Posts Tagged ‘grief’

American Psychiatric Association’s Push to Broaden Definitions of Mental Disorders Sparks Revolt

Wednesday, January 25th, 2012

Jan. 24 (Bloomberg)

An effort that promises to broaden the definitions of mental illnesses is spurring a revolt among health-care professionals in the U.S. and the U.K.

A panel appointed by the American Psychiatric Association is proposing changes to the industry’s guide for mental illnesses, which determines how patients are diagnosed and treated, and whether insurers pay for care. The new edition of the Diagnostic and Statistical Manual of Mental Disorders is scheduled to be published next year.

The draft is sparking a backlash among practitioners concerned the expanding mandate will increase the number of patients treated with drugs. The guide would loosen diagnostic criteria on some existing ailments and brand as mental disorders some common behaviors, including having temper tantrums three times a week or a lack of sexual arousal. The changes may spur unneeded and dangerous treatment of the healthy, said Allen Frances, a psychiatrist who helped write the current guidelines.

“Everyday disappointments, sufferings and eccentricities are being redefined as psychiatric disorders, and that could lead to medication treatment,” said Frances, a professor emeritus at Duke University who lives in San Diego, California. “This is expanding the boundaries of psychiatry.”

In many cases, family doctors will use the new definitions to treat patients, Frances said by telephone. Pressure from drugmakers to use medications can combine with media representations to create “an epidemic,” he said. “Once primary care doctors and patients have the idea that they saw a certain condition on TV, it becomes real.”

‘Medicalizing Normality’
Darrel Regier, the psychiatric group’s research director, characterized critics as being unconvinced medical treatment is better than counseling. The idea of “medicalizing normality comes from a perspective that there are no psychiatric disorders, and you need to avoid stigmatizing people by giving them one,” he said in a telephone interview.

An Oct. 22 letter critical of the changes, sponsored by units of the American Psychological Association in Washington, was signed by more than 10,800 people, including psychologists, psychiatrists, counselors, and community activists. The British Psychological Association, based in Leicester, England, sent a similar letter in June 2011.

The letters identify changes such as the one affecting ADHD, or Attention Deficit Hyperactivity Disorder, a long- identified illness that involves hyperactive people who have difficulty staying focused and controlling behavior, according to the National Institutes of Health in Bethesda, Maryland.

ADHD Changes
In the present manual, a diagnosis for ADHD requires six symptoms to be identified in adults, including some present before age 7. The new manual requires only four to be identified and the disorder no longer must present itself in childhood.

The changes consider research findings that impairment persists after age 18 as symptoms decline, basically allowing lesser issues to be addressed, according to the website set up by the Arlington, Virginia-based Psychiatric Association to describe the update. www.dsm5.org

“The definitions of mental illness are becoming so porous, they’re losing meaning,” Frances said. “You overtreat labeled patients, and take resources away from the severely ill.”

The new guide also creates a malady it calls Sexual Interest/Arousal Disorder in Women, though no field trials are being done to support the diagnosis, according to the DSM5 website. This illness should be diagnosed when there is an absence or reduced interest in sex and erotic fantasies tied to distress, the proposal suggests.

Temper Outbursts
Disruptive Mood Dysregulation Disorder, also new, is listed as being characterized by temper outbursts that occur at least three times a week that are out of proportion to a provocation. This disorder is being studied in trials, according to the site.

One in 5 Americans experienced some form of mental illness this year, according to a report this month by the U.S. Substance Abuse and Mental Health Services Administration, using the manual’s current criteria to develop the data. According to the National Institutes of Mental Health, costs in this area rose 63 percent to $57.5 billion in 2006 from a decade earlier.

Critics say those figures may rise quickly if the new manual is approved as proposed.

by Elizabeth Lopatto

Read the rest of the article here: http://www.sfgate.com/cgi-bin/article.cgi?f=/g/a/2012/01/24/bloomberg_articlesLY8B1S0UQVI901-LYB5B.DTL

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Psychiatry bible ‘turns sorrow into sickness’

Saturday, December 3rd, 2011

The Age
By Jill Stark
December 4, 2011

IT’S been branded a “dangerous public experiment” that could turn normal human experiences into an epidemic of mental illness with healthy people being drugged unnecessarily.

In radical changes to the way mental health conditions are diagnosed, what was once considered a child’s temper tantrum could be labelled ”disruptive mood dysregulation disorder”. If a widow grieves for more than a fortnight she might be diagnosed with ”major depressive disorder”.

If a mother in a custody battle tries to turn a child against the father, it might create ”parental alienation disorder”.

These are among new conditions proposed for the fifth edition of the psychiatrist’s bible, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), due to be finalised next year.

Some doctors in Australia are arguing the revised manual – used globally to diagnose mental disorders – is pathologising unhappiness.

