# Author of DSM says “there is no definition of a mental disorder"



## Pablo (Sep 1, 2005)

The guy who literally wrote the book on mental illness has said that "these concepts are virtually impossible to define precisely with bright lines at the boundaries."... "there is no definition of a mental disorder. It's bullshit. I mean, you just can't define it."

http://www.wired.com/magazine/2010/12/ff_dsmv/all/1


----------



## babybowrain (Aug 24, 2010)

That's funny I was just thinking of this symptom my doctor consideres an illness but I consider just a symptom of anxiety/real life difficulties hmmm


----------



## babybowrain (Aug 24, 2010)

Although I gotta add I do believe mental illnesses are real and the suffering is real and without categories of these illnesses and disablities I'd have no money cause I was unable to work for a period of time


----------



## Pablo (Sep 1, 2005)

babybowrain said:


> Although I gotta add I do believe mental illnesses are real and the suffering is real and without categories of these illnesses and disablities I'd have no money cause I was unable to work for a period of time


Yeah I don't think he is saying mental illness isn't real like its imagined, rather he is questioning the way it is defined, as we are all unique people with unique problems so really we all need our own individual label, for example everyone here on this site would probably categorise as having dp yet nearly all of us have varying symptoms and have other degrees of things like anxiety and depression all mixed in, but it is impossible to give everyone a label so some sort of categorisation is needed. I think the point is to use the labels as general guides but don't take them too literally and many disorders are just medicalising of normal human reactions or states.


----------



## Visual (Oct 13, 2010)

Oh so true! There are HUGH conflicts of interest:

"The book is the basis of psychiatrists' authority to pronounce upon our mental health, *to command health care dollars from insurance companies for treatment and from government agencies for research*"

Also, "*bad science but of bad faith, hubris, and blindness, of making diseases out of everyday suffering and, as a result, padding the bottom lines of drug companies*"

So attention that should be about helping people gets diverted to $$$ and individual pride.

Well, in the end we work with what we got and just try to make it better.


----------



## Guest (Feb 1, 2011)

Pablo said:


> Yeah I don't think he is saying mental illness isn't real like its imagined, rather he is questioning the way it is defined, as we are all unique people with unique problems so really we all need our own individual label, for example everyone here on this site would probably categorise as having dp yet nearly all of us have varying symptoms and have other degrees of things like anxiety and depression all mixed in, but it is impossible to give everyone a label so some sort of categorisation is needed. I think the point is to use the labels as general guides but don't take them too literally and many disorders are just medicalising of normal human reactions or states.


_*"This is hardly the first time that defining mental illness has led to rancor within the profession. It happened in 1993, when feminists denounced Frances for considering the inclusion of "late luteal phase dysphoric disorder" (formerly known as premenstrual syndrome) as a possible diagnosis for DSM-IV. It happened in 1980, when psychoanalysts objected to the removal of the word neurosis-their bread and butter-from the DSM-III. It happened in 1973, when gay psychiatrists, after years of loud protest, finally forced a reluctant APA to acknowledge that homosexuality was not and never had been an illness. Indeed, it's been happening since at least 1922, when two prominent psychiatrists warned that a planned change to the nomenclature would be tantamount to declaring that 'the whole world is, or has been, insane.' "*_

As noted the DSM has always been in dispute. But medicine is frequently an art not a science. And understanding the brain most difficult.

I can only use the best example ... AIDS. I was around in 1984 (or thereabouts) when AIDS was finally discussed openly by the Surgeon General as a concern that affected the entire population, not just gay men. It was originally called GRID (Gay Related Immune Disorder), and was also associated with a degenerate lifestyle, drug use, "poppers" and every thing else.

Then it was found it could be gotten by straight people, women, and children through blood transfusions.

Also, in the early 1900s it wasn't understood that NOT washing hands after moving on to another patient was causing the spread of disease. Medicine evolves as does the understanding of the brain.

I do believe that the DSM will indeed be subsumed by the ICD and many mental illnesses will finally be recognized as neurological disorders.

The clear cut serious brain disorders such as schizophrenia, bipolar, OCD, clinical depression, autism are seen CLEARLY on a spectrum, but they need to be treated as they are medical conditions. I don't know why we don't see, even here on the Board that all of us ARE UNIQUE. No, we can't be placed in one simple category. But for the sake of treatment focus, insurance purposes, research, there has to be some organization of classes of disorders.

PTSD is finally recognized as a legitimate disorder though it was mentioned in the Civil War ... battle fatigue, shell shock, etc. Soldiers frequently didn't survive wars and so these problems were chalked up to "cowardice", etc. Also, nowadays a soldier can survive a severe traumatic brain injury (TBI) and have all sorts of psychological and cognitive problems to boot. So we have a whole generation of military personnel who need special treatment.

