Mental Illness Overdiagnosed


    Yes! Yes! Yes! I thought DSM 5 is a crock of oop:, too.

    I think we need to go back to the basics and remind ourselves what mental illness is...

    It is a persistent pattern of behaviors (at least 5 out of 9) that lasts at least 6 months or longer that have had a negative affect on the person's life. People should meet the criteria every time they are assessed (while untreated; treatment is different--the traits should be absent).

    Also, from my understanding, true mental illness (stemming from genetic and environmental factors) is present in the absence of mood altering substances (drugs/alcohol/caffeine).

    Now, that being said, I think if someone suffers from situational depression or psychosis (i.e. postpartum depression/psychosis or depression due to the loss of a loved one) and would like medication to help, they should get it. I do not think medication should be the go to thing first off. I think people who lost loved ones should be able to grieve how ever they need to (that doesn't hurt themselves or others); then, if it is excessive, maybe counseling or something. But, I don't think situational issues should be included in the mental illness category.

    I welcome thoughts and comments....
  2. 11 Comments

  3. by   VivaLasViejas
    I agree with that last sentence. Normal grieving is not pathological; it's a very necessary part of processing a loss that we must go THROUGH, not around, not under, not over.

    However, postpartum psychosis isn't necessarily situational; it is often a marker for bipolar disorder that usually gets missed. I know it was for me, and I wonder sometimes if things would have gone better if I'd been diagnosed earlier in my life.

    It also concerns me that if the media put enough stories out there claiming Americans are over-diagnosed, the 'sheeple' might get the message that there really is no such thing as mental illness, and those who do suffer from actual psychiatric disorders could face more public ridicule and discrimination than they already do. Additionally, it might give those who are 'on the fence' about their own MH issues a reason to doubt their diagnosis and stop taking their medications, with potentially disastrous results. (Personally, I'd love to deny the fact of my own illness and not have to take $200/month worth of meds to manage it; unfortunately, all the evidence points in the opposite direction and I have the mood charts to prove it. )

    Just my two pence worth......
  4. by   TopazLover
    As the DSM expands to encompass all forms a aberrant, but not mental illness as we were all educated to understand, the mental health budget goes down. Not only are we getting a glut of PTSD because we are able to keep warriors alive during combat now there is an attempt to diagnose things we never saw as illness and remove some of the things that seem to fit our understanding of MI.

    Does anyone in authority communicate with those who fund the programs that are in response to the diagnosis to treat and decrease symptoms?

    Grief is normal. We are not educated as to death, as a nation. There is a great debate about sex ed. but even the subject of death, dying, grief, and funereal customs is taboo.

    it is still a source of shame for many of us who have a diagnosis of MI. Those who seem to have the loudest voices about mental illness seem to be people like Ted Nugent and Mr. LaPierre. While both may be experts in dysfunction they certainly are not qualified to discuss any mental health/illness issues. It continues stereo-types that are not reality. We are in the infancy of understanding the brain. Too few people realize how little we really know.
    Last edit by TopazLover on Mar 18, '13
  5. by   wish_me_luck
    I still think DSM 5 is a bunch of bologna. Mental illness does exist; but, as long as we are going to call every quirk or difference in people or caffeine addiction (that is totally a society thing--we drink lots of coffee, soda, sweet tea, etc.) a mental becomes a joke. All I am saying is that it should go by the criteria that I mentioned earlier and you should be able to check it at anytime and get the same results.
  6. by   leslie :-D
    personally i don't have a problem with dsm-5.
    offhand its benefits outweigh its detriments.
    yet even IF they were legitimate diagnoses, they do not always and immediately warrant medications.
    that is what i take issue with.
    i 'get' that prescribers are either pressured (self-induced or otherwise) or motivated to write scripts.
    compound that with living in a generally entitled society that demands instant gratification... we are.

    i think these dxs need additional input from their authors...
    perhaps advising when to contact your dr.,
    followed by other advice in managing one's personal adversity.

    medication should never be a first choice...
    only a last resort.

  7. by   wish_me_luck
    2. DSM 5 Is Guide Not Bible"Ignore Ten Worst Changes | Psychology Today

    Article from a physician (I think he is a psychiatrist, to be specific) about what he considers to be the top ten worst changes in the new DSM...I think he revised it to be 11 changes--the 11th is that they are going to cause a lot of possible physical problems to have a psychiatric diagnosis.
  8. by   TopazLover
    So true. Almost all the drugs used for some type of mental illness have very nasty side effects. Some have been almost ignored by those who do not suffer them. Place someone on an antidepressant and have them gain 40+ pounds. Now the depression they feel is related to body image as well as endogenous reasons. Not much help. Some meds cause tremors. Many do not know that Lithium + NSAIDs is almost a guarantee of mix master type shakes. Get rigid from antipsychotics, take Cogentin. No you need blasting caps to deal with the constipation. On and on.
  9. by   leslie :-D
    this thread hit home to me.
    my 22yo son was dx'd with bipolar a few yrs ago.
    i did not agree with the dx but he agreed to go and stay on lithium/seroquel regimen.
    he also has become toxic a few times.

    just last week i was telling him how proud i am that he has (and continues to) developed into a fine, upstanding young man.
    j. then shared with me that he had stopped taking his lithium and seroquel a few months prior...
    which confirms to me, that he was not ever bipolar.
    and much to his relief, he also reminded me that "i was right";
    that he had never truly had bp, and his journey to maturity was proof of that.

    and yes.
    mi is dangerously overdiagnosed and its meds, aggressively prescribed.
    some of these drs need to be held accountable.

