Posts Tagged ‘Diagnostic and Statistical Manual’

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Psychiatry’s Diagnosis Manual Under Fire – will feed culture of overdrugging/overdiagnosing

Saturday, November 26th, 2011

San Francisco Chronicle – 11/26/2011
by Erin Allday

"Another diagnosis, dysphoric mood dysregulation disorder, is basically temper tantrums," Robbins said. "Next thing you know, you could have 2-year-olds on psychotropic medications."

The “bible” of American psychiatry – a manual of mental health used around the world by doctors, consumers and insurance providers – has come under fire from a growing group of psychologists who worry that proposed revisions will feed into a culture of overdiagnosing, and overtreating, otherwise healthy people.

The Diagnostic and Statistical Manual of Mental Disorders, or the DSM, is undergoing its fifth major revision in the more than 60 years since it was first published by the American Psychiatric Association. The last update was in 1994, and the new manual is expected to be released in spring 2013.

Revisions to the DSM are often hotly debated, but after two decades of major, and frequently controversial, shifts in how mental health problems are diagnosed and treated in the United States, this latest update has become especially contentious, many mental health providers say.

Last month a group of psychologists with the Society for Humanistic Psychology posted a petition against many of the suggested DSM revisions, citing what they see as a broadening of the definition of mental health disorders, which, in turn, would lead to overtreatment with drugs.

7,000 signatures

The petition now has more than 7,000 signatures, and last week it won the support of San Francisco’s Saybrook University, with roughly 60 faculty members who emphasize a holistic approach to treating mental illnesses.

“There’s this propensity to push pills instead of looking at what’s really going on with the person,” said Saybrook President Mark Schulman. “When we saw in the DSM-5 that there was going to be a push in the direction of a more medical, less holistic way of doing things, we felt we should take a stand.”

A work in progress

The American Psychiatric Association has posted an online response to the petition, welcoming critiques to and comments on the proposed revisions. Their response notes that the manual is still a work in progress and, as more scientific evidence becomes available, some of the changes may become more palatable to critics.

Since the last diagnostic manual update, research has increasingly pointed to biological causes for a wide variety of mental health conditions and, in response, treatment has turned toward pharmacological answers, some psychologists say. Drugs are being used to solve mental health problems that aren’t problems at all, they add.

In 2010, 1 in 5 American adults was using some type of mental health medication, a 22 percent increase over the past decade, according to a report released last week by Medco Health Solutions, a pharmacy-benefits management company.

Therapy is still popular, but part of the problem is that there simply aren’t enough trained counselors to fill the mental health need. Patients are turning to primary care doctors for medical relief from symptoms for everything from depression and anxiety to attention deficit disorder, many mental health providers say.

Because many primary care doctors rely on the DSM to help them understand and diagnose mental health problems, it’s critical that the manual be as accurate and science-based as possible, say psychologists who have signed the petition.

While trained psychiatrists might be able to distinguish between a mental health disorder that needs medical intervention and a so-called normal human response to a difficult time or situation, primary care doctors may struggle.

Critics’ concerns

Critics of the DSM update say that the task force assigned to make the revisions has suggested broadening the definitions of too many mental health problems, opening the door to even more diagnoses and treatments.

Grief after the death of a loved one, for example, may be included under the diagnosis of major depressive disorder. That means a person’s grief could be labeled a pathological disorder, and not a normal human experience, said psychologist Brent Robbins, a professor at Point Park University in Pittsburgh and an author of the petition.

2-year-olds on meds

“Another diagnosis, dysphoric mood dysregulation disorder, is basically temper tantrums,” Robbins said. “Next thing you know, you could have 2-year-olds on psychotropic medications.”

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How PTSD took over America

Wednesday, November 16th, 2011

Salon Magazine- November 15, 2011 by Alice Karekezi

The diagnosis is now being applied to everything from muggings to childbirth. An expert explains why it’s bad news

We’re not saying that people don’t have difficult emotional experiences and aren’t suffering. What we’re saying is this is not necessarily a disorder that people are experiencing, and if people think like that, it can be very disempowering to them. ( Photo Credit: David Royal Hanson via Shutterstock)

In the past 30 years, post-traumatic stress disorder has gone from exotic rarity to omnipresent. Once chiefly applied to wartime veterans returning from combat, it is now a much more common diagnosis, still linked to traumatic events but now including those occurring outside the battle zone: the death of a loved one on a hospital bed, a car crash on the highway, an assault in the neighborhood park. Many would argue that this is a good thing: greater recognition of psychologically distressing events will lead to more people seeking treatment and a decrease in the preponderance of PTSD – a win-win.

Stephen Joseph disagrees. In his new book, “What Doesn’t Kill Us,” the professor of psychology, health and social care at the University of Nottingham (in the U.K.) warns that our culture’s acceptance of PTSD has become excessive and has led to an over-medicalization of experiences that should be considered part of ordinary, normal, human experience. This has kept us from proactively working through our grief and anxiety: We’ve become too quick to go to the shrink expecting him to fix us, rather than allowing ourselves the opportunity to grow and find new meaning in our lives as a result of painful, but common, events. Joseph advocates for a push toward post-traumatic growth as therapy to treat the stress of trauma, which he distinguishes as being different from the hokey, blue skies and rainbows, pop psychology that he claims has exploded in our culture in the past decade.

Joseph spoke to Salon over the phone to discuss our misunderstanding of the disorders, the meaning and usefulness of suffering, and if some cultures are more prone to PTSD than others.

How would you define a traumatic event? Is it subjective or are there some basic requirements that must be met?

I see trauma as a psychological rupturing. It’s when something happens to us that ruptures our psychological skin. Or, something which shatters our assumptions about ourselves in the world. That’s what I think of as traumatic, and in a way that can be many things. So, that can include a wider range of experience, and I can understand trauma in that broader way. There are lots of different experiences, such as being in a road traffic collision, or experiencing an illness – those sorts of things can be traumatic to people. It can be experienced as psychologically traumatic. But whether it’s necessary to create a psychiatric diagnostic category to capture those experiences is perhaps not necessary.

Do you believe that PTSD is over-diagnosed?

