“Mental ‘illnesses’ have no validity”

http://gentlementalannie.com/2015/07/29/stigma-about-mental-illness-causes-people-to-refuse-to-seek-diagnosis-and-treatment/

bpdtransformation says:
July 29, 2015 at 3:41 pm
Perhaps the answer is to stop diagnosing people. Mental “illnesses” have no validity and reliability: pseudo-illnesses like bipolar and borderline PD have no proven biological or genetic basis or cause, and cannot be reliably identified by different psychiatrists. If we understood people’s “mental illnesses” as what they are: individualized problems in adapting to life challenges, or severe difficulties in handling feelings and relationships, rather than as false “illnesses”, I feel the stigma would be much less.
And unfortunately, in America, seeking help for a mental illness can perversely lead to a worse outcome, because being labeled as mentally ill and given too much long-term medication can cause the poor outcomes people fear.

https://bpdtransformation.wordpress.com/2015/02/04/21-the-nightmare-of-psychiatric-hospitalization-in-america/

“Mood disorders are biologically-based mental illnesses”, the psychiatrist announced authoritatively, surveying the 15 young-adult patients in front of him. “But while these illnesses might be biological, it doesn’t mean you can’t manage them effectively.”

My mind reacted explosively: How the fuck could you possibly know this, you pathetic excuse for a mental health “professional”? What actual evidence do you have?!

I desperately wanted to shout at him. But I remained silent, slouching backward in my chair in the mental hospital’s group therapy room.

After concocting a suicide plan that almost succeeded, I had been involuntarily committed to this hospital for my own protection. But I was now becoming a captive of a different kind: a prisoner of psychiatry’s hopeless ideology.

This is the story of my time in a mental hospital – what it taught me about myself, about my fellow human beings with “mental illnesses”, and about the web of lies that is American psychiatry…

When the psychiatrist said that BPD could not be cured, I felt furious. If I had a gun, I would have liked to shoot him right there and then. I imagined how satisfying it would be to put a bullet through his forehead, see his chair topple over onto the ground, the blood spilling everywhere, and for there to be one less idiot psychiatrist able to medicate patients into oblivion. It made me think of the opening scene in the movie Casino Royale…

This experience influenced my thinking about BPD and other so-called “mental illnesses” being invalid diagnoses…

That’s weird, my experience in a psychiatric hospital actually convinced me that depression and bipolar were real medical conditions.  It’s hard to deny something that’s staring right at you. I can imagine that some of the other patients had similar fantasies about shooting people who disagreed with them, just like you, Mr. Dantes.  In case you didn’t know, that could be considered abnormal.  Perhaps a sign of unresolved (and potentially explosive) anger issues.

Whether mental illness is under- or over-diagnosed is probably a good question, but to question its very existence seems odd, especially for someone who’s been diagnosed with bipolar. Is it fear, denial, shame, or all three?

Suicide is an extreme reaction, and considering the very strong will to live in our evolutionary chain, it’s also considered abnormal.  Do you think your suicidal ideation was something that is prevalent in the general population?  But it’s really just a symptom of a bigger problem, like drug addiction is usually a symptom of a mental health issue.

The brain is a marvelous organ, but it is negatively affected by many things. Violence and poverty are just two things that can change the way our brains work, and along with our DNA, create mental illness. And usually, it’s a life-long struggle to manage these conditions. Once your brain experiences bad things, there’s no going back. But just like with cancer, medications can bring about a type of remission.

It’s also weird how you allegedly advocate for less stigma about mental illness, yet you don’t believe it exists.  What is that, cognitive dissonance?

https://bpdtransformation.wordpress.com/2015/06/26/26-why-bpd-should-be-abolished-and-what-should-replace-it/

If a psychiatrist labels or has labeled you as BPD, or if the voice of people calling you borderline is stuck in your mind, I encourage you to tell them something like this:

“The BPD label you’ve called me is a simplistic checklist of distress factors, factors which anyone under stress for long enough can experience to different degrees. There are no reliable genes, brain-scans, or other biomarkers which can identify so-called BPD. In fact, BPD is in no way a reliable classification; it is an “illness” fabricated out of thin air without a basis in real science.
There is therefore no proof that I have an illness like you say, or that there is anything innately wrong with my brain; most likely, I am reacting in a perfectly logical way to the stresses I’ve gone through. There are other, better ways to understand my problems, and I do not accept the false label of BPD that you are putting onto me. If I get enough help, I can fully recover and live the life that I want.”

