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Tuesday, January 03, 2006

HOW WE LIVE - A Psychiatric Review

Psychiatric diagnosis is used when doctors can't seem to find out what ails you, or won't take the time to try to figure it out. There is something here for you to think about, and if you need a real medical detective visit

Psychiatry's sick compulsion from the Los Angeles Times

By Irwin Savodnik
Irwin Savodnik is a psychiatrist and philosopher who teaches at UCLA.

January 1, 2006

IT'S JAN. 1. Past time to get your inoculation against seasonal
affective disorder, or SAD — at least according to the American
Psychiatric Assn. As Americans rush to return Christmas junk, bumping
into each other in Macy's and Best Buy, the psychiatric association
ponders its latest iteration of feeling bad for the holidays. And what
is the association selling? Mental illness. With its panoply of major
depression, dysthymic disorder, bipolar disorder and generalized
anxiety disorder, the association is waving its Calvinist flag to remind
everyone that amid all the celebration, all the festivities, all the
exuberance, many people will "