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(MSNBC)   Thanks to the DSM-5's new definition of General Anxiety Disorder, we can now all be labeled mentally ill. The Psychiatric and Pharmacological industries approve   (msnbc.msn.com) divider line 26
    More: Stupid, DSM, anxiety disorders, Paleolithic, pharmaceutical research, stay-at-home mother, Temple University, IMS Health, American Psychiatric Association  
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3435 clicks; posted to Geek » on 15 Jul 2012 at 8:36 AM (2 years ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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Archived thread
2012-07-15 08:41:06 AM  
3 votes:
Insurance companies demand codes and labeling for all your treatment needs. As someone who will be a licensed clinical social worker soon I could care less about labeling you. The DSM-V stuff is for getting your insurance to cover your sessions and medication and also for job protection or possible disability benefits. Some people also feel better if they can name what they are feeling. My psychopathology class was filled with people asking why the had to label people so quickly and how unjust they felt in doing so.

The DSM-V is also going to fark with people grieving. If you lose your spouse and is takes your more than two weeks to pull yourself together and get out of bed it is a form depression. Your get two weeks to grieve and then you better suck it up.
2012-07-15 12:59:21 PM  
2 votes:
"It is no measure of health to be well adjusted to a profoundly sick society." -Jiddu Krishnamurti
2012-07-15 11:33:12 AM  
2 votes:
ugh, articles like this are so annoyingly one-sided, where do i even begin?

they didn't interview anybody who's benefited from psychiatric treatment, only people who felt they were harmed, or, at best simply didn't improve. the articles paints these people as helpless victims subject to the whims of their pcps or psychiatrists, as if they had no say whatsoever in seeking treatment or asking questions about the medications they were prescribed. the demon drug-pushers were just stuffing medications down their throats.

it also doesn't get any expert opinion on some of the alleged prescribing patterns that were discussed. for example, one woman says, "[the psychiatrist] gave me Lexapro," to which a psychiatrist added Paxil, Xanax and Klonopin. that would be a highly unusual combination of medications--2 ssris, one short-acting benzo, and one long-acting benzo, which makes me question the veracity of the claim. assuming it's true, however, the article's author should have had an expert weigh-in on the reasonableness of this polypharmacy. instead, the author includes this anecdote as if to suggest that psychiatrists just throw drugs around willy nilly and have no qualms about putting people on such regimens. so, either the anecdote itself is exaggerated or the author is citing an unorthodox example as if to represent what the entire profession practices.

the article also doesn't discuss the role of psychotherapy in treating conditions such as social phobia (which is quite amenable to short-term psychotherapy like cbt). of course, there are myriad reasons why psychotherapy isn't used as much as it could be--lack of access, lack of insurance reimbursement, more time consuming--that would be a great topic for the author to explore, but, again, that was neglected. unfortunately, we live in a society in which people often look for the quick-fix and drugs are usually seen as such in treating psychiatric conditions. i think prescribing professionals and patients are both complicit in maintaining this attitude.

i also think psychiatry finds itself in a difficult position a lot of the time. even with the mental health parity laws having gone into effect in 2008, it's still a real struggle to get insurance companies to reimburse for psychiatric treatment, and nigh impossible without an axis I diagnosis. so the paradox is this: a person is struggling with "situational anxiety" as described in the article (whether that be losing a loved one, losing a job, having a baby, etc) and it's impairing them enough that they seek treatment for it. is the anxiety, in itself, pathological? oftentimes it probably isn't and is, in fact, a very normal and appropriate reaction to a given situation. so the person is struggling and maybe having a hard time functioning to their "normal" levels, but this probably doesn't represent mental illness per se. however, such a nuanced explanation doesn't cut it with insurance companies who just want a nice tidy answer on whether there's an axis I diagnosis, and who will not reimburse you if there isn't one.

this really exemplifies one of the major difficulties psychiatry faces. there are many bona fide psychiatric illnesses (schizophrenia, bipolar disorder, ocd) that clearly represent psychopathology and are associated with long-term disability and functional impairment. there are a lot of "psychiatry-light" issues that probably aren't real psychopathology, but that impair people in some way, for some time and that leads them to seek treatment. until the system is changed, and these situations can be treated and reimbursed more fairly, we're going to have situations like the article is describing.

i should also say that i don't think the solution to this problem is making diagnostic criteria less stringent in dsm-5. that's a mistake. i think that current diagnostic criteria are already not as rigorously applied as they could be and it would be ridiculous to lower the threshold.