As for me, I have breast cancer. My aunt had it back in the early 1970s. At that time you didn't talk about it. It had as much stigma as mental illness has today. But women had been dying of breast cancer for centuries ... throughout history. At that time, my aunt had her entire breast, chest wall and lymph nodes removed and had only a choice of two types of chemo. She died.

I on the other hand have had MANY more choices of treatment, my outcome is a zillion times better than hers. I did not have radical destructive surgery though I had a mastectomy. I did NOT have to have chemo as there was a new genetic test for my TUMOR available (since 2004) that indicated that tumor would respond no better to infused chemotherapy (the deadly shit where your hair falls out and you can die from it all) than an oral hormone therapy I have to take for 5 years. No one would have believe these things in the 1970s.

Medicine changes. Psychiatry is the most difficult. The brain is the most complex organ in the body.

The DSM has a lot of problems, psychiatry is rife with problems. When mental illnesses are fully recognized as medical/neurological we will have psychoneurology or neuropsychiatry and psychiatry will be a thing of the past. Psychology and counseling will STILL be needed, but for coping, CBT, etc.

And if you have ever seen an autistic child or a child with ADHD, REAL ADHD you would not argue that these are legitimate and frequently very disabling. Children who respond well to treatment can actually function in school and in social situations. Once you are a parent of such a child you would understand.

Not saying that psychiatry hasn't gotten things terribly wrong ... especially ... well I'd like to hit Freud in the head, but he did contribute SOME important things to psychiatry, but many of his theories are completely irrelevant today. Mothers don't make their children schizophrenic, etc. This was also believed back in the 1970s.

Also, in 50 years, psychneurologists will look back at treatment we receive now and call it barbaric. Just as we look back at medical treatment received by heart/lung patients back in the 1950s. Barbaric, when 50% of patients died on the operating table.

I'm 52 and have indeed "been around the block" ...


----------



## Guest (Feb 1, 2011)

I have also mentioned numerous times here, and no one is interested, that you can write to the committee and make comments on the new DSM. I give up.

And Yes Visual Dude, we have to educate ourselves, and advocate for ourselves.

Also recall, my friend's father died of diabetes at age 45. Nowadays you can live your entire life with that illness. Not everyone, but such an early death is far less common. Etc., etc., etc.


----------



## gill (Jul 1, 2010)

I think the book is probably useful for having a reference of different types of issues so that problems which share similar symptoms but are not  aren't confused. For instance, a lot of people on here say that, well DP is a possible symptom of schizo. Well, maybe I have schizo. When really, they don't. So, having a general definition can help to differentiate the two avoiding confusion, then you can get more accurate treatment.

Of course, mental issues are subjective, so at the end of the day, it's really in the eye of the beholder as to whether they consider their issue a disorder. The way I look at it is, if something is continuously affecting me negatively like DP then it is a disorder. For instance, if I just experienced DP a couple minutes a day every few days, then I wouldn't consider myself to have DPD. But, when it became this continuous occurrence, then I thought of it as a disorder.


----------



## Guest (Feb 1, 2011)

gill said:


> I think the book is probably useful for having a reference of different types of issues so that problems which share similar symptoms but are not aren't confused. For instance, a lot of people on here say that, well DP is a possible symptom of schizo. Well, maybe I have schizo. When really, they don't. So, having a general definition can help to differentiate the two avoiding confusion, then you can get more accurate treatment.
> 
> Of course, mental issues are subjective, so at the end of the day, it's really in the eye of the beholder as to whether they consider their issue a disorder. The way I look at it is, if something is continuously affecting me negatively like DP then it is a disorder. For instance, if I just experienced DP a couple minutes a day every few days, then I wouldn't consider myself to have DPD. But, when it became this continuous occurrence, then I thought of it as a disorder.


Unless you self-diagnose, having DP SHOULD NOT be mistaken (as I see here sometimes) as "the warning sign of schizophrenia" ... that is misinformed DOCTORS who don't have enough training.

If you have MET someone with schizophrenia in person WHEN THEY ARE EXHIBITING SYMPTOMS, there is no mistaken, at minimum that they are psychotic, making no sense, are terrified, have cognitive problems, etc. Now, they could be having a psychotic episode of bipolar, or post-partum psychosis. PSYCHOSIS is a series of behaviors/thoughts/actions that must be properly diagnosed. You can also meet an individual with schizophrenia, bipolar, etc. IN REMISSION, and never know they were ill. And if they don't tell you, you wouldn't know, as they know the stigma that comes with it.

You don't give the same treatment to someone with schizophrenia in a psychotic episode (NOT SCHIZO - I HATE THAT WORD) as you would to someone who is bipolar in a psychotic MANIC episode. Also, someone can present as psychotic who is on a horrible drug trip -- THAT needs to be sorted out.

