The history of medicine has its glorious moments, but is also littered with false theories, blind allies, and harmful treatments. The emergence of invasive therapies in ancient Greece inspired Hippocrates to make 'First, Do No Harm' the foundational injunction of western medicine. Psychiatric medicines are quite effective when correctly prescribed for clearcut disorders. But Americans are taking too much medicine, often casually and unnecessarily prescribed by the wrong people for the wrong reasons, and causing lots of needless harm.
The really bad news is that the bulk of psychiatry is no longer done by psychiatrists. Psychiatric medicines are most often prescribed by primary care doctors who are always busy and usually under trained in psychiatry. And their diagnostic and treatment decisions are heavily influenced by drug company advertising aimed directly at patients combined with aggressive marketing campaigns aimed at doctors.
The result is massive overprescription of medicine for off label, untested, and inappropriate indications. Drug companies have more unregulated freedom in the U.S. than anywhere else in the world to push their product where it does not belong. Their success is measured in returns to shareholders, not benefits to patients.
It simply makes no sense that the antipsychotics are now the largest revenue producers among all classes of medicines -- bringing in $15 billion per year -- much of it coming from excessive use in vulnerable populations of children and the elderly. Antipsychotics often cause large weight gains increasing the risks of diabetes, heart disease, and shortened life expectancy. Almost equally concerning is that eleven percent of U.S. adults are taking an antidepressant medicine, making these the fourth most lucrative class for drug companies. Perversely, only a third of severely depressed people get the medicine they so desperately need, while many taking antidepressants do not need them at all and receive no more than placebo effect. And 4% of our kids are on stimulants for ADD, sometimes without a careful diagnostic workup and consideration of alternative approaches. A large secondary market has encouraged a third of college students to use stimulants for performance enhancement and/or recreation. We seem to be creating a brave new world in which everyone will take a psychiatric medicine, and some will take two or three or even more.
Psychiatric diagnosis and treatment is particularly subject to fads and undue drug company influence because judgments are still based on subjective data that cannot be confirmed or disproved by laboratory tests. The pride of psychiatry is the enormous neuroscience base accumulated in the past thirty years, but the brain is the most complicated organ in the known universe and reveals its many secrets only very slowly. We have learned a great deal about normal brain functioning -- but still know very little about what causes the mental disorders. This enormous leap from basic brain science to clinical psychiatry will take decades to bridge in very small steps. In the meantime, decisions about diagnosis and treatment are only as good as the people making them -- and too often they are made after brief and cursory evaluations that ignore best diagnostic and treatment practices.
I am a psychiatrist and was chair of the group that prepared DSM-IV -- the manual that currently guides psychiatric diagnosis. Sad to say, DSM-IV is often used carelessly or not at all (especially in primary care) -- resulting in a great deal of mislabeling and unnecessary treatment. The overdiagnosis of mental disorders has recently gotten out of hand with faddish false epidemics of childhood bipolar disorder (increased by forty fold), autism (increased by twenty fold), and attention deficit (doubled). One quarter of the general population would now qualify for a diagnosis in any given year, more than half lifetime.
The next edition of the diagnostic manual (DSM 5) is in preparation now and will become official in 2013. I'm terribly concerned that it will make our current worrying situation a great deal worse. Unless its ambitions are trimmed dramatically, DSM 5 will promote the misdiagnosis of tens of millions of people and an even greater misuse of potentially harmful medication. It proposes to introduce many new diagnoses and broaden the criteria for existing ones. Normal grief will be mislabeled major depression; everyday worries, stress, and sadness will become mixed anxiety/depression; one episode of binge eating a week will label you mentally ill; older people with expectable memory problems will be inaccurately warned that they are on the road to dementia; difficult to manage kids will be given unproven diagnoses that will lead to even more misuse of antipsychotic drugs, and there will be a further boost to the false epidemic of attention deficit disorder.
