternative" points of view in a world which, itself, has gone mad.

crazy is the new sane.