Well, that’s a really, really tricky question to answer because in a way it’s diagnosed pretty much exactly as it’s described in the Diagnostic and Statistical Manual (DSM). So whether the definition of PTSD is too broad is a different question, if you see what I mean. When PTSD was first introduced in 1980, it was defined much more tightly. The gatekeeper criterion to the diagnosis was: Have you experienced a traumatic event? In 1980, it was defined in such a way that only people who had experienced an event that was really outside the range of usual human experience, [like] Vietnam or the Holocaust, had experienced the sorts of experiences that were thought to elicit PTSD. So if you experienced something like a car accident or a traumatic birth, then you couldn’t get a diagnosis of PTSD, because, by definition, you hadn’t experienced a traumatic event.

In 1994, the definition changed in such a way as to include other, broader experiences. Equally persistent was the person’s subjective experiences of what they thought was traumatic. When that happened, people who had experienced car accidents, traumatic births, what we would have otherwise thought of as more ordinary life events, insofar as they are not statistically unusual, could then be diagnosed as a having PTSD. So now we are in a position where lots of people are able to receive the diagnosis of PTSD. So it’s not that it’s being over-diagnosed in that sense. The difficulty or problem, if there is one, is whether, generally speaking – PTSD would be part of this – the DSM over-medicalizes human experience. Things which are relatively common, relatively normal, are turned into psychiatric disorders.

Can you describe some of the typical symptoms of PTSD?

When people experience trauma, when their assumptions about themselves and the world come crashing down, there’s often a period of avoidance. People just try to block out what happened. Switch off. Turn their attention to other things. That’s quite understandable. Then, over time, that gives rise to memories and emotions that come flooding in as the person sort of begins to try to make sense of what happened, and that can become so powerful and distressing that they have to push that away again and go back into a period of avoidance. So sometimes people go through that, periods of avoidance and intrusion. That seems to me as a healthy and adaptive way of working through something painful, emotionally painful, that has happened to us. So those are the experiences. PTSD is when those experiences become so overwhelming that the person can’t function anymore – at work, or school, or in their social life. It takes over so much. But otherwise the symptoms of PTSD are fairly normal, natural ways of dealing with adaptation.

It’s important to see those experiences as quite normal and natural. They are not symptoms of a disorder by themselves. They’re just the way that people deal with an upsetting event in order to be able to make sense of things and to move on. It’s only when they become so overwhelmingly intense that they might be considered a disorder. I think that’s where we get into the problem with what PTSD is: when people are going through that normal experience, but they see it as having a disorder rather than a normal process of adaptation.

That will diminish over time?

Exactly.

Is the emotional pain overblown in such cases?

The suffering is very real. We’re not saying that people don’t have difficult emotional experiences and aren’t suffering. What we’re saying is this is not necessarily a disorder that people are experiencing, and if people think like that, it can be very disempowering to them.

What is the detrimental effect of over-medicalizing these more common human experiences of grief and pain?

When we think of ourselves as suffering from a disorder in a medical sense, well we go to the doctor and we expect the doctor to prescribe whatever the medical treatment is. We’re not in the driver’s seat. We go along – we tell them [our] symptoms, they listen to us, they diagnose what the problem is, and then they work out what the appropriate treatment is. That’s the mind-set when we’re working within a medical framework and we think of ourselves as suffering from a disorder. We sit down in front of the therapist and we expect the therapist to be like a doctor – to be looking out for what the symptoms are so that they can make the correct diagnosis and prescribe us the right treatment. The language of PTSD invokes those ideas, and I think it’s those ideas that can be quite unhelpful at times. For what we’re talking about here, if it’s a normal, natural process, what’s really important is for the person to be in the driver’s seat for themselves – to make their own choices, their own decisions, because we’re dealing not with a disorder, but a battle within the person to find new meanings and new ways of understanding the world. That’s what they have to do. Nobody else can do that for them.

What is “post-traumatic growth”?

Post-traumatic growth is when people come out of trauma having learned new things about themselves and about the world and about their relationship with the world. People develop new philosophies of life. They develop new priorities in life. People learn an awful lot about themselves: their strengths; what they’re good at; having new respect for themselves. They sort of see their lives as divided into two halves: before the event happened and after the event happened. There is a clear demarcation. And they recognize that something happened to them that sliced their world in half in that way, and things for them are now completely different. How they lead their lives has been transformed – their priorities about life, their relationships.

I think one of the things that captures that the most [starts with] the idea that, sometimes, people lead their lives in a way that is dictated by external forces of status and wealth, which are very much big drivers in our capitalist society. We often, in our everyday lives, forget about the small things that are quite important – our relationships: remembering to nurture them, to look after the people around us, to be giving, to be compassionate. When traumatic events happen, people are often shaken back to reality, and remember what really matters to them. Often it is those other things – remembering somebody’s birthday; nurturing our friendships; looking after our parents, the people around us; really embracing our relationships; and letting go of a more materialistic outlook. People often describe it as getting back to who they really are, or feeling more true to themselves, or being more genuine or more authentic. Somehow the idea of the false self that people create around them is shattered, like Humpty Dumpty falling off a wall. The essence of who they are emerges.

Yes, becoming truer to oneself captures the idea very well. Realizing that life is short and sometimes there isn’t as much time left as we thought to put up facades.

This kind of makes trauma sound like a blessing (you even mention people describing it as a “gift”). Is finding meaning the same thing as condoning the traumatic event? And doesn’t this talk of growth all sound very “kumbaya-ish” and unrealistic?

One of the reasons, sometimes, that post-traumatic growth can be seen unfavorably is that it seems like saying that trauma can lead to greater happiness; that for people who have been through trauma, it’s a good for them – they’re happier. That’s just so not the message. It’s not saying that trauma leads to happiness, in terms of smiling and feeling good and laughing and joy – not that type of happiness. What we’re talking about is how trauma can lead to a deeper, more existentially meaningful and fulfilling life, and that in turn may lead to greater happiness further down the road. But, post-traumatic growth is not about happiness in the sort of yellow, smiley face sense.

In essence, post-traumatic growth is a very simple idea, but it has been overshadowed by this mass of psychiatric literature over the past 30 or 40 years about the overwhelming destructive side of trauma, and about how these lead to medical problems. It’s a very simple idea, but [post-traumatic growth] sits, on the one hand, very uncomfortably within mainstream culture of the world of psychology and psychiatry, and on the other hand it seems to sit very comfortably with some other parts of Western culture, such as positive thinking, but it also clashes with some of that literature which is quite superficial, and not grounded in scientific research, and makes unsupported claims.

