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Madness in Mental Health

Posted Oct 08 2013 7:27am


By Moira Dolan, M.D.

If we were to listen to the National Association for Mental Illness, one out of three Americans has a mental illness. The numbers from the National Institute of Mental Health are pretty alarming: over 2.2 million adult Americans have schizophrenia, 40 million have anxiety disorder and 5.7 million are bipolar. It doesn’t stop there.

For a better sense of just how crazy we are supposed to be, take a look at the American Psychiatric Association’s billing bible, the Diagnostic and Statistical Manual of Mental Disorders (DSM). It started off as a 130-page paperback with a handful of clinical descriptions. It has mushroomed to a heavy 886 page book describing 297 mental afflictions.

The current version, DSM-IV-Revised, finds “illness” in every aspect of daily life. There is virtually no one who would not at some time fall into a category in this book. Sex, drugs and food are favorite topics in the DSM. While early DSM versions focused on too much sexuality, the current version goes into more detail on under-sexuality, including Inhibited Sexual Desire Disorders, Premature Ejaculation Disorder, Male Erectile Disorder and Female Sexual Arousal Disorder. There is even a psychiatric diagnosis for people who fail to get sexually aroused when viewing pornography. These are just a few of the 21 sexual disorders in the book.

Who you think you are (Identity Disorder) and what you think about (Obsessive Disorder) can be diagnosable illnesses. But don’t act on your thoughts, or you’ll come down with Compulsive Disorder. There is also a Rumination Disorder, which is hard to tell from Obsessive Disorder, so perhaps it belongs in the DSM for cows. It’s a great reference to use when explaining to someone why you don’t like them, as the entire range of disagreeable human behavior is accounted for in one disease or another. In case you don’t have time to peruse the whole book, just remember that Borderline Personality Disorder is the mental illness of someone who really irritates you.

The degree and timing of distress is also important, as nine different labels can account for anxiety, from Acute Stress Disorder to Panic Disorder to Generalized Anxiety Disorder. Just to be safe, call it Anxiety Disorder Not Otherwise Specified. DSM covers behavior around the clock, in case you suffer from Sleep Disorders and Nightmare Disorder. Dyssomnias, Primary Insomnia, Primary Hypersomnia, Narcolepsy, Breathing-Related Sleep Disorder, Circadian Rhythm Sleep Disorder (formerly Sleep-Wake Schedule Disorder), Dyssomnia Not Otherwise Specified, Parasomnias, Nightmare Disorder (formerly Dream Anxiety Disorder), Sleep Terror Disorder, Sleepwalking Disorder, Parasomnia Not Otherwise Specified, Sleep Disorders Related to Another Mental Disorder, Insomnia Related to Another Mental Disorder; Hypersomnia Related to Another Mental Disorder, On the other hand, it just may be Substance-Induced Sleep Disorder, Sleep Disorder Due to a General Medical Condition, or simply Other Sleep Disorders.

DSM is a handy book of excuses, too. If you want to show the post office clerk who’s boss, just claim Post-traumatic Stress Disorder. But if it’s an IRS form that sets you off just once a year, call it Intermittent Explosive Disorder. If you kid’s getting poor report cards, you can blame ADD; it’s more appropriate to use Oppositional Defiant Disorder if he talks back to the teacher and he has bad grades.

Why is the DSM turning every moment of life experience into a disease? As with other trends in medicine, follow the money. It turns out that 56 % of 170 psychiatric “experts” who helped work on the latest (1994) edition of the Diagnostic and Statistical Manual of Mental Disorders had financial links to drug makers at some point from 1989 to 1994. This is outright financial backing, and doesn’t even consider that those “financial links” included ownership of drug company stock, travel expenses, research funding, consulting fees and payment for gifts. In the parts of the DSM that define schizophrenia, mood disorders and psychotic disorders, all of the contributing DSM authors had financial links.

In a study of DSM and drug company influence, researchers from University of Massachusetts and Tufts University concluded, “The connections are especially strong in those diagnostic areas where drugs are the first line of treatment for mental disorders.”