Say, Mr. Dantes, would you happen to be a Scientologist?

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11 thoughts on ““Mental ‘illnesses’ have no validity”

    • On the contrary. My father was severely “bipolar” his whole adult life, hospitalized, ECTed, medicated, all of that. Myself, I experienced all the borderline symptoms for not one single day, but many years.
      I know what it’s like. I just don’t believe in the false dichotomies of illness which psychiatrists have developed nor the idea that anything chemical or genetic is causing these problems. But the painful experience and distress people have, absolutely it’s real.
      I won’t call you an ass 🙂

      Like

      • I’m not a fan of labels myself and feel that everyone’s experiences of a particular ‘Disorder’ are very different and personal to them. Not everyone with Bipolar for example, will suffer with the same symptoms or strength of symptoms.
        Having given more thought to your ideas and beliefs, I’m beginning to see the validity and would like to take this opportunity to apologise for my rash previous comment. I would very much like to debate this subject further and understand more about your point of view.

        Liked by 1 person

        • Thanks… I’m not such a bad guy and actually do want to help people, probably very similar to you and the guy who originally made this post. I apologize that my writing had initially upset you.
          I’m trying to say that we should have the most empathic, human, accurate understanding we can of severe distress (this is my preferred term for mental illness). My bias is that traditional psychiatric diagnosis is not a particularly accurate way of conceptualizing people’s distress, as you seem to allude to also, although you may think of it differently than me.
          When I go on different online web boards, I notice that some people – a minority of people it seems – seem to be helped and comforted by the idea that their problems have “a name” (i.e. a mental illness diagnosis) because they feel this explains or captures what is going on. If this is actually helping then maybe diagnosis is not always a bad thing. My biased opinion is that the notion of a diagnosis helping is somewhat of an illusion, because diagnoses do not really explain why someone is distressed. We all know the classic interaction between patient and psychiatrist, “Why do you think I’m schizophrenic?”…. “Because you are hearing voices”… “Yes but why does that make me schizophrenic?”…. “Because that is one of the symptoms of schizophrenia”…. “Yes but that still doesn’t explain why I’m schizophrenic”… “You’ll just have to trust me, hearing voices is one of the things that schizophrenics do”… “ok doctor…” In other words, such a mental illness label doesn’t really explain why someone is having the experiences they are having.
          Part of my strong feelings on this come from my father (who was “bipolar”, although arguably mislabeled because he only had one manic episode his whole life, along with many depressive periods) because he was constantly obsessed with the label bipolar and truly thought if he only found the perfect combination of medication, his problems would be fixed. Of course it never worked out the way he wished, and he was never aware that factors like his mother abusing him, or his father being very distant, or the fact that he kept stressing himself out with jobs he hated, etc. were contributing to what was going on. And he never wanted to talk about his feelings, just try new pills. So all of this experience, as well as the nasty stigma around Borderline PD, biased me very much to be against diagnosis (by bias, I mean its neutral sense of influenced, not that I am totally biased, at least I hope not!!! 🙂 )
          Sure would be happy to hear some of your point of view.

          Like

  1. I wouldn’t want you to assume I agree 🙂

    Let me discuss a few of your points:

    Regarding homicidal fantasies and suicidal ideation being “abnormal” – I would say they are understandable reactions to extreme stress. I don’t feel that pathologizing such reactions is helpful, although it often happens because such strong feelings make people uncomfortable. Rather, being able to be with people in extreme states and accept that their homicidal fantasies or suicidal feelings make sense in the context of what they’ve experienced, is empathic and helpful. I’d much rather have been treated this way than be told my feelings are “abnormal” or the results of “an illness.”

    Do you think it’s more helpful to tell people that their suicidal feelings are “abnormal”?