So, no, post-traumatic growth] doesn’t mean that [people] value or cherish the bad thing that has happened to them. They just accept that it has happened to them. People will often say they wish it hadn’t happened, or they wish they could go back, but there is a realism that they know they can’t. So it’s accepting that they can’t go back; they can’t change things. The only way forward is to go forward. It’s when people can’t accept that something has happened, and they [try] to go back to how they were before, is when they struggle. Acceptance is just being realistic – not seeing it as a good thing.

And someone not experiencing growth — or experiencing PTSD — is that person always trying to go back?

I think that often that’s what gets people stuck – trying to go back, trying to rebuild their lives exactly as it was before. That can lead people to get very stuck because it just isn’t possible when traumatic events happen and we’re presented with new information about the world, or with losses. It just isn’t possible to go back and make things as they were. We have to somehow accept what has happened to us and move on.

Is post-traumatic growth something completely in opposition to PTSD or post-traumatic stress? Either you have one or the other?

They can sit together. The way I see it, post-traumatic growth mostly arises out of post-traumatic stress. So it’s how people deal with the post-traumatic stress; how they manage to deal with the intrusive thoughts that are plaguing them; and the new sense they make of their experiences. So it’s through the post-traumatic stress, through the struggle of post-traumatic stress that post-traumatic growth arises. So often there’s a period of time in which people will begin to talk about post-traumatic growth but they will still be suffering from post-traumatic stress. They’re not in opposition. In a way, they are opposite sides of a coin.

You make a claim that true happiness is something that in and of itself cannot be pursued, and one is doomed to fail if one tries. How is that?

Well, that’s an idea that some philosophers have put forward. Some of the research seems to suggest that what’s really important to finding happiness is meaning and purpose in life. If we think our road to happiness is through seeking hedonistic pleasures night after night, then that’s not likely to lead to a deep, fulfilling level of happiness. But, if we find ways of finding meaning and purpose, wherever that might be, then we’re not setting out directly aiming for happiness but that’s what we’re going to get. We’re going to find a more fulfilling life. Happiness is a byproduct, but in a sense it’s more guaranteed.

When we think of psychological therapies, and the helping professions in general, they often have been about helping people feel better. [For] people with various problems of depression, anxiety or post-traumatic stress, therapy is about getting the person to have a more positive emotional state. That’s been, really, what the therapy world has been about for 50 years, and yet that’s only half the picture. The other half is about the meaning we put on things, our purpose in life, our sense of ourselves, our sense of autonomy, our relationships. Psychology can also be about those things. I’m not saying that therapists have ignored them altogether; for sure, they haven’t, but those more existential ideas have been overshadowed by trying to feel good. This is the idea between what psychologists call subjective well-being, which is about feeling good, and psychological well-being, which is what you could call “meaning-good,” and it’s just about getting the balance between those two things right.

Are there some cultures that are more prone to post-traumatic growth?

That’s a really good question. I don’t think the research has really documented that yet as to whether it may be more common. What the research has shown, however, is that post-traumatic growth is something observed in pretty much all cultures that have been investigated, though differently defined in slight ways. “Post-traumatic growth” sounds like a very Western idea, but [it’s one that] gets back into history and into all sorts of cultures. It’s an idea that’s very resonant with Buddhist and some Chinese philosophy ideas, as well as ideas in Western religion.

http://www.salon.com/2011/11/15/how_ptsd_took_over_america/singleton/

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Mental illness redefined

Wednesday, October 12th, 2011

The Chicago Tribune

By Julie Deardorff, Tribune Newspapers

 October 12, 2011

When psychiatrists diagnose mental illness, they turn to an unwieldy book called the Diagnostic and Statistical Manual of Mental Disorders, or DSM for short.

First published in 1952, the tome also is used as a standard by researchers, the health insurance industry and pharmaceutical companies.

But the American Psychiatry Association is now in the middle of a historic and controversial revision of its bible. The fifth and highly anticipated edition, DSM-5, has sparked dissension among psychiatrists and generated more than 8,000 public comments on topics ranging from sexual- and gender-identity issues and anxiety disorders to mind-body problems.

The proposed revisions are “based on the most rigorous and up-to-date scientific findings available,” said Dr. Darrel Regier, the DSM-5 task force vice chairman. Inclusion, meanwhile, “means that a mental illness is more likely to be a target of research, which ultimately will improve our understanding how best to diagnose and treat psychiatric disorders,” he said.

Critics say some of the new entries broadly extend some definitions of mental illness and lower thresholds for some existing disorders, which will result in higher rates of diagnoses. That, they argue, “could result in massive overtreatment with medications that are unnecessary, expensive and often quite harmful,” Dr. Allen Frances, chairman of the DSM,-IV task force, wrote in the Psychiatric Times.
Read the rest of the article here OR get the facts about psychiatric disorders here  

No Science No Cures

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Are you shy? Then you have a mental disorder

Thursday, September 8th, 2011

The mad claim that 165 million Europeans suffer from ‘mental illness’ confirms that normal emotional states are now seen as diseases.

Spiked – September 8, 2011

by Tim Black

‘Mental health disorders are Europe’s largest healthcare challenge in the twenty-first century’, announced Hans-Ulrich Wittchen this week.

A professor of psychology and psychotherapy at the University of Dresden, Wittchen wasn’t saying anything we haven’t heard before. The World Health Organisation has also gleefully predicted that by 2020, ‘depression will be the second leading contributor to the burden of disease’. Still, the magnitude of Wittchen’s Europe-wide diagnosis is more than a little shocking: 38 per cent of Europeans, he said, are suffering from a mental disorder. That’s about 165million people.

Wittchen arrived at these shocking results, published in Neuropsychopharmacology, after a three-year-long review of data from previous studies involving over 500 million people in 30 European countries. Therein he discovered that nearly 40 per cent of those 500million were suffering from one of nearly a hundred mental or neurological problems, the most common of which were anxiety disorders, insomnia, depression, alcohol and drug dependence, and dementia.

‘Although the figure [of 165million] seems shockingly high, this is the most rigorous study done in Europe’, saidGraham Thornicroft, a professor of community psychiatry at the Institute of Psychiatry at King’s College London.

There is a great deal of scepticism towards Wittchen’s results and what they mean. And no wonder. Even in these overly medicalised times, where feeling well is increasingly confused with awaiting diagnosis, the idea that well over a third of Europe is suffering from a mental disorder just doesn’t tally with our actual lived experience. After all, does it not seem absurd to think that one in every three Europeans is mentally ill?