The changes have also caused an international outcry, with the American Counselling Association, American Psychological Association, the British Psychological Society and others calling for the draft of the new edition to be independently reviewed.

They fear it is so inclusive, it risks labelling millions of healthy people as mentally ill.

”It’s such a narrow and limited view of human experience, to want to reduce every bit of suffering to medical diagnosis,” said Jon Jureidini, professor of psychiatry at the University of Adelaide. He said the changes would lead to increased prescribing.

The authors say ”misinformation” about the manual, produced by the American Psychiatric Association since 1952, is creating unnecessary fear and any inclusions will be based on robust scientific evidence. Psychiatrist Ian Hickie, director of Sydney University’s Brain and Mind Research Institute, rejects claims that the new manual would medicalise unhappiness. ”When people are in pain and suffering elsewhere we don’t say people are pathologising that. We say, let’s try and do the best we can to relieve that and get them back to function in the appropriate way,” Professor Hickie said.

The rift reflects division within the mental health community over a global rise in the use of antidepressants, stimulants and antipsychotics, with many clinicians critical of drugs with potentially serious side effects being favoured over more costly talk-based therapies. Others argue that medication can be life-saving where other therapies have failed. The inclusion of conditions such as attention deficit hyperactivity disorder (ADHD) and autism in previous DSM editions is believed to have contributed to increased prescribing.

In the new edition, the diagnosis threshold for some existing disorders is also being lowered so that

over the death of a loved one can qualify as a major depressive illness.

The authors of DSM-5, however, argue that a bereaved person who is suffering from major depression is currently ineligible for that diagnosis, preventing them from getting help if they need it.

”A broad range of evidence … shows that there are little to no systematic differences between individuals who develop a major depression in response to bereavement and in response to other severe stressors – such as being … raped … or the loss of your treasured job,” Dr Kenneth Kendler, a member of the DSM-5 mood disorders group, said.

The changes also mean children only have to display six of 13 possible symptoms for a diagnosis of ADHD, compared with six of nine in the previous manual.

”Under the new criteria it’s almost harder not to get diagnosed with ADHD than it is to get diagnosed with it,” Martin Whitely, a West Australian Labor MP and anti-ADHD medication campaigner, said. ”There were about 60,000 Australian children on ADHD medications in 2010 – a lot of money has gone into marketing and selling the disease.”

One of the manual’s biggest critics is the man who developed the last edition, American psychiatrist Allen Frances. He told The Sunday Age the fact that the authors of the new edition have described it as a ”living document” makes it a ”dangerous public health experiment”.

”The DSM-5 is used in real life-and-death decisions – it shouldn’t be a set of hypotheses to be tested,” he said. ”The worst outcome of this would be all these suggestions get included and a lot of people get medicine they don’t need. But an almost equally bad outcome would be that psychiatry gets so tarred by this aberration that people who really need psychiatry and need the medicine stop taking it.”

http://www.theage.com.au/national/psychiatry-bible-turns-sorrow-into-sickness-20111203-1ocmm.html

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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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Grief is most definitely not a mental illness

Thursday, April 21st, 2011

The Daily News,  April 21, 2011

by Wendy Pratt

Those of us working at Nanaimo Hospice were shocked at this headline. The proposed revisions to the Diagnostic and Statistical Manual of Mental Disorders designating grief as a mental illness leaves us wondering if we, as humans, have lost our way. And although I am not a cynical person, one has to wonder who is behind this kind of move to “medicalize” grief — who would benefit most?

Let me be clear — grief is not a mental disorder. It is a natural reaction to a life transition that we must all face many times over a lifetime.

At hospice we know that accessing the right support and having someone to reassure you that you are not “going crazy” and that the emotions and physical symptoms you are experiencing are normal makes a huge difference.

What troubled me most was a quote by Dr. Allen Frances who is, in fact, against changes to the DSM, but who says, “the DSM already allows the diagnosis of major depression soon after a loss if the grief symptoms are severe — when the bereaved becomes incapacitated, suicidal, or psychotic.”

No one is going to disagree with psychoses — but incapacitation and suicidal ideation are not uncommon in the people hospice supports through their grief.

Some losses just seem too hard to move through, but we know that when people access our services, healing is possible.

I am reminded of a gentleman who was ready to end his life just days after his wife died. He came to hospice as the home care nurse’s urging. He was sure we could not help. After nine months of support he sent a card signed “from a reluctant client, you saved my life — thank you.”

A year and a half later he was planning his wedding to someone who had also suffered a loss. Together they honoured and celebrated the memories of their lost spouses at the same time as they were building a new life filled with hope and happiness.