/end rant
2012-07-15 11:27:19 AM  
2 votes:
Dr. Caron: I have to be quick! About a tenth of a percent of the population had the opposite reaction to the Pax. Their aggressor response increased beyond madness. They have become... *CRASH* *sobs* Well, they've killed most of us. And not just killed... they've done things...

Wash: Reavers... They made them.

Dr. Caron: I won't live to report this, but people have to know. We meant it for the best... to make people safer.

i50.tinypic.com
2012-07-15 11:14:37 AM  
2 votes:
You know, if your doctor gives you a prescription for powerful medications you don't think you need, not only do you not have to take them, but you don't even have to get the prescription filled.

And, you can go see a different doctor.
2012-07-15 06:59:19 AM  
2 votes:
We could all be labeled mentally ill with DSM-I, it just took a little longer to look it up.
2012-07-16 07:33:34 PM  
1 votes:

Treefingers: Technically, we, as a society, are running at an anxiety baseline that should be reserved for those I'm-'bout-to-get-eaten-by-a-bear-fight-or-flight moments. The stress hormone, cortisol, is a neurotoxin, and should not be sustained in the blood stream for extended periods of time. In a state of constant anxiety, cortisol is prevalent in the bloodstream until we're asleep (providing you're relaxed enough to sleep). This is especially a concern for pregnant women, who expose their undeveloped child to daily surges of cortisol if constantly stressed out. In-utero cortisol exposure has been linked to all kinds of birth defects, developmental disabilities, a predisposition to schizophrenia, etc....

So.... I guess my point is, chill the fark out. Otherwise you're just going to eat away at your brain with cortisol. Do some yoga. Meditate, don't medicate: Just as effective as prozac, but FREE! (Big Pharma would LOVE that!)


By pure coincidence, I just sent this cartoon to someone this morning:

www.halecollege.com
2012-07-15 03:30:54 PM  
1 votes:
Technically, we, as a society, are running at an anxiety baseline that should be reserved for those I'm-'bout-to-get-eaten-by-a-bear-fight-or-flight moments. The stress hormone, cortisol, is a neurotoxin, and should not be sustained in the blood stream for extended periods of time. In a state of constant anxiety, cortisol is prevalent in the bloodstream until we're asleep (providing you're relaxed enough to sleep). This is especially a concern for pregnant women, who expose their undeveloped child to daily surges of cortisol if constantly stressed out. In-utero cortisol exposure has been linked to all kinds of birth defects, developmental disabilities, a predisposition to schizophrenia, etc....

So.... I guess my point is, chill the fark out. Otherwise you're just going to eat away at your brain with cortisol. Do some yoga. Meditate, don't medicate: Just as effective as prozac, but FREE! (Big Pharma would LOVE that!)
2012-07-15 01:45:27 PM  
1 votes:

LowbrowDeluxe: fark off to subby and all the wingnuts agreeing with him. To be a diagnosable illness it must be affecting the quality of your life or interfering in your ability to perform basic functions. Psychiatry may be as much voodoo as science, but most of the complaints about it amount to sheer idiocy.


"Affecting the quality of your life" can be freakin' anything. I'm a bit tired today, was up late last night, and it is affecting the quality of my life, as I really don't want to do anything but take a big nap.

And you are high if you think the only people perscribed psych meds are those having difficulty performing basic functions.
2012-07-15 01:10:50 PM  
1 votes:

GBmanNC: Forbidden Doughnut: propasaurus: Damn, the Scientologists were right!

I think a lot of psychiatry (as it's practiced today) will be viewed as quackery in the future. I certainly don't discount actual biochemical problems that some people have that cause mental illness, and i have no problem with them taking proscribed medication.

/ not a Scientologist
// agree with them a little bit about people over-relying on drugs & useless therapy sessions
/// their "solutions" to those issues is worse than the disease, IMHO.

I agree.

Here's what I don't get. If we really believe biochemical causes of mental illness, why doesn't it fall under neurology? And for mental illness that doesn't fall under biochemical we already have psychology. So what role does psychiatry really fill?