In fact, what Wittchen’s findings really indicate is the expansion of the diagnostic categories of mental illness, not the expansion of mental illness itself. Writing in the Guardian on Wednesday, Lisa Appignanesi rightly drew attention to the ever-expanding girth of the so-called bible of the psychiatric profession, the Diagnostic and Statistical Manual of Mental Disorders (DSM).

When it was first published in 1952 it contained a then unprecedented 60 diagnostic categories for mental illness. And subsequent editions have expanded its diagnostic reach even into everyday, mundane behaviour. By 1994, the fourth (and current edition) recognised a total of 384 mental ailments (plus 28 ‘floating diagnoses’). And if the preliminary revisions are any indication, the fifth edition, due in 2013, looks set to supply psychiatric practitioners with yet more labels for disorders and illnesses we didn’t even know we had.

As many have observed before, absurdity abounds in the psychiatric worldview. The most banal of everyday behaviours, emotional states that I’d wager almost everyone has encountered at some point in their lives, have been given technical, medical-sounding names. So shyness becomes ‘avoidant personality disorder’; anger becomes ‘intermittent explosive disorder’; and if the experts get their way, not throwing stuff away will become ‘hoarding disorder’. In an incredible bit of insightless prose, we are told by DSM’s recent consultation document that, ‘The symptoms [of hoarding disorder] result in the accumulation of a large number of possessions that fill up and clutter active living areas of the home or workplace to the extent that their intended use is no longer possible’.

While it is easy to make fun of the silliness of the psychiatric industry for giving our most banal behaviours a jargonised sheen, there is a serious point here, too. When everyday subjective states, such as shyness or distractedness, are turned into clinical objects, they become ripe for external, clinical intervention. We cease to be capable of overcoming a bout of anxiety, perhaps brought about by job worries; instead we are encouraged to see ourselves as in need of professional, expert help. And any practical problems at the root of, say, ‘depression’ or ‘anxiety’ – like unemployment or marital problems, for instance – are transformed into mental problems in need of psychiatric solutions. Wittchen’s assertion that the ‘immense treatment gap… for mental disorders has to be closed’ is therefore charged with ominous Brave New World intent. Europe is a continent of therapeutic supplicants in the making.

Read the rest of the article here:  http://www.spiked-online.com/index.php/site/article/11060/

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Psychopharmaceutical industry seeks world of dispassionate sheeple

Wednesday, May 11th, 2011

Natural News, May 10,2011
by Monica G. Young

People who obediently follow the herd, never markedly sad, angry or excited; children who play quietly and never annoy or talk out of turn – this is the object of the psychiatric/pharmaceutical industries. And when anyone steps out of line, the answer is simple: stamp them “abnormal” and give them a pill.

Human sorrow could soon be more easily diagnosed and medicated as a mental disorder. Psychiatrists creating the next edition of the psychiatric bible – the Diagnostic Statistical Manual (DSM-5, due out in 2013) – are recommending to eliminate the time clause for major depressive disorder. So instead of grieving for two months to qualify, if you mourn the loss of a loved one for only two weeks doctors could label you mentally ill and prescribe a drug.

The first DSM published in 1952 was a 132-page volume listing 128 mental disorders. With nearly 900 pages, the current edition (DSM-IV, published in 1994) lists 357 disorders – an over 300% increase. Since its release, DSM-IV has generated a 256% increase in psychiatric drug sales and billions of dollars in government funding.

Drug companies are notorious for downplaying disabling effects of psychotropic drugs. Additionally, medical journalist and Pulitzer Prize nominee Robert Whitaker reports that many psychiatric drug users acquire a more severe form of mental illness than they started with. For instance, antidepressant users tend to spiral down into long-term depression – yielding even greater profit for psychiatrists and drugmakers.

Creating drugged and docile youth

Psychiatry’s worst social meltdown concerns our youngest. The threat of ADHD, bipolar, autism and other alleged childhood diseases – which duped teachers, counselors and parents are on constant lookout for – presses children into a “socially acceptable” mold.

Several ADHD websites even boast that medication benefits include: “the child is no longer distinguishable from classmates” – their words!

A Medco Health Solutions Report in 2009 revealed children to be the pharmaceutical industry’s most expanding market. Child prescriptions have increased at four times the rate of the general population.

Every new disorder equals more prescriptions and more profit. With changes planned for DSM-5, toddlers with recurring tantrums could be drugged for “temper dysregulation disorder”, upset six-year-olds could be drugged for “Disruptive Mood Dysregulation Disorder” and kids with “overly familiar behavior (verbal or physical violation of culturally sanctioned social boundaries)” could be drugged for “Disinhibited Social Engagement Disorder.”

Social totalitarians

DSM officials admit that everyone has instances of sadness and anger, and assert that diagnoses depend on the severity and frequency of symptoms.

And who decides when a child or adult has crossed from normality into abnormality? Psychiatrists – a field financially joined at the hip with Big Pharma.

Per the current DSM, social no-nos deserving an abnormal imprint (and likely to lead to a prescription drug) include:

* Heightened self-esteem (“manic episode”)
* Very sensitive to criticism (“avoidant personality disorder”)
* Defying and disobeying authority figures (“oppositional defiant disorder”)
* Behavior that deviates markedly from the expectations of the culture (“personality disorder”)

The Soviet Union also used psychiatric labels for social control. People who defied communism were diagnosed as mentally ill, isolated and forcefully medicated.

Ahead of his time, Aldous Huxley anticipated psychiatric totalitarianism in his classic novel, Brave New World: “And if ever, by some unlucky chance, anything unpleasant should somehow happen, why, there’s always soma* to give you a holiday from the facts. And there’s always soma to calm your anger, to reconcile you to your enemies, to make you patient and long-suffering. In the past you could only accomplish these things by making a great effort and after years of hard moral training. Now, you swallow two or three half-gramme tablets, and there you are.” [*In this fictional novel, soma is a hallucinogenic drug used by those in power to subdue the citizens.]

Sources include:

http://www.montrealgazette.com/heal…

http://communities.washingtontimes….

http://www.cchrint.org/cchr-issues/…

http://www.youtube.com/watch?v=OOcJ…

About the author:
Monica G. Young is a human rights investigator and educational writer with a purpose to expose the truth about the pharmaceutical and psychiatric industries and safeguard human liberty. She encourages non-drug alternative approaches based on healthy lifestyles and human decency. She supports the Citizens Commission on Human Rights and like-minded groups.

