Medicine's big new battleground: does mental illness really exist?

[King_Klonopin]

96. My two cents:

The psychoanalytical community (i.e. psychologists, "talk" therapists)
have been debating with the psychiatric community (i.e. M.D.s who
primarily prescribe medication) since the beginning of the
psychology movement.

Holistic approaches make most sense (to me) when diagnosing and
treating any illness -- mental or physical (as if the two are exclusive)
An Either-Or, All-or-nothing mind set is not helpful in any situation.

It is wise to consider physical, mental, environmental and spiritual
factors regarding any dis-ease. When you see a therapist,
you don't drop off your head in a suitcase and say,"please, fix this."
And, when you see an oncologist, you don't leave your head in the
waiting room while you have chemotherapy.

There may or may not be underlying motives to proposing the
abandonment of "labeling" people with a diagnosis. Who can say?
Diagnoses in the DSM were intended to provide criteria (guidelines)
for treatment based on symptoms and behaviors.

I agree that, as a society, we are assigning the term "disorder" to
what is simply bad/irresponsible behavior in many cases.
I agree that, as a society, we look to fix our problems with pills
or other substances rather than changing our "selves".
I agree that the pharmaceutical industry has a lot invested in
having us be "sick". That certain medications (such as Adderall)
are over-prescribed and certain illnesses (such as Bipolar Disorder)
are over-diagnosed.

Like any science, the knowledge base of psychiatry evolves with
time, and certain beliefs and practices evolve along with it.
Examples have already been mentioned on the thread.
I am wondering if the psychological community, as a whole, is
finally taking steps to clean up the confusion it has allowed.

I have worked in the mental healthcare field for 30 years. I am
an RN (which is medical model) but I also have a degree in psychology.
I have seen cases where medication was essential in treatment and cases
where no amount of medication would ever fix the problem. What
confounds the issues of diagnosis, treatment, and society's perception
of the mentally ill is that too many people are being treated under the
umbrella of mental illnesses.

The DSM divides diagnoses into two major Axes : Axis I covers the
addictions, mood and thought disorders; and Axis II covers the
"personality disorders."
Axis I diagnoses have a biochemical component and will respond
better to medications. Axis II diagnoses are vastly different.
Medications treat their symptoms -- not their causes. If they are to
get well, they have to change their "psyche" (i.e. the personality
and all that defines it.) Yet, in the acute care setting, all are put
together and treated the same. At some point in the future, psychiatric
medicine is going to have to change; for example, stop hospitalizing
people who only get sicker in hospitals (i.e. borderline personality) or who
should be in prison (i.e. sociopathic personality), stop throwing
medications at people in a desperate attempt to fix something that only
the patient can fix, and accept that some problems can't be fixed by
your medicine or therapy.

Addictions can't be fixed with medications or ECT -- but are treatable --
and an addict/alcoholic who has mood swings is not necessarily "BIpolar".

Patients with Personality Disorders who act-out and have tantrums
are not "Bipolar". The nature of their malady exhausts resources which
are already limited and is actually worsened by conventional treatment.
At some point, it may be considered unethical to hospitalize or medicate
people with these disorders.

Alzheimer's Disease, brain injuries, etc. are organic/neurological problems
and are not supposed to be treated as "psychiatric" problems.

Changing the way we use labels and words is not going to change or fix
these problems one damn bit.