The director of the APA’s research division, Dr. Darrel Regier, said he didn’t believe the DSM contributors’ financial links to drug companies had influenced the manual. He said that if the “experts” who wrote the manual were not involved with the pharmaceutical industry, “that would mean they were really out of step with the major advances in the treatment of mental illness.”

The DSM editors describe it as “a work in progress”. They admit that it relies heavily on “empirical findings in history”, meaning, what someone said about how a person acted.

A tally of the estimates of people supposedly afflicted with all of the bizarre diagnostic labels, including Mathematics Phobia and Keyboard Anxiety Disorder, will add up to more than the entire US population. That means that each adult American, on average, has more than one mental disorder. The extent to which the attempt to make a disease out of everything in human experience extends to the extreme. And now that the FDA has approved a drug to treat the phantom pains experienced by the depressed person, a currently running TV commercial asks, “Where does depression hurt?” Answer: “Everywhere!” “Who does depression hurt?” Answer: “Everyone!”

The numbers of children who are supposed to be mentally deranged is even more alarming. Bipolar disorder alone has soared as a diagnosis for the under-18 group, with a 40 fold increase in just 9 years. The parallel increase in psychiatric drug prescribing is what the drug makers are most interested in. In the State of Michigan, for example, there were over 265,000 psychotropic drug prescriptions written for Medicaid kids alone, billing the government more than $20 million for these drugs.

Bipolar disorder was not a diagnosis recognized by the American Psychiatric Association until the publication of its 1980 version of Diagnostic and Statistical Manual. In fact, no other country in the world even recognizes bipolar as a disorder in children. To the rest of the world, it’s just normal childhood. Bipolar symptoms sound suspiciously like everyday life. Drug ads encourage labeling normal everyday situations as signs of mental illness. TV and internet ads portray usual daily mood changes as a sign of serious instability, needing medication, of course. New drug-maker sponsored specialty medical journals have popped up (Bipolar Disorders and the Journal of Bipolar Disorders). You can take your pick of bipolar societies, all funded by the drug makers. Any month of the year you can find a company-funded bipolar conference to attend.

Some of the drugs being marketed to treat bipolar disorder are called “mood-stabilizers”. There have been no controlled trials that prove these drugs have any long term mood stabilizing effect. In fact, one of the only really objective measures of mental derangement is suicide or suicide attempt. An analysis of the combined result of four studies of children on “mood stabilizers” shows more suicides and suicide attempts occurs in those on the drugs than in children who were taking sugar pills.

The most commonly offered treatment for bipolar-ism is the class of drugs known as neuroleptics. This is from the Greek root words neuro- plus -lēptikos, meaning “seizing”, from lambanein meaning “seize, take”. Brain seizing drugs don’t market too well under that name. They were once known as major tranquilizers, or more accurately, chemical straightjackets. Today they are called “anti-psychotic” drugs, even though they all contain warnings that they can in fact cause the person to become psychotic, a side effect that is seen even in a previously healthy person. Since the bipolar diagnosis has been made popular, sales of “anti-psychotic” drugs have gone from less than $10 billion per year to over $40 billion in the last decade. The widespread drugging of our population for a made up “disease” has not done anything to decrease the numbers of mentally distressed people. Diagnoses have increased and so have the frequency of sudden acts of senseless violence committed by such drugged persons.


Carey, B, Bipolar Illness Soars as a Diagnosis for the Young, The New York Times, Sept 4, 2007

Cosgrove, L, Krimsky, S, Vijayaraghavan, M, Schneider, L, Financial Ties between DSM-IV Panel Members and the Pharmaceutical Industry, Psychotherapy and Psychosomatics 75:154-160 (2006).

Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR Fourth Edition, American Psychiatric Association, 2000

Steuart Watson, T, Skinner, CH, Encyclopedia Of School Psychology, Springer, 2004

Storosum JG, Wohlfarth T, Gispen de Wied CC, Linszen DH, Gersons BP, Suicide-risk in placebo controlled trials of treatment for acute manic episode and prevention of manic-depressive episode. Am J Psychiatry 2005, 162:799–802.

Copyright MoiraDolanMD2013.


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