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Mad World:”A pill to make you numb, a pill to make you dumb, a pill to make you anybody else”— Marilyn Manson

Wednesday, April 20th, 2011

“A pill to make you numb, a pill to make you dumb, a pill to make you anybody else”"

– Marilyn Manson, “Coma White”

OpEd News, April 20, 2011

By Damien Qui

If you’ve ever watched two episodes of House M.D., you know the routine. The doctors are on a mad rush to get a diagnosis, throwing one treatment after another at the symptoms to see if it works. All tests have been inconclusive, all theories have been shot down, and the only thing that can save the day is the last minute epiphany of a brilliant and eccentric doctor. If you take away that last step you get a somewhat less interesting show where the patients always die, but also a much better metaphor for the psychiatric industry.

Let’s put on our diagnostic whiteboard the term “chemical imbalance”. What is the cause? Unknown. What are the physiological signs of a chemical imbalance? Since there is no control model for a chemically balanced brain, there are no physiological signs of an imbalance. What are the symptoms? Now we’re getting somewhere. If you suffer from periods of sadness (depression), happiness or agitation (mania), emotional numbness, confusion, extreme boredom, hyperactivity, inactivity, increased or reduced sex drive, sleeplessness, restlessness, oversleeping, lack of interest, changes in behavior, drug use, lack of stimulation, and/or procrastination, then you have just tested positive. What is the treatment? That’s the easy part. Simply start depositing your paychecks into the accounts of your doctor’s favorite pharmaceutical company and you are on your way to a life-long course of treatment that will make damn sure that you have a chemical tornado in your brain, whether you did in the first place or not.

This is an issue particularly personal to me, though I’m sure it’s not uncommon. I’m sure we’ve all known someone who’s gone on the anti-depressant rollercoaster, and most are still riding it. My mother is one of those people. Her first husband killed himself in front of my young eyes in August of 1983. Though the trauma of that experience never faded from her, she went on with her life. Sometimes it was too much and she would turn to drinking and drugs, or just sink into a depression that could last weeks. Even twenty years later, the occasional feelings of guilt and loss would be unbearable, but she maintained. She worked hard and took care of herself, and held fast to an independent spirit that brightened the air around her. Most of the year this was her, but every year around August she would feel that weight begin to crush her again.

One year, she finally decided to seek help, and what she found would destroy her. Being a typical lower-middle class woman, she couldn’t afford the best. A cheap clinic diagnosed her with bipolar disorder, which allowed her to draw social security and disability benefits that would help her see a doctor. The doctor confirmed the diagnosis and prescribed a drug that made her unable to get out of bed in the morning, but she was encouraged to stay on it until her body had fully adapted to it. When they finally let her switch, we learned our first lesson in withdrawal. Switching from the first drug (whose name I can’t remember) to Prozac was accompanied by violent mood swings and unpredictable behavior. She physically attacked several people unprovoked and couldn’t remember why. Then came Zoloft, Lithium, and a host of others. With them came blackout mania, dissociative fugue, and multiple suicide attempts. She was eventually living under my care and supervision as ordered by a judge, and the intelligent, vibrant, and headstrong woman I had looked up to as a child had long since transformed into a babbling, paranoid, and delusional stranger. The last time I talked to this person, she was living with a pedophile that had me baker-acted (sent to a mental institution) when I found him out and tried to separate them. Can you guess what I found out there? Apparently I’m bipolar as well.

They never tested me, and it wouldn’t have mattered if they did. There are no tests that can prove the necessity of a psychiatric drug, because the drugs are designed to treat a purely theoretical cause of the disorder for which they are prescribed. No psychiatrist has ever ordered an MRI as part of their diagnostic routine. There is no blood work that can be done, no gene markers that can be identified, and no abnormalities in neurological structure (yet) that can be found to specifically identify bipolar, manic-depressive, or any other psychological disorders. We continue to treat them with drugs that are permanently addictive, mind-altering, and endangering.

They (the psychiatric industry) say that mental illness affects about twenty-five percent of the population, so the odds are that you know someone who is either being baited or already in the trap.The standard for diagnosis is The Diagnostic and Statistical Manual of Mental Disorders IV (available online at http://allpsych.com/disorders/dsm.html ). Spend some time browsing through this massive compilation of mental illness, and you will start to realize just how sick you apparently are. The category vaguely labeled “mood disorders” consists of across the board psychotropic drug treatment. In describing this category, the manual says “The disorders in this category include those where the primary symptom is a disturbance in mood.  In other words: inappropriate, exaggerated, or limited range of feelings.  Everybody gets down sometimes, and everybody experiences a sense of excitement and emotional pleasure.  To be diagnosed with a mood disorder, your feelings must be to the extreme.” Fair enough, until you look at the most popular diagnosis for young and old, and my personal favorite, bipolar disorder:

Under the DSM-IV definition of Bipolar 1 symptoms:
For a diagnosis of Bipolar I disorder, a person must have at least one manic episode” an intense high where the person feels euphoric, almost indestructible in areas such as personal finances, business dealings, or relationships. They may have an elevated self-esteem, be more talkative than usual, have flight of ideas, a reduced need for sleep, and be easily distracted” Depression is often experienced as the high quickly fades and as the consequences of their activities becomes apparent, the depressive episode can be exacerbated.

Sounds like the bipolar we all know and love. What about bipolar 2? It can only get worse, right?

Under the DSM-IV definition of Bipolar 2 symptoms:

Similar to Bipolar I Disorder, there are periods of highs as described above and often followed by periods of depression. Bipolar II Disorder, however, is different in that the highs are hypo manic, rather than manic. In other words, they have similar symptoms but they are not severe enough to cause marked impairment in social or occupational functioning and typically do not require hospitalization in order to assure the safety of the person.

Funny, it almost sounds like this person is moody, but that term wasn’t medical enough. Note that we still haven’t heard any physiological symptoms, as are required to identify as a disease and/or determine the target of pharmaceutical treatment, but all that does is open the door to the pharmaceutical companies. If a diagnosis can be based on generic medical opinion and theory, the same goes for the treatment.

Under the DSM-IV definition of Bipolar (1 and 2) treatment:

Medication, such as Lithium, is typically prescribed for this disorder and is the corner stone of treatment.

By the way, just in case your moods don’t swing quite far enough for you to feel like Bipolar 2 is your particular brand of crazy, they’ve got an even more medical sounding term for you.

Under the DSM-IV definition of Cyclothymia symptoms:

Like Bipolar II Disorder, symptoms of cyclothymia include periods of hypomania (see above). Depressive symptoms are also present as the hypomania fades. These symptoms, however, do not meet the criteria for a major depressive episode, in other words, are not as severe as those found in Bipolar Disorder.