As author Dr. Alan Wofelt once said, “grief is the price we pay for loving deeply.”   We concur.

http://www.canada.com/Grief+most+definitely+mental+illness/4654257/story.html

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A mother’s grief — without time limits

Wednesday, September 8th, 2010

by Marianne Leone

The Boston Globe, September 8, 2010

FIVE YEARS ago, I found my 17-year-old son dead in his bed, and apparently five years is too long to be manifesting the symptoms of sadness: sleeplessness, the sudden and inexplicable onset of overwhelming memories and tears, the occasional entire day spent lying in bed. My time was up two weeks after we found him, according to the proposed fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. If the new edition is approved, my symptoms will be diagnosed as a major depressive disorder.

I don’t go to a psychiatrist. I don’t take anti-depressant drugs. I don’t judge anyone who does. But I bristle at the idea of a group of psychiatrists giving me an arbitrary cutoff date for how long I am allowed to grieve.

My mother died six months before my son, my favorite aunt four months after him, my favorite uncle and the family dog a year later, along with my fictional television son on “The Sopranos.’’ Does that appalling list net me a few extra weeks grace from the people who want me to be a regular customer of Big Pharma? (OK, maybe the fictional son is a stretch.)

I wrote a book about my son Jesse, a memoir celebrating his life and mourning his death that was published yesterday. Most people ask me whether it was “cathartic’’ to write the book, a tremor of hope fluttering under their hesitant words. Catharsis means “the purging of emotions.’’ But Jesse hasn’t been disappeared from my life, Soviet-style. His memory is with me always, and sometimes it makes me cry because I miss him so much, because it hurts to see his friends becoming fine men when he didn’t get the chance, because I want to hold him with a longing that is visceral, even after he’s five years gone.

My mother grew up in the Abruzzo region of Italy, where the inhabitants of that old culture have experienced war, earthquakes, famine. They are not afraid to acknowledge death and the sadness that follows; a folk song about death is called “scura mai’’ — you have left me dark. They’re not afraid to represent the archetypical mother, Mary, with seven swords in her heart after the death of her Son. What are we afraid of here in the United States?

Since Jesse died, I have felt joy. I have even laughed until tears came to my eyes. I have written a book and essays, I have acted on television and in film, I have hosted huge family parties.

But, full disclosure: I have taken to my bed for the entire day sometimes, on Jesse’s birthday, and on the January date I found him dead. Because what makes more sense to me, the actual person who has suffered a loss, are the words C.S. Lewis’s character speaks in the film “Shadowlands’’: “The pain now is part of the happiness then. That’s the deal.’’

And if the shrinks think that’s a major depressive disorder, they’re the crazy ones, not me.

Read the article here: http://www.boston.com/bostonglobe/editorial_opinion/oped/articles/2010/09/08/a_mothers_grief__without_time_limits/

For information on the book Knowing Jesse – http://search.barnesandnoble.com/Knowing-Jesse/Marianne-Leone/e/9781439183922/

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Now Psychiatrists Want to Repackage Grief as a “mental disorder”

Sunday, August 15th, 2010
The New York Times
by Allen Frances, an emeritus professor and former chairman of psychiatry at Duke University, was the chairman of the task force that created the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders.

Illustration credit: Cyprian Koscielniak

A startling suggestion is buried in the fine print describing proposed changes for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders — perhaps better known as the D.S.M. 5, the book that will set the new boundary between mental disorder and normality. If this suggestion is adopted, many people who experience completely normal grief could be mislabeled as having a psychiatric problem.

Suppose your spouse or child died two weeks ago and now you feel sad, take less interest and pleasure in things, have little appetite or energy, can’t sleep well and don’t feel like going to work. In the proposal for the D.S.M. 5, your condition would be diagnosed as a major depressive disorder.

This would be a wholesale medicalization of normal emotion, and it would result in the overdiagnosis and overtreatment of people who would do just fine if left alone to grieve with family and friends, as people always have. It is also a safe bet that the drug companies would quickly and greedily pounce on the opportunity to mount a marketing blitz targeted to the bereaved and a campaign to “teach” physicians how to treat mourning with a magic pill.

It is not that psychiatrists are in bed with the drug companies, as is often alleged. The proposed change actually grows out of the best of intentions. Researchers point out that, during bereavement, some people develop an enduring case of major depression, and clinicians hope that by identifying such cases early they could reduce the burdens of illness with treatment.

This approach could help those grievers who have severe and potentially dangerous symptoms — for example, delusional guilt over things done to or not done for the deceased, suicidal desires to join the lost loved one, morbid preoccupation with worthlessness, restless agitation, drastic weight loss or a complete inability to function. When things get this bad, the need for a quick diagnosis and immediate treatment is obvious. But people with such symptoms are rare, and their condition can be diagnosed using the criteria for major depression provided in the current manual, the D.S.M. IV.

What is proposed for the D.S.M. 5 is a radical expansion of the boundary for mental illness that would cause psychiatry to intrude in the realm of normal grief. Why is this such a bad idea? First, it would give mentally healthy people the ominous-sounding diagnosis of a major depressive disorder, which in turn could make it harder for them to get a job or health insurance.