The people working on DSM 5 mean well, are not drug company shills, and genuinely believe their suggestions will help patients. The problem is that they are researchers who have worked in ivory tower settings with little experience in how the diagnostic manual is often misunderstood and misused in actual practice. A suggestion that might be fine in their own hands can cause disaster if misapplied by a less expert primary care doctor. As researchers they are much less worried than I am that their proposals are largely untested. They call them 'scientific hypotheses' that can always be tested and corrected after DSM 5 is published. This is dead wrong and dangerously reckless. DSM 5 will have a dramatic effect on peoples lives and everything in it must be certified safe and scientifically sound.
Final decisions on DSM 5 will be made soon. I will post a series of blogs highlighting its worst proposals and updating the efforts to shoot them down before they can become official. Public health will be adversely affected by DSM 5 -- the public should become informed and have its say before it is too late.
Allen Frances is a professor emeritus at Duke University and was the chairman of the DSM-IV task force.
Allen Frances: Preventive Psychiatry Can Be Bad for Our Health
Dr. Sohom Das: Personality Disorder - What Is it, and What Does Diagnosis Mean?
A filing for Legal Guardianship has been approved, and amongst the various rights that have been revoked, is the right to approve, decline, or otherwise modify the proposed treatment plans devised by the medical staff.
I became confined to New Hampshire Hospital on May 28, 2011, under the tenets of an Involuntary Emergency Admission. Once one has been confined in such a manner, one may change one's status to voluntary. Such a change in status may reduce one's stay to a handful of days, whereas, if one remains held involuntarily, one's stay may extend to a number of years.
Being released from the hospital seems to become more a matter of leaving the hospital as soon as possible, rather than promoting health or allowing people the freedom to pursue avenues of their choice towards health and wellbeing.
I've devised two petitions in regard to this matter, and I pray that your heart may be touched.
The petitions may be found at the following addresses:
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US Citizens Are Being Confined Without Having Been Charged with a Crime.
http://www.change.org/petitions/governor-of-new-hampshire-us-citizens-are-being-confined-without-having-been-charged-with-a-crime
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Guardianship Granted to Those Who Are Shown to Be Abusive Influences
http://www.change.org/petitions/governor-of-new-hampshire-george-and-monica-lajoie-guardianship-granted-to-those-who-are-shown-to-be-abusive-influences?share_id=QsNkHeQSuH&
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Please offer your support in regard to this matter.
Take care,
Jeremy
In regard to being overmedicated, I have expressed on numerous occasions, that in my experience, not only are antipsychotics not beneficial towards health, they are abjectly harmful.
Under the influences of these substances, I find that cognition is crippled.
I much prefer the experience of life without these substances.
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I am currently confined at New Hampshire Hospital, and I've indicated on numerous occasions that antipsychotics are, in my experience, harmful.
Such indications has been largely disregarded by the staff.
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http://www.ageofautism.com/2011/08/allen-frances-thomas-insel-and-the-black-white-rise-of-autism-its-fashionable.html
Bad enough that parents are being fed such commentary that is so void of understanding or competence that it only serves to misinform.
But I think their true nature is revealed when they are so busy with the standard personal attacks that they can't even figure out that Allen is a man.
Sadly, a not trivial number of people fall for such nonsense.
W&N
http://dsm5-reform.com/the-open-letter-committee-calls-for-independent-review-of-dsm-5/
To me, over prescribing is just one problem.
Most importantly for those concerned about autism in the new DSM-V, as I am, autism cannot be catagorized along with mental disorders like depression, anxiety. Although those on the spectrum can often struggle with both, autism is a metabolic disorder affecting every organ in the body. So of course, the brain is also affected. But children with autism have many terrible physical disorders like oxidative stress, autoimmune disorder, inflammatory bowel disease-often seizures.
Personally I don't think autism belongs in the DSM at all.