Prognosis: Prognosis is good when the proper combination of medication and therapy are received.

The next step down seems to be complete apathy, for which I’m sure there is an excellent prescribed treatment. The problem is that we have trusted psychiatrists and pharmaceutical companies to define what is abnormal without ever defining what is normal. It is an impossible standard to define. We as a society only allow it because we don’t want to accept that “normal” does not always equal comfortable. That is why more than six million children in America are medicated in the name of ADHD. Drugging your child so that they are easier to deal with cuts so much of the hassle out of parenting. Besides, it’s much nicer to believe your child is naturally focused and reserved, just a victim of an unfortunate illness, than to accept that hyperactivity and disorganized thought are the natural state of a child (unless we are to redefine the term “childish”).

Sometimes we have to deal with the annoyance, whatever it may be, because it is part of life. A screaming, hyperactive kid is hard to deal with. Sadness can seem impossible to overcome. Emotion, pain, and even life as a whole can be a great burden to bear. It is part of the human experience, and sometimes it sucks. That doesn’t make you abnormal. Sometimes you can’t think straight. Sometimes you can’t make any sense of anything and you don’t know what to do. Sometimes there really may be something wrong. That doesn’t mean that there is a pill to fix it. The best treatment for mental disorder is to find someone to talk to, be it a friend, family member, or a professional therapist. There are good doctors out there who don’t buy their prescription pads in bulk. If your doctor can’t show you the hard evidence of what they are medicating, refuse the medication. Any other field of medicine will easily pass this test. No oncologist would prescribe chemotherapy for troubled breathing, he’ll check your lungs for a tumor. A doctor doesn’t put your leg in a cast because it hurts, he does it to set a broken bone. This is because chemo can kill you, and an unnecessary cast both incurs a wasteful expense and masks the potentially serious cause of the leg pain. Why, then, do we allow psychiatrists alone to prescribe dangerous drugs for ambiguous symptoms with an unknown cause, throwing unprovable medicine at theoretical conditions? I’m not against the medical industry, prescribed medicine, or even psychiatry as a whole.

I just don’t believe in hammering at invisible nails. Then again, I’m a little crazy.

http://www.opednews.com/articles/Mad-World-by-Damien-Qui-110417-174.html

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Psychiatrists Want To Label Grief a Mental Disorder

Monday, April 18th, 2011
The Montreal Gazette, April 18, 2011
By Sharon April 18, 2011

"This is a disaster," says Frances, a renowned U.S. psychiatrist who chaired the task force that wrote the current edition of the DSM

Human grief could soon be diagnosed as a mental disorder under a proposal critics fear could lead to mood-altering pills being pushed for “mourning.”

Psychiatrists charged with revising the official “bible” of mental illness are recommending changes that would make it easier for doctors to diagnose major depression in the newly bereaved.

Instead of having to wait months, the diagnosis could be made two weeks after the loss of a loved one.

The current edition of the Diagnostic and Statistical Manual of Mental Disorders – an influential tome used the world over – excludes people who have recently suffered a loss from being diagnosed with a major depressive disorder unless his or her symptoms persist beyond two months. It’s known as the “grief exclusion,” the theory being that “normal” grief shouldn’t be labelled a mental disorder.

But in what critics have called a potentially disastrous suggestion tucked among the proposed changes to the manual, “grief exclusion” would be eliminated from the DSM.

Proponents argue that major depression is major depression, that it makes little difference whether it comes on after the loss of a loved one, the loss of a job, the loss of a marriage or any other major life stressor. Eliminating “grief exclusion” would help people get treatment sooner than they otherwise would.

But critics fear that those experiencing completely expectable symptoms of grief would be labelled mentally “sick.” Dr. Allen Frances says the proposal would pathologize a normal human emotion and could bring on even wider prescribing of moodaltering pills.

“This is a disaster,” says Frances, a renowned U.S. psychiatrist who chaired the task force that wrote the current edition of the DSM, which is now undergoing its fifth revision. “Say you lose someone you love and two weeks later you feel sad, can’t sleep well, and have reduced interest, appetite, and energy. These five symptoms are completely typical of normal grieving, but DSM-5 would instead label you with a mental disorder.”

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The Illegitimacy of the “Psychiatric Bible” by Thomas Szasz, Professor of Psychiatry

Tuesday, March 29th, 2011

The Moral Liberal – March 29, 2011

by Thomas Szasz

Professor of Psychiatry Emeritus, Dr. Thomas Szasz

“Mental health experts ask: Will anyone be normal?” So read the title of a July 27 Reuters report. The “experts” warned that the fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM), scheduled for publication in 2013, “could mean that soon no-one will be classed as normal. . . . [M]any people previously seen as perfectly healthy could in future be told they are ill.”

This is not news. More than 200 hundred years ago Johann Wolfgang von Goethe (1749–1832) warned: “I believe that in the end humanitarianism will triumph, but I fear that, at the same time, the world will become a big hospital, each person acting as the other’s humane nurse.”

Moreover, Goethe foresaw the moral hollowness of the “humanitarian science” on which such therapeutic tyranny would rest: “I could never have known so well how paltry men are, and how little they care for really high aims, if I had not tested them by my scientific researches. Thus I saw that most men only care for science so far as they get a living by it, and that they worship even error when it affords them a subsistence.”

The depths to which such men would happily sink when worshiping error brings them fame and fortune became obvious only in the twentieth century.

Joaquim Maria Machado de Assis (1839–1908), the great Brazilian novelist and playwright, advanced the prescient literary satirization of the dark art of psychiatric diagnosis and the engine that drives it: the phony expert’s insatiable vanity and thirst for controlling his fellow man. His short story “O alienista” (1882, “The psychiatrist”) is a fable of a celebrated doctor retiring to a small town to pursue his scientific investigation of the human mind, gradually finding more and more of the townsfolk insane and needing to be incarcerated in his private asylum. Eventually he alone is left at liberty. As soon as modern psychiatry became a legitimate branch of medicine, Machado de Assis recognized and exposed its quintessentially unscientific-sadistic character.

It remained for the French playwright Jules Romains (1885–1972) to call public attention to the corruption of modern medicine by political power. “It’s a matter of principle with me,” declares his protagonist, “Dr. Knock” (1923), “to regard the entire population as our patients. . . . ‘Health’ is a word we could just as well erase from our vocabularies. . . . If you think it over, you’ll be struck by its relation to the admirable concept of the nation in arms, a concept from which our modern states derive their strength.”