It seems psychiatry just stumbled into their current role after Freudian theory was abandoned mid century. But, like Freud's work, there is very little empirical evidence for what they do, and also like Freud's work, our views of mental illness will change so much in the future as to make modern psychiatry look ridiculous.


psychiatry unfairly bears the brunt of this notion that it's modern-day quackery, whereas other areas of medicine are relatively spared. i think this stems from there being an ongoing bias in how mental illness is viewed, compared to medical illness. it's quite reasonable to assume that all medicine is going to make progress in our lifetimes and certainly in the decades and centuries after. years from now, people will look at treating cancer with chemotherapy--medication that literally kills the cells in your body, healthy ones as well as cancerous ones--and wonder how we could have thought that essentially poisoning people was the best treatment we could offer. future generations will question why amputating a limb was the best and only option we could present to someone with gangrene. these are extreme examples to be sure, but they reflect that modern medicine is still ignorant of so much and as we illuminate our understanding on the pathophysiology of many illnesses, what we consider state-of-the-art, high tech, cutting-edge medicine will look ridiculous. but i think it's unfair to single out psychiatry in this critique.

briefly, re: your question about the role of psychiatrists: psychiatrists have the medical training of neurologists in order to promptly and effectively diagnose and treat medical conditions that might be co-morbid with or causative of psychiatric illness (skills that psychologists don't have), with an understanding and ability to manage the psychological and behavioral aspects of mental illness that neurologists don't have.
2012-07-15 11:20:02 AM  
1 votes:
The way our healthcare system is we need catchalls to label people with otherwise insurance will never pay for care. Fix that and maybe we can fix our labels.

/LCSW rant.
F42
2012-07-15 11:10:00 AM  
1 votes:
FTFA Anxiety was working properly among survivors of Hurricane Katrina, Wakefield and Horwitz contend. Years after the devastating 2005 storm, schools, housing, policing and other aspects of life in New Orleans had still not returned to normal. Using DSM criteria, a 2007 study concluded that half the surviving residents were "mentally ill" because they experienced anxiety about those lingering effects.

That's dumb, it's not "not an illness" because there's a cause for that illness.

"Oh, he's bleeding is he? Well that's normal, he got stabbed", you still suffer and need to be treated, damn.
2012-07-15 10:58:39 AM  
1 votes:

UNAUTHORIZED FINGER: They say that there are only two things to worry about. Either you're healthy or you're not. If you're healthy, you have no worries.
If you're not healthy, you only have two worries. Either you live or you die. If you live, you have no worries.
If you die, you only have two worries. Either you go to Heaven or Hell. If you go to Heaven, you have no worries.
If you go to Hell, you'll be too busy greeting old friends to worry.


LOL, I like it!
2012-07-15 10:53:24 AM  
1 votes:

Adolf Oliver Nipples: It was only a matter of time until it was determined that we were all sick. It's been going in that direction for years. Drugs are the salvation of our species.

The good news is that if we're all sick, nobody is, so take solace in the fact that if you need drugs to function there's nothing wrong with you, it's perfectly normal.


A gramme is better than a damn.

/off to the feelies
2012-07-15 10:43:21 AM  
1 votes:

namegoeshere: Really? Anxiety over finances and health for longer than a few weeks makes you officially nuts?

Well lets see... been through two seperate cancer scares in the past year (benign, thank FSM) still need surgery that I can't afford, small business owner trying to keep going in this still shiatty economy, business is still way down, firstborn is already looking at colleges, roof is leaking, everybody needs braces...

Yep. I'm farking loony. Barking. Crackers. I haven't been anxiety-free since summer 2008.

Oh wait. I have no insurance, and can afford neither a shrink nor a long term perscription.

I'M CURED!!! No diagno$i$ for me! Woohoo! I feel happy....


You'd be crazy not to be loony. Congrats on beating Big C. Keep pushin' that boulder up that hill.

They say that there are only two things to worry about. Either you're healthy or you're not. If you're healthy, you have no worries.
If you're not healthy, you only have two worries. Either you live or you die. If you live, you have no worries.
If you die, you only have two worries. Either you go to Heaven or Hell. If you go to Heaven, you have no worries.
If you go to Hell, you'll be too busy greeting old friends to worry.
2012-07-15 10:34:13 AM  
1 votes:

namegoeshere: Really? Anxiety over finances and health for longer than a few weeks makes you officially nuts?