    What I am questioning is not the existence of extreme distress or severely maladaptive ways of relating / managing feelings. Not at all. From my writing you can see I’m empathic about these real experiences. And, I’d add, they are real experiences that affect brain chemistry. My disagreement is that patterns of distress and the way complex life problems affect brain chemistry can be categorized reliably into “illnesses”, especially illnesses with the assumption that brain chemistry or genes are causing the problems.

    If you support the categorization of people’s problems as mental illnesses, perhaps you can offer some evidence that there are reliable biomarkers for so-called illnesses like depression and BPD?

    I’m not against that idea in theory. I just don’t think the evidence is there.

    Related to this, I was recently reading this essay by Thomas Insel, head of NIMH, in which he admitted that DSM categories are unreliable and that the NIMH should be “reorienting” its research way from symptom based illnesses:

    http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml

    As for medication bringing about “a remission of mental illness” – do you have something to back that up? Surely you know that medications on average are only 10-15% more effective at reducing distress than placebos, or sometimes no more effective than placebos… There are books on this like The Emperor’s New Drugs, Anatomy of An Epidemic, The Bitterest Pills, etc.

    And my advocacy is not for less stigma about mental illness, but for understanding severe distress in a less stigmatizing, more hopeful way. There’s a difference.

    Liked by 1 person

  2. I don’t think you can describe homicidal fantasies and suicidal ideation as “strong feelings.” These are more than strong, they are extreme. They are extreme solutions to problems. Usually, when the brain is doing something extreme, it’s sick. I’d call that an illness.

    Yes, I don’t mind telling people that suicidal thoughts are abnormal. But just because we have them doesn’t mean that we are abnormal. Sometimes, suicide is a reasonable option, and sometimes it’s not. Sometimes, our brains think about options in a logical way, and sometimes they don’t. When they don’t, perhaps our brains are sick.

    Even though I support the categorization of chronic pain as an illness — a medical condition — I don’t have any biomarkers or evidence to give you that it exists. There’s no reliable test for pain. I suppose you could tell me that my pain isn’t real because, like depression, there is no test for it. Doctors and insurance companies like to say my pain is subjective not objective. As if it’s the fault of patients that the medical industry hasn’t been able to create these tests yet.

    People have different ideas on what constitutes “evidence.” Medical science is all about theory — about proving a theory. But it’s not always right, especially when it’s written by those with ulterior motives. No, I don’t base my opinions solely on what medical science has to say. Because you never know when they’re going to be wrong.

    Yes, the new DSM is a joke. Everybody knows that. But that’s not a fact which supports your opinion that bipolar and depression don’t exist.

    The only time I’ve read something similar to “medications on average are only 10-15% more effective at reducing distress than placebos, or sometimes no more effective than placebos,” is when I’m reading about antidepressants. But even with those drugs, the effective percentage is probably a little bit higher. Ten to 15% is more in the placebo-only range.

    Your words can sometimes sound good, like your last paragraph. But I think it’s very disingenuous of you to tell others to reject psychiatry, while pretending to advocate for less stigma surrounding mental illness.

    Because this would include less stigma about suicide, and there are too many suicidal people out there who need professional help. And all that means is that they are currently unable to help themselves. Asking for help is a sign of courage, not weakness. Asking a psychiatrist for help with your coping skills or when your brain is sick is like asking a plumber to fix your toilet — there’s a better chance that professionals will do the job correctly.

    I’m sorry that you don’t want to be considered “ill.” You can reject this label if you want to. More power to you, dude.

    Liked by 1 person

  3. Hey, Dude 🙂

    Much of this debate comes down to semantics. I enjoy these conversations so I will respond to some of your points.

    First, don’t be sorry that I didn’t accept the illness label. From my perspective it’s a good thing!

    No one can practically prove that depression and bipolar do not exist – you are quite correct that my criticism of the DSM does not prove that. However, it’s equally true that there are no reliable biological or genetic markers for these “illnesses”. That’s why when I asked you to name biomarkers, you were wise to avoid that question. At this point, I think we must accept uncertainty as to whether depression and bipolar actually exist as reliably diagnosably medical illnesses. Perhaps biological foundations of these illnesses will be discovered in the future, we don’t know.