Sigmund Freud (1856–1939), too, has played an important part in persuading people that health is an abnormal state. This old joke is illustrative: “If the patient is early for his appointment, he is anxious; if he is on time, he is obsessive-compulsive; if he is late, he is hostile.”

Particular psychiatric diagnoses have not escaped professional criticism. Wishing to make a name for themselves as psychiatrists, “critics” object to one or another diagnosis (homosexuality)—or to “overdiagnosis” (ADHD)—but continue to respect the American Psychiatric Association (APA) as a scientific organization and regard the various incarnations of the DSM as respectable legitimating documents. This is dishonest. Confronted with the DSM, the challenge we face is to delegitimize the authenticators, the APA and DSM, not distract attention from their fundamental phoniness by ridiculing one or another “diagnosis” and trying to remove it from the magical list.

I have consistently rejected this piecemeal approach. In my essay “The Myth of Mental Illness,” published in 1960, and in my book with the same title that appeared a year later, I stated my view forthrightly. I proposed that we view the phenomena conventionally called “mental diseases” as behaviors that disturb others (or sometimes the self), reject the image of “mental patients” as helpless victims of patho-biological events outside their control, and refuse to participate in coercive psychiatric practices as incompatible with the foundational moral ideals of free societies. In short, I rejected the authority of the APA as a legitimating organization and of the DSM as a legitimating document. I believe nothing less can undo the mischief wrought by the successive editions of the “psychiatric bible.”

Settled by Political Power

But times have changed. Fifty years ago it made sense to assert that mental illnesses are not diseases. It makes no sense to do so today. Professional debate about what counts as mental illness has been replaced by political-judicial decree. The controversy about the nature of so-called mental diseases/disorders has been settled by the holders of political power: They have decreed that “mental illness is a disease like any other.” Political power and professional self-interest have united in turning false beliefs into lying facts: “Mental illness can be accurately diagnosed, successfully treated, just as physical illness” (President William Clinton, 1999). “Just as things go wrong with the heart and kidneys and liver, so things go wrong with the brain” (Surgeon General David Satcher, 1999).

The claim that “mental illnesses are diagnosable disorders of the brain” is not based on scientific research; it is a deception and perhaps self-deception. My claim that mental illnesses are fictitious illnesses is also not based on scientific research; it rests on the pathologist’s materialist-scientific definition of illness as the structural or functional alteration of cells, tissues, and organs. If we accept this definition of disease, then it follows that mental illness is a metaphor, and asserting that view is stating an analytic truth not subject to empirical falsification.

For centuries the theocratic State exercised authority and used force in the name of God. The Founders sought to protect the American people from the religious tyranny of the State. They did not anticipate, and could not have anticipated, that one day medicine would become a religion and that the alliance between medicine and the State would then threaten personal liberty and responsibility exactly as they had been threatened by the alliance between church and State.

The Founders faced the challenge of separating the cure of souls by priests from the control of people by politicians. Today the therapeutic State exercises authority and uses force in the name of health. We face the challenge of separating the consensual treatment of patients by medical doctors from the coercive control of persons by agents of the State pretending to be healers.

When psychiatry was in its infancy the belief that all human “dysfunctions” are manifestations of brain diseases was a naive error. In its maturity the mistake was treated as a valid scientific theory and the justification for a powerful ideology and the powerful institutions based on it.

Today, in its senescence, psychiatry is deceit and self-deceit—coercion concealed as objective science (“medical diagnosis”) and benevolent help (“medical treatment”). As a result, paraphrasing Orwell, telling the truth becomes “a revolutionary act.”

http://www.themoralliberal.com/2010/12/20/the-illegitimacy-of-the-%E2%80%9Cpsychiatric-bible%E2%80%9D/

Dr. Thomas Szasz is a Professor of Psychiatry Emeritus at the State University of New York, Adjunct Scholar at the Cato Institute and a Lifetime Fellow of the American Psychiatric Association. Considered by many scholars and academics to be psychiatry’s most authoritative critic, Szasz has authored more than 35 books on the subject, the first being The Myth of Mental Illness, a book which rocked the foundations of psychiatry upon its release more than 50 years ago.  Read more here: http://www.cchrint.org/about-us/co-founder-dr-thomas-szasz/

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25 Good Reasons Why Psychiatry Must Be Abolished

Monday, March 21st, 2011

by Don Weitz, Psychiatric Survivor & 24-year activist in the psychiatric liberation movement

1. Because psychiatrists frequently cause harm, permanent disabilities, death – death of the body-mind-spirit.

2. Because psychiatrists frequently violate the Hippocratic Oath which orders all physicians “First Do No Harm.”

3. Because psychiatrists patronize and dis-empower people, especially their patients.

4. Because psychiatry is not a medical science.

5. Because psychiatry is quackery, a pseudo-science which lacks independent diagnostic tests, testable hypotheses, and cures for “schizophrenia” and all other types of alleged “mental illness” or “mental disorder”.

6. Because psychiatrists can not accurately and reliably predict dangerousness, violence, or any other type of human behaviour, yet make such claims as “expert witnesses”, and with the media promote the “dangerous mental patient” myth/stereotype.

7. Because psychiatrists have caused a worldwide epidemic of brain damage by promoting and prescribing brain-disabling treatments such as the neuroleptics, antidepressants, electroconvulsive brainwashing (electroshock), and psychosurgery (lobotomy).

8. Because psychiatrists manufacture hundreds of “mental disorders” classified in its bible called “Diagnostic and Statistical Manual of Mental Disorders” (a modern witch-hunting manual); such “mental disorders” and “symptoms” are in fact negative, class-and-culturally-biased moral judgments for dissident ways of coping with personal problems and alternative ways of perceiving, interpreting or being in the world.

9. Because psychiatrists, blinded by their medical model bias, fraudulently pathologize and label people’s serious life or existential crises as “symptoms” of “mental illness” or “mental disorder” such as “schizophrenia”, “bipolar affective disorder”, and “personality disorder”.

10. Because psychiatrists compound this fraud by falsely claiming, without scientific proof, that these “mental disorders” are caused by a “biochemical imbalance” in the brain, genetic factors or “genetic predispositions”, despite the fact that there are no genetic factors in “mental illness”.