Also, if you see a depressed person in your office, if you don't get the correct information, observe, etc., if you give them an SSRI, thinking they "only have depression" you can send them into a manic episode. Someone with bipolar needs a MOOD STABILIZER like Lithium where someone with clinical depression needs an ANTIDEPRESSANT.

These are VERY important distinctions in treatment. The old way -- give everyone a heavy duty tranquilzer and institutionalize them.

*The criteria for being disabled, or having a disorder is INABILITY TO FUNCTION SOCIALLY AND OCCUPATIONALLY. That's it. That's true if you have a heart condition or severe OCD, or bipolar. You cannot study, work, or interact properly with other people.*

Even Freud said -- one thing that says exactly the same thing -- "The goal of treatment is not to cure everyone of their everyday 'neuroses' but to make them able TO WORK and TO LOVE." That's it. Granted, I don't buy most of his theories of mental illness, but that is the same as

*WORK - occupational functioning* (or study as a student -- that is your work)
*LOVE - social functioning* -- interaction on a constructive level with other people and the motivation to do so, accounting for personality type, etc. It is normal to seek companionship in friendship, love, loving one's child, etc. If one is so ill one cannot do this, that is a problem.

Simple.


----------



## Guest (Feb 1, 2011)

And as I've said a thousand times

You can have a diagnosis of schizoprhenia, bipolar, OCD, depression and HAVE DP/DR as one of your symptoms. If DP/DR is your PRIMARY disabling symptom then it is "co-morbid"with your main disorder. With schizophrenia that would be unlikely .. one would figure it is a secondary symptom. BUT EACH CASE IS UNIQUE.

My main disorder is
Social Anxiety/Generalized Anxiety
I also have Depersonalization Disorder CO-MORBID with the above
I also have Clinical Depression CO-MORBID with the above

Depression has anxiety as a symptom, and vice versa as well.

Also, in theory I am a "cancer survivor" ... the cancer was removed. But what I just love is they cannot say 100% that I have no other cancer cells in my body, and that is why I must take an oral medication for five years. This will "REDUCE" recurrence, or will hopefully kill any cancer cells -- even one -- that make be moseying around in my body. Science does not even understand enough about CANCER. But I am very, very lucky and feel I have a good outcome and a long life ahead of me.

*Ladies, get your Mammograms. My cancer could NOT BE FELT and it was 2.1 cm in size.*


----------



## Sleepwalker (Dec 4, 2008)

Edited by me.


----------



## Sleepwalker (Dec 4, 2008)

...


----------



## Guest (Feb 6, 2011)

*Sleepwalker, why have you deleted your comments? You've made some interesting points.*


----------



## babybowrain (Aug 24, 2010)

Pablo said:


> Yeah I don't think he is saying mental illness isn't real like its imagined, rather he is questioning the way it is defined, as we are all unique people with unique problems so really we all need our own individual label, for example everyone here on this site would probably categorise as having dp yet nearly all of us have varying symptoms and have other degrees of things like anxiety and depression all mixed in, but it is impossible to give everyone a label so some sort of categorisation is needed. I think the point is to use the labels as general guides but don't take them too literally and many disorders are just medicalising of normal human reactions or states.


I think the government already knows this as they decide who can go on disablity payments on a case by case basis...so doctors probably know it too.


----------



## wouhou (Mar 11, 2010)

Thanks Dreamer for share your knowledge, everytime that comforts me , thanks.

Also yes, mental disorder who are created by DSM it's just an approximative thing, for know the psychological problems of the person and try to give an appropriate treatment ~ isn't absolute.

There are many form of bipolar disorder as schizo as depression that of persons..

ps: bad english, sorry.

-woowoo


----------



## shogun (May 15, 2010)

Dreamer* said:


> _*"This is hardly the first time that defining mental illness has led to rancor within the profession. It happened in 1993, when feminists denounced Frances for considering the inclusion of "late luteal phase dysphoric disorder" (formerly known as premenstrual syndrome) as a possible diagnosis for DSM-IV. It happened in 1980, when psychoanalysts objected to the removal of the word neurosis-their bread and butter-from the DSM-III. It happened in 1973, when gay psychiatrists, after years of loud protest, finally forced a reluctant APA to acknowledge that homosexuality was not and never had been an illness. Indeed, it's been happening since at least 1922, when two prominent psychiatrists warned that a planned change to the nomenclature would be tantamount to declaring that 'the whole world is, or has been, insane.' "*_
> 
> As noted the DSM has always been in dispute. But medicine is frequently an art not a science. And understanding the brain most difficult.
> 
> ...


Great post, you are a great asset to this board.

The branches of psychiatry popping up like psychoneuroendocrinology, Psychoneuroimmunology and Psychoneurology are the future and i'm excited to see these fields grow.


----------