    I want to say again that I do think that people’s feeling depressed or feeling manic, etc., is quite real and worthy of being taken seriously and understood. Of course. How could I say otherwise – I’ve been through a hell of a lot of this pain myself.

    Regarding medication efficacy, I encourage you to read the books I referenced… and if you have some other books you think are good sources of information that you like, tell me about them. I think the efficacy of psychiatric medication is lower than commonly believed, partly because of the file drawer effect (i.e. studies showing poor results are rarely published) and also because of the distorted way that “effect” is measured (i.e. primarily symptom reduction, not functional or quality of life measures). This is reported in the books by Kirsch, Moncrieff, Whitaker, etc.

    Regarding chronic pain, sometimes it does have a physically identifiable cause, and sometimes it doesn’t. When it doesn’t, that is a mystery – you are correct that we don’t always have clear physical causes for physically expressed distress. But, most other physical illnesses do have a biological or genetic cause that can be measured, scanned, or identified in some way. In that way they differ from “mental illnesses” – at least outside of dementia, Alzheimer’s, etc., which are true brain diseases.

    Regarding, “it’s very disingenuous of you to tell others to reject psychiatry, while pretending to advocate for less stigma surrounding mental illness.” – No, I don’t advocate for less stigma surrounding mental illness. I advocate for less stigma via understanding emotional distress as primarily due to social and psychological factors, and thus not understandable or cureable in the same way as a physical lllness. As I said earlier, much of this argument may be about semantics. I do accept, of course, that emotional distress expresses itself in brain chemistry, which is not the same thing as saying that people’s reports of emotional distress is a brain disease.

    Regarding, “Asking for help is a sign of courage, not weakness. Asking a psychiatrist for help with your coping skills or when your brain is sick is like asking a plumber to fix your toilet — there’s a better chance that professionals will do the job correctly.” – Absolutely, asking for help is a sign of courage. Unfortunately, the 10-15 minute med checks that comprise most visits to a psychiatrists are unlikely to “do the job correctly”, in my opinion. I feel psychiatrists and therapists need to spend much more time getting to know distressed people, understanding their stories, and being with them on a level emotionally, instead of managing and drugging them. It’s unfortunate that such a low level of financial resources is available to provide the support, understanding, and love that severely distressed people need.

    If you have time, you might like this video –

    It’s pretty shocking some of the data this psychiatrist reports about stigma and diagnosis.

    Like

  4. “That’s why when I asked you to name biomarkers, you were wise to avoid that question.”

    Like how you avoided my question about whether you were a Scientologist?

    I didn’t avoid your question. Medical science isn’t avoiding your question. Just like biomarkers for Alzheimer’s have been found, researchers have also found biomarkers for depression:

    http://www.sciencedirect.com/science/article/pii/S0278584613002121

    I think they’re still trying to figure out what all these biomarkers mean, and how reliable they will prove to be, but that doesn’t mean they don’t exist.

    “But, most other physical illnesses do have a biological or genetic cause that can be measured, scanned, or identified in some way.”

    I don’t believe that’s true. I think there are plenty of physical illnesses that can’t be measured, especially pertaining to all the new chemicals added to our air and water. Some chemicals have been proven to be carcinogenic, but they don’t do a lot of testing on chemicals that might cause depression or bipolar.

    “I do accept, of course, that emotional distress expresses itself in brain chemistry, which is not the same thing as saying that people’s reports of emotional distress is a brain disease.”

    Most people who suffer from a verifiable brain disease also suffer from emotional distress. Which came first? Changes in brain chemistry don’t always mean the brain is sick, but it can be an indication.

    When you’re sad, you’re not clinically depressed. When you’re clinically depressed, you’re not just sad. Yes, there’s an awfully thin line between the two, but that’s how the brain works.

    No, 10-15 minute med checks aren’t enough, but seeing a psychiatrist for med checks usually means the patient is also seeing a therapist. At least, that’s how it should work. But now, a lot of the prescribing for depression and bipolar is done by primary care doctors, without the talk therapy. There will be patients for whom talk therapy doesn’t help, but I would guess that for most, it’s an important part of treatment.