Many parents struggling with autistic children want to know why a neurological condition is in the Manual of Mental Disorders in the first place. They'd also like to know why Frances ignores the stories of tens of thousands of parents who report that their child was born healthy and was developing normally until they received certain routine vaccinations. Suddenly those kids got sick with things like bowel disease, sleep disorders, and seizures. Many stopped talking and lost learned skills, eventually ending up with an autism diagnosis. Why does Frances neatly omit any mention of the concomitant health problems of so many children with autism?
Frances can't explain where all the autistic children are coming from so, according to him, they don't really have autism. I can't think of a worse example of the medical community simply turning their backs on an epidemic of sick children they can't reasonably explain.
Anne Dachel, Media editor: Age of Autism http://www.ageofautism.com/
Or that you will have missed the attempts by some to profit by hiding this from parents.
Good news: the courts haven't missed these facts. And things are looking pretty bad legal-wise for the vaccines cause autism crowd. The real question left is how many will end up convicted felons?
But then I don't think there has been any coverage of the these legal problems at Age of Autism. Wonder why....
W&N
The federal government also conceded the vaccine damage case of Hannah Poling, a young Georgia girl who regressed into autism following her vaccinations.
See CBS News story from Sept, 2010http://www.cbsnews.com/8301-31727_162-20015982-10391695.html
Anne Dachel, Media editor: Age of Autism http://www.ageofautism.com/
Claire Dwoskin from the National Vaccine Information Center and Leslie Manookian, producer and writer of new movie, "The Greater Good," talked about vaccine safety claims with NY talk show host Thom Hartmann on Nov. 21. http://www.youtube.com/watch?v=38qPvdFit_U&feature=channel_video_title
They discussed the poor design of the research used as proof that vaccines are safe. No one ever talks about this!
Anne Dachel, Media editor: Age of Autism http://www.ageofautism.com/
Strange, you would think that if there were allegations that parents were being conned out of huge sums of money with useless/dangerous treatments you would want to post the legal proceedings.
Very strange indeed....
W&N
http://www.ipetitions.com/petition/dsm5/
PTSD treatment for Veterans found ineffective.
Risperdal and Eli Lilly Zyprexa can cause diabetes.
This is a powerful drug that can damage a young person physiologically for life.
Please take with caution and learn as much as you can about side effects.
*FIVE at FIVE* The Zyprexa antipsychotic drug,whose side effects can include weight gain and diabetes, was sold for "children in foster care, people who have trouble sleeping, elderly in nursing homes.
*Five at Five* was the Zyprexa sales rep slogan, meaning *5mg dispensed at 5pm would keep patients quiet*.
WARNING- If a drug Risperdal (Zyprexa) lists anything about the pancreas among the side effects, it probably means it can cause diabetes.
Risperdal,Zyprexa is glorified Thorazine at ten times the price.
-- Daniel Haszard Zyprexa victim activist.
FMI
http://www.zyprexa-victims.com
These new categories will lead to greater misdiagnosis (even than is already unfortunately occurring) of organic illness as psychogenic, leading to psychogenic dismissal of illness symptoms and signs, both in patients given diagnoses denoting illnesses of uncertain aetiology (such as ME/CFS), and in patients with established ‘uncontested’ illnesses, such as cancer, AIDS and diabetes. They will lead to an epistemic ‘laziness’ preventing doctors from working to elucidate and treat organic dysfunction so patients are at risk of further harm.
While advances in psychiatric and medical reasoning might render the current DSM categories associated with default psychogenic explanations defunct, the insertion of CSSD and SSSD into DSM-5 is worrying because those who propose these new diagnoses clearly believe their propositions already denote advances in psychiatric thinking, when they do not. Erroneous confidence in their use appears high. Their insertion risks irrational ‘black-boxing’ of alleged but un-elucidated and therefore unsafely assumed ‘psychogenic’ processes, so that doctors will not be required to robustly defend the logic or rationality of their diagnosis, increasing the risk of misdiagnosis.