11. Because psychiatrists frequently misinform their patients, families and the public by claiming that brain-disabling procedures such as the neurotoxins (e.g., “antipsychotic medication” and “antidepressants”), electroconvulsive brainwashing (electroconvulsive therapy/”ECT”), psychosurgery (lobotomy) and other behaviour modification-mind control procedures are “safe, effective and lifesaving”.  The exact opposite is tragically true.

12. Because psychiatrists routinely deceive or lie to patients, prisoners, their families, and the public.

13. Because psychiatrists routinely and willfully violate the medical-ethical principle of “informed consent” by misinforming or not informing their patients about the numerous toxic, disabling and frequently permanent effects of the neuroleptics such as memory loss, tardive dyskinesia, tardive psychosis, parkinsonism, dementia (all signs of brain damage), and death.

14. Because psychiatrists routinely threaten, intimidate or coerce many patients – particularly women, children, the elderly, and prisoners – into consenting to health-threatening/brain-damaging “treatment” such as the antidepressants, neuroleptics, electroconvulsive brainwashing, and hi-risk experiments.

15. Because psychiatrists frequently fail to fully inform psychiatric inmates and prisoners about existing safe and humane, non-medical alternatives in the community such as survivor-controlled crisis centres, drop-ins, self-help or advocacy groups, diet, massage, wholistic medicine, affordable supportive housing, and jobs.

16. Because psychiatrists are sexist in frequently stereotyping women in crisis as “hysterical” or “over-emotional”, blaming women whenever they voice real complaints and assertively express their feelings and emotions, prescribing massive doses of tranquilizers and antidepressants to disproportionately large numbers of women, and in sexually assaulting women in their offices and institutions.

17. Because psychiatrists, particularly white male psychiatrists, are homophobic – the American Psychiatric Association (APA) once labelled homosexuality as a “mental illness” or “mental disorder” – and have used forced electroshock on lesbians, trying to coerce them into adopting a heterosexual life style.

18. Because psychiatrists are ageist in prescribing tranquilizers, antidepressants (“medication”) and electroconvulsive brainwashing for disproportionately large numbers of elderly people – a form of elder abuse.

19. Because psychiatrists are racist in disproportionately incarcerating and drugging people of African descent, aboriginal people, other people of colour and labelling them “psychotic” or “schizophrenic”.

20. Because psychiatrists routinely violate people’s civil rights, human rights and constitutional rights such as imprisoning innocent people without court trial or public hearing (“involuntary commitment”), and subjecting them to cruel and unusual punishments or tortures such as forced drugging, electroconvulsive brainwashing, psychosurgery, solitary confinement, “chemical restraints”, and 4-point or 5-point restraints.

21. Because psychiatrists masterminded the mass murder of hundreds of thousands of vulnerable people including disabled children, the elderly and psychiatric patients during The Holocaust in Nazi Germany, and “selected” hundreds of thousands of concentration camp prisoners for death (“T-4 euthanasia” program) – historical facts still missing in psychiatric textbooks and histories.

22. Because psychiatrists have willingly participated in and administered mind-control experiments in the United States and Canada since the early 1950s – its chief targets have been poor patients, women, dissidents and prisoners.

23. Because psychiatry, particularly institutional-biological psychiatry, is based on the 3 Fs: Fear, Fraud, and Force.

24. Because psychiatry is a form of social control or punishment – not treatment.

25. Because psychiatry, particularly institutional-biological psychiatry, is fascist – a direct threat to democracy, human rights and life.

A note from the author: This statement is a slightly revised version of the original written in spring 1998.  Feel free to add and publish your own reasons.  I am a psychiatric survivor and antipsychiatry activist who has been involved in the psychiatric survivor liberation movement for 24 years.  I am also co-editor of “Shrink Resistant: The Struggle Against Psychiatry in Canada” (1988), host-producer of the antipsychiatry program “Shrinkrap” on CKLN radio (88.1 FM) in Toronto, member of People Against Coercive Treatment (P.A.C.T.), and member of the Ontario Coalition Against Poverty (OCAP).

PLEASE SNOWBALL, COPY AND PUBLISH THIS STATEMENT INCLUDING THE NOTE. NO COPYRIGHT OR PERMISSION REQUIRED.

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Psychiatry’s Billing Bible, the DSM: The Debate over Diagnosis

Monday, March 21st, 2011

Montreal Gazette
By Donna Nebenzahl

Psychiatric disorders are not discovered in labs, they are voted into existence by the American Psychiatric Association

Expected to be published in May 2013, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) – the bible of the American Psychiatric Association – has created a firestorm of controversy in its suggested treatment of individuals who have gender identity issues.

According to the manual, an individual questioning gender identity and meeting certain criteria suffers from gender identity disorder, which is therefore considered a mental disorder. And the new edition, whose revisions have been in the works for more than a decade, is likely to once again disappoint the vocal community that has been arguing for years that being transgendered is not a mental illness. (Preliminary revisions for DSM-5 are available for review at www.DSM5.org.)

Many medical practitioners and activists argue that the inclusion of gender identity disorder, even in its likely DSM-5 configuration as gender incongruence, “pathologizes a normal variant of human sexuality,” as Fordham University researcher Sarah Kamens wrote recently in the magazine of the Society for Humanistic Psychology.

“In the DSM that’s currently in use, it’s classified the same way homosexuality was 30 years ago,” says Dr. Shuvo Ghosh, who treats children with gender identity issues at the Montreal Children’s Hospital.

“The diagnosis stigmatizes trans people; it makes it look like they’re mentally ill, and they’re not,” says Françoise Susset, psychologist and president-elect of the Canadian Professional Association for Transgender Health. “Many of the people I see are very high functioning and have no mental illness whatsoever.”

“It’s being called a disorder and treated as a disorder, and I would say it should stay there,” argues Dr. Pierre Assalian, head of the human sexuality unit at the Montreal General Hospital. “I would say that until we find something biological that explains why somebody feels wrong in their body, I would have to consider it as a disorder.”

The research on biological underpinnings of gender identity issues is being carried out around the world, but in the meantime the American Psychiatric Association’s manual, considered the No. 1 source of diagnostic categories, maintains the condition’s psychiatric listing – with some troubling inclusions. One group of professionals proposed online that new indicators in the DSM-5 such as “strong preference for toys and games of the other gender . and playmates of the other gender” should be struck from the forthcoming manual, since preference for play and playmates, they argue, have “no place in diagnostic criteria for a psychiatric disorder.” http://www.montrealgazette.com/health/Debate+over+Diagnosis/4469318/story.html#ixzz1HFmnUm00

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