    What I see you trying to do is equate emotional distress with illnesses like Major Depressive Disorder and bipolar. While they’re all a part of one another, they are separate conditions. Emotional distress could mean anything from crying over a sad commercial to grief. But to describe depression and bipolar as emotional distress is like describing high-quality chocolate as just plain sugar.

    Liked by 1 person

  5. Your question about scientology made me laugh; I assumed it was a joke and a rhetorical question. No, of course I’m not, the only thing I know about that group is that Tom Cruise is in it (?).

    I agree that reliable biomarkers may exist for so-called mental illnesses, although they have not yet been clearly identified. The speculative article you cited does not represent a confirmation of reliable biomarkers; rather, as the article says, the patterns of stress hormones it identified were peripheral and correlational. Hundreds of these articles are out there if you google depression and biomarkers; it’s easy to find biological patterns among people reporting depressed feelings, but not so easy to replicate the findings or to prove that these biological patterns represent a unitary illness.

    I think what is called depression would be better understood as a syndrome which can be caused by many different things and can exist in many varieties and degrees. It’s very hard to find biological causes for something like that, because such an approach is too reductionistic. That is my opinion.

    Here are thoughts from Steven Hyman, former NIMH director, on the failure to find reliable biomarkers for mental illness diagnoses – http://dana.org/Cerebrum/Default.aspx?id=39489

    As for your thoughts about “also seeing a therapist” being how it should work, absolutely I agree. Talking to someone and understanding what is going in someone’s life in context should be the heart of treatment, more than just getting a pill. But unfortunately it’s really common now for people to only get medicated and not get significant therapy. Here is an article on that trend:

    http://www.nytimes.com/2011/03/06/health/policy/06doctors.html?pagewanted=all&_r=0

    Unfortunately it’s more profitable, and easier, to just drug people with serious problems rather than spend time getting to know them.

    Lastly, your statement about different diagnoses being “a part of one another, but separate conditions” is confusing. Your idea seems to be that illnesses represent reliable entities which can be “carved at the joints” so to speak, or clearly divided, because they are separate entities at some level in nature. My position is that people’s ever-shifting problems are too complex to be accurately divided or concretized into illnesses like depression or bipolar. If you look at the reliability ratings for DSM diagnoses here (0.32), it’s pretty scary that this symptom chechlist is what most research is being based on:

    http://1boringoldman.com/index.php/2015/06/23/down-pat/

    A 0.20 reliability rating means that it’s pure chance whether psychiatrists will agree on what illness a person “has”. And depression is very close to that level. This is the problem when you try to reduce a syndrome or multi-determined set of problems into an illness. What do you think about that?

    Also, your thinking contains the assumption that severely depressed or bipolar people’s feelings and actions are “abnormal”, i.e. the way they feel and behave represents illnesses or an aberration of brain chemistry. I would argue this attitude is unintentionally somewhat stigmatizing – it’s more empathic, to me, to understand extreme distress as an expectable or understandable reaction to extreme circumstances. This relates to why abuse and trauma are so highly correlated with labels like depression, bipolar, and especially borderline PD and schizophrenia, an example being the research here described for so-called schizophrenia:

    http://psychcentral.com/news/2006/06/13/child-abuse-can-cause-schizophrenia/18.html

    Ok, that is enough for now.

    And if you don’t comment, I’ll just assume you agree with me 🙂

    http://psychcentral.com/news/2006/06/13/child-abuse-can-cause-schizophrenia/18.html

    Ok, that is enough for now!

    Like

    • I think you split a lot of hairs with your arguments. I think you don’t believe in psychiatry, even though talk therapy is a part of psychiatry. I think our understanding of the brain is in the beginning stages and this is all just theory.

      And lastly, I don’t think being abnormal is a bad thing. I use that term to differentiate some people who find it very, very hard to be the same as the majority of the population (who have been defined as normal or average).

      But as everyone knows, being normal is boring. 🙂

      Like

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