  10. by   VivaLasViejas
    I'm glad to hear that, Leslie. I can't imagine carrying around a bipolar dx for years and taking multiple medications for it, only to find out that I never had it to begin with.

    Somehow, I don't think that'll ever happen for me (currently dx'd BP II but pdoc hasn't ruled out BP I due to the severity of my manic episodes), but for a young person like your son, it's got to feel like a huge burden has been lifted. How wonderful for him.....and you too!

    Love you, my friend
  11. by   Spidey's mom
    This is a great idea for a thread.

    It has bothered me since I started nursing school how quickly people reach for a magic pill to make them all better; and with the help of a physician too.

    One of my experiences in clinical was sitting in on a supposed counseling session (I've told this story before so sorry if some of you have read it). It was a 9 year old boy who lost his dad and his mom was going from man to man and living in a KOA campground. The kid was situationally depressed. Mom was also using drugs and alcohol.

    This doc decided the kid neede Prozac. This was over 15 years ago. The kid actually brightened up after the doc handed him a box of meds and said something like "Oh goodie, drugs". Instead of getting this kid some real help, the doc decided to medicate his situation.

    I see this all the time at school now as the district nurse. A normal, bouncy and wiggly boy in Kindergarten too soon is in trouble for making his toy car go "vroooooom!". Or is in trouble because he can't sit still to do all the worksheets that unfortunately Kindergarten has become. So, his teacher and parents want him assessed for ADHD. And put on drugs. How about not putting him in Kindergarten until he is actually ready?

    I know I'm focusing on kids here but that's my life/job right now.

    Our society wants an easy fix. Pop a pill and all is better. We have a very large prescription pill addiction problem in the U.S.

    It takes some hard work to slough through depression or a tough home-life situation. I know a kid who was depressed as a teen and the general practioner prescribed an anti-depressant w/o any real assessment. Even the pro's want an easy fix.

    And yes, bipolar seems to be the ADHD over-diagnosis of the day now.

    I'm NOT taking anything away from folks who really suffer from mental illness. But let's assess better and not run straight to medicating ourselves first.
    Last edit by Spidey's mom on Mar 22, '13 : Reason: typos
  12. by   VivaLasViejas
    True that. ^^

    I'll be the first to agree that we Americans are far too eager to try to medicate everything, from grief over the loss of a loved one to a backache from working in the garden too long. And yes, I think bipolar disorder is the "flavor of the month" that gets overdiagnosed, especially in children, which is sad considering the fact that once you have a diagnosis like that, you carry it around forever even if you later are dx'd with something else. And there are entirely too many celebrities who make mental illness seem almost glamorous, who somehow NEVER get fat from psychiatric medications or look like hell from going several nights without sleep.

    Where it gets rough is when a person who truly suffers is not taken seriously because these disorders are so often trivialized, both in the media and in everyday life. It is a VERY serious decision to take medications for a mental illness, not only because of the side effects but because, in essence, they change how one goes about the process of living their life. And they usually have to be taken for life because mental disorders aren't curable.

    I've got more to say on this subject, but duty calls......
  13. by   VivaLasViejas

    OK, duty is done, sister has been to doctor and hairdresser, prescriptions filled and brought home. And with that thought, I'll resume my White Paper On the Subject Of Mental Health Medications. Or something like that, LOL.

    I honestly don't know what's up with people who think drugs are the answer to everything. If I had my druthers, I'd be on NO meds, because I really hate spending my hard-earned money on them (one of my psych meds is $165 for a 30-day supply!!) and I loathe having to take pills in order to be 'normal'---normal blood pressure, normal blood sugar, normal breathing, normal moods and mental function. There are several residents at my assisted-living community who are in their 90s and don't even take Tylenol for a headache; I can't even imagine that. But it would be nice to not have to be on so many (12 Rx, 3 OTC).

    However......I have this funny thing about sanity. Now that I've experienced it, I've come to like it and really want more of it, so I take four different drugs to maintain it (five if you count the OTC melatonin for sleep). I did NOT accept this reality easily. For years, I denied even the possibility of being bipolar because I didn't want to take lithium, which scared the pants off me. So I went on and off antidepressants for a decade---I'd switch into what I now recognize as mania, and stop them because I feared they had something to do with the crazy feelings I was having; then when the inevitable happened and I crashed into a blubbering, raging, desperate episode of depression, I'd call my internist and get a new AD prescription.......lather, rinse, repeat.

    So when I was told that I would need to take medication for the rest of my life, my first instinct was to rebel. I wasn't about to become "dependent" on meds just to function......and yet, time and experience have proven that I absolutely, positively MUST be medicated in order to live my best life. And isn't that what we all want?

    Yes, there are times when I'm uncomfortable, sad, anxious, blue, upset, distressed, angry, and disappointed; these are emotions that everyone experiences, and they can't---and shouldn't---be medicated away. But when one's mental issues are overwhelming to the point that they are affecting every area of life, it's time to think about getting help, and a combination of therapy and pharmaceuticals gives us the best chance of accomplishing our goals.

    And that's all I have to say about that.