Adonis Diaries

Posts Tagged ‘Diagnostic and Statistical Manual of Mental Disorders

Attention deficit hyperactivity disorder…Diagnosis of grieving Human

The news that 11% of school-age children now receive a diagnosis of attention deficit hyperactivity disorder — some 6.4 million — give the chill.

Ted Gup, an author and fellow of the Edmond J. Safra Center for Ethics at Harvard University, published this April 2, 2013

“My son David was one of those who received that diagnosis.

In his case, he was in the first grade.

Indeed, there were psychiatrists who prescribed medication for him even before they met him.

One psychiatrist said he would not even see him until he was medicated.

For a year I refused to fill the prescription at the pharmacy. Finally, I relented. And so David went on Ritalin, then Adderall, and other drugs that were said to be helpful in combating the condition.

In another age, David might have been called “rambunctious.” His battery was a little too large for his body. And so he would leap over the couch, spring to reach the ceiling and show an exuberance for life that came in brilliant microbursts.

As a 21-year-old college senior, he was found on the floor of his room, dead from a fatal mix of alcohol and drugs.

The date was Oct. 18, 2011.

No one made my son take the heroin and alcohol, and yet I cannot help but hold myself and others to account.

I had unknowingly colluded with a system that devalues talking therapy and rushes to medicate, inadvertently sending a message that self-medication, too, is perfectly acceptable.

My son was no angel (though he was to us) and he was known to trade in Adderall, to create a submarket in the drug among his classmates who were themselves all too eager to get their hands on it.

What he did cannot be excused, but it should be understood.

What he did was to create a market that perfectly mirrored the society in which he grew up, a culture where Big Pharma itself prospers from the off-label uses of drugs, often not tested in children and not approved for the many uses to which they are put.

And so a generation of students, raised in an environment that encourages medication, are emulating the professionals by using drugs in the classroom as performance enhancers.

And we wonder why it is that they use drugs with such abandon. As all parents learn, and to their chagrin, our children go to school not only in the classroom but also at home, and the culture they construct for themselves as teenagers and young adults is but a tiny village imitating that to which they were introduced as children.

The issue of permissive drug use and over-diagnosis goes well beyond hyperactivity.

In May, the American Psychiatric Association will publish its D.S.M. 5, the Diagnostic and Statistical Manual of Mental Disorders.

This voluminous book is called the bible of the profession.

Its latest iteration, like those before, is not merely a window on the profession but on the culture it serves, both reflecting and shaping societal norms. (For instance, until the 1970s, it categorized homosexuality as a mental illness.)

One of the new, more controversial provisions expands depression to include some forms of grief. On its face it makes sense.

The grieving often display all the common indicators of depression loss of interest in life, loss of appetite, irregular sleep patterns, low functionality, etc. But as others have observed, those same symptoms are the very hallmarks of grief itself.

Ours is an age in which the airwaves and media are one large drug emporium that claims to fix everything from sleep to sex.

I fear that being human is itself fast becoming a condition. It’s as if we are trying to contain grief, and the absolute pain of a loss like mine.

We have become increasingly disassociated and estranged from the patterns of life and death, uncomfortable with the messiness of our own humanity, aging and, ultimately, mortality.

Challenge and hardship have become pathologized and monetized.

Instead of enhancing our coping skills, we undermine them and seek shortcuts where there are none, eroding the resilience upon which each of us, at some point in our lives, must rely. Diagnosing grief as a part of depression runs the very real risk of delegitimizing that which is most human — the bonds of our love and attachment to one another.

The new entry in the D.S.M. cannot tame grief by giving it a name or a subsection, nor render it less frightening or more manageable.

The D.S.M. would do well to recognize that a broken heart is not a medical condition, and that medication is ill-suited to repair some tears.

Time does not heal all wounds, closure is a fiction, and so too is the notion that God never asks of us more than we can bear.

Enduring the unbearable is sometimes exactly what life asks of us.

But there is a sweetness even to the intensity of this pain I feel. It is the thing that holds me still to my son.

And yes, there is a balm even in the pain. I shall let it go when it is time, without reference to the D.S.M., and without the aid of a pill.

A version of this op-ed appeared in print on April 3, 2013, on page A27 of the New York edition with the headline: Diagnosis: Human.
Note: And billion of people go hungry, suffer malnutrition…and die of curable diseases before the age of 5.

Your irascible kid will be ordered to get psychiatric treatments; (Mar. 9, 2010)

            Any single behavior of yours has now a psychological label attached to it.  An irascible kid is diagnosed “humor deregulation with dysphory”; an eccentric adolescent is treated for “syndrome of psychotic risk”; and if you are into much sex activities then you are labeled “hypersexual troubled person”

            A few expert psychiatrists of the American Psychiatry Association (APA) have been efficaciously working for a decade on categorizing and revisiting the “Diagnostic and Statistical Manual of Mental Disorders (DSM).  The proposed revisions are published on the APA site www.dsm5.org are opened for comments till April 20, 2010.  The definitive version DSM-V is due on May 2013. Comments, validation studies, complementary evaluations, and the vote of the administration council of APA will deliver the final acceptance decision of this version.

            Mental illnesses are intrinsically related to family and community supports, health structures, and mental customs in treatments; all these factors are irrelevant to multinational pharmaceutical companies with interest to globalize definitions of psychiatric syndromes and treatments.

            Based on globalize diagnostics and criteria, individuals will be considered suffering from mental troubles, prescribed standardized psychotrops, and health insurance coverage encouraged.  The president of APA, Alan Schatzberg, said “The DSM may have incidences on the way individuals perceive others and perceive themselves. It influences the nature of research and their methodologies.  There are repercussions in justices, industries, and public health.”

            There is no doubt that millions of people will be taking pills that were not necessary in many societies in the first place; they will suffer secondary effects that are more dangerous and harmful than the original ailments. Worse, the revised DSM-V will be imposed globally to include all societies as the definitive Psychiatric Bible. APA will enjoy hegemony in that troubled field.

            For example, a “depressed” Nigerian would say he has burning in the head; a Chinese would say he has pain in the shoulders or stomach; a Salvadorian would claim to have sensation of intense corporal heat.  Ethan Watters published “Crazy like Us: The globalization of the American Psyche”. There is a terrifying global tendency to de-humanizing people by imposing unified cultural outlooks.

            Western, more specifically US, repertory of mental symptoms and treatments is trying to homogenize it globally, as if there are no specificities to various societies differing vastly from Western concepts of mental illness.  Since it is Western States that are contributing mostly to natural disasters and catastrophes, then the US medical teams have disseminated their diagnostics related to post-traumatic ailments.

            Multinational pharmaceutical industries are heavily lobbying to redefining mental symptoms so that they sell medical pills that DSM might be recommending, especially allowing public health institutions and health insurance to cover the mental disorders expenses.


adonis49

adonis49

adonis49

October 2020
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