Well lets see... been through two seperate cancer scares in the past year (benign, thank FSM) still need surgery that I can't afford, small business owner trying to keep going in this still shiatty economy, business is still way down, firstborn is already looking at colleges, roof is leaking, everybody needs braces...

Yep. I'm farking loony. Barking. Crackers. I haven't been anxiety-free since summer 2008.

Oh wait. I have no insurance, and can afford neither a shrink nor a long term perscription.

I'M CURED!!! No diagno$i$ for me! Woohoo! I feel happy....


Having anxiety and having anxiety attacks (especially constantly) are completely different, and is addressed in the diagnosis of "General Anxiety Disorder"

Until you experience it yourself, your perspective will likely be skewed. It isn't your fault. It is hard to relate to something LOOKING so benign, but something feeling so serious.

My anxiety attacks have a wide range of symptoms that are hard to live with. Sometimes, I get stroke like symptoms. Slurred speech, massive confusion, lack of coordination, etc. Others, I become paralyzed. I literally can't move. The doctors have said this was likely due to my brain being so electrically active, that it is having trouble operating my motor functions. My least favorite is when something seems to "break" inside after a prolonged attack, and I start dreaming while awake.
2012-07-15 10:23:57 AM  
1 votes:
Really? Anxiety over finances and health for longer than a few weeks makes you officially nuts?

Well lets see... been through two seperate cancer scares in the past year (benign, thank FSM) still need surgery that I can't afford, small business owner trying to keep going in this still shiatty economy, business is still way down, firstborn is already looking at colleges, roof is leaking, everybody needs braces...

Yep. I'm farking loony. Barking. Crackers. I haven't been anxiety-free since summer 2008.

Oh wait. I have no insurance, and can afford neither a shrink nor a long term perscription.

I'M CURED!!! No diagno$i$ for me! Woohoo! I feel happy....
2012-07-15 10:13:20 AM  
1 votes:
I've been taking benzos daily for a year now. Now I'm physically addicted and experience extreme discomfort if I'm late on a dose. Just thinking about running out gives me heart palpitations and sweaty palms. Fark you, Doctor Know-it-all! Just kidding, I need my meds.
2012-07-15 10:11:33 AM  
1 votes:
In today's world if you're not paranoid, you're not paying attention.
2012-07-15 09:55:57 AM  
1 votes:

Gwendolyn: Insurance companies demand codes and labeling for all your treatment needs. As someone who will be a licensed clinical social worker soon I could care less about labeling you. The DSM-V stuff is for getting your insurance to cover your sessions and medication and also for job protection or possible disability benefits. Some people also feel better if they can name what they are feeling. My psychopathology class was filled with people asking why the had to label people so quickly and how unjust they felt in doing so.

The DSM-V is also going to fark with people grieving. If you lose your spouse and is takes your more than two weeks to pull yourself together and get out of bed it is a form depression. Your get two weeks to grieve and then you better suck it up.


I'm more wondering how it will affect other things. You've not only got the insurance companies looking for loopholes, but rule mongers like the ATF and homeland security.
Will this lead to ending up on a watch list if you've been sad for a bit too long?
That kind of thing can cost people their careers at a moment in their lives when they don't need a second punch to the gut.

Adding a new kind of red flag to pop up in our hidden records, it's not something I would describe as an appealing situation.
2012-07-15 09:47:29 AM  
1 votes:

Gwendolyn: I could care less about labeling you


http://www.youtube.com/watch?v=om7O0MFkmpw
2012-07-15 09:23:01 AM  
1 votes:
I'm OK with this as long as it means I can get a script for medical marijuana.
2012-07-15 09:06:04 AM  
1 votes:

Gwendolyn: I could care less about labeling you


Would you say then that you care somewhat about labeling people?
2012-07-15 08:46:15 AM  
1 votes:
"We're sorry. The entire US population has been diagnosed with General Anxiety Disorder. We have therefore dropped coverage of all of you, due to a pre-existing condition."
2012-07-15 07:38:02 AM  
1 votes:
I am mentally ill. No one's ever needed a book to figure that out.
2012-07-15 07:01:30 AM  
1 votes:
Damn, the Scientologists were right!
 
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