Then there would be the expense and the potentially harmful side effects of unnecessary medical treatment. Because almost everyone recovers from grief, given time and support, this treatment would undoubtedly have the highest placebo response rate in medical history. After recovering while taking a useless pill, people would assume it was the drug that made them better and would be reluctant to stop taking it. Consequently, many normal grievers would stay on a useless medication for the long haul, even though it would likely cause them more harm than good.

The bereaved would also lose the benefits that accrue from letting grief take its natural course. What might these be? No one can say exactly. But grieving is an unavoidable part of life — the necessary price we all pay for having the ability to love other people. Our lives consist of a series of attachments and inevitable losses, and evolution has given us the emotional tools to handle both.

Read the rest of this article here http://www.nytimes.com/2010/08/15/opinion/15frances.html

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The Total Failure of Modern Psychiatry

Sunday, June 27th, 2010

Natural News
By David Gutierrez
June 27, 2010

Modern psychiatry went wrong when it embraced the idea that the mind should be treated with drugs, says Edward Shorter of the University of Toronto, writing in the Wall Street Journal.

Shorter studies the history of psychiatry and medicine.

Modern U.S. psychiatry has adopted a philosophy that psychological diseases arise from chemical imbalances and therefore have a very specific cluster of symptoms, he says, in spite of evidence that the difference between many so-called disorders is minimal or nonexistent. These “disorders” are then treated with expensive drugs that are no more effective than a placebo.

“Psychiatry seems to have lost its way in a forest of poorly verified diagnoses and ineffectual medications,” he writes.

Shorter calls for U.S. psychiatry to abandon its emphasis on “psychopathology” and instead adopt the European approach, which focuses on the symptoms and needs of people as individuals. Yet the draft of the latest edition of psychiatric diagnostic “Bible,” the Diagnostic and Statistical Manual of Mental Disorders (DSM), shows that U.S. psychiatry has no intention of changing course.

“With DSM-V, American psychiatry is headed in exactly the opposite direction: defining ever-widening circles of the population as mentally ill with vague and undifferentiated diagnoses and treating them with powerful drugs,” Shorter writes.

U.S. psychiatry was not always obsessed with psychopharmacology, he notes. Its early years were marked by a psychoanalytic approach that categorized mental disorders in broad, fluid categories such as “nerves,” “melancholia” or “manic-depressive illness.” These categories sufficed because similar treatments would work for people suffering from any version thereof: lithium treated both mania and severe depression, for example, while the specific symptoms experienced by an anxious person had little influence on the therapies needed.

“Our psychopathological lingo today offers little improvement on these sturdy terms,” Shorter said. “A patient with the same symptoms today might be told he has ‘social anxiety disorder’ or ‘seasonal affective disorder.’ … The new disorders all respond to the same drugs, so in terms of treatment, the differentiation is meaningless and of benefit mainly to pharmaceutical companies that market drugs for these niches.”

In the 1950s and ’60s, a new wave of psychiatrists sought to turn away from psychoanalysis — perceiving it as focusing excessively on “unconscious psychic conflicts” — and toward a more “scientific” model instead. As a result, the DSM-III introduced the vague new categories of “major depression” and “bipolar disorder,” even though evidence suggests that there is no substantial difference between the two conditions. At the same time, “major depression” absorbed what Shorter calls two very different conditions, “neurotic depression” and “melancholia.”

“This would be like incorporating tuberculosis and mumps into the same diagnosis, simply because they are both infectious diseases,” he writes.

DSM-V only continues the trend of extending the disordered label to more and more normal people, Shorter warns: “To flip through the latest draft of the American Psychiatric Association’s Diagnostic and Statistical Manual, in the works for seven years now, is to see the discipline’s floundering writ large.”

For example, the new disorder of “psychosis risk syndrome” associates a whole new class of people with full-blown schizophrenia, under the logic, Shorter says, that “even if you aren’t floridly psychotic with hallucinations and delusions, eccentric behavior can nonetheless awaken the suspicion that you might someday become psychotic.” The implication, of course, is that such people should be treated with antipsychotics.

Symptoms of “psychosis risk syndrome” include such vague descriptors as “disorganized speech.”

Other new “disorders” include hoarding, mixed anxiety-depression and binge eating. “Minor neurocognitive disorder” describes a reduction in cognitive function over time, such as that normally experienced by people over the age of 50, while “temper dysregulation disorder with dysphoria” refers to children who suffer from outbursts of temper.

“DSM-V accelerates the trend of making variants on the spectrum of everyday behavior into diseases,” Shorter says, “turning grief into depression, apprehension into anxiety, and boyishness into hyperactivity.”

Read entire article:  http://www.naturalnews.com/029088_psychiatry_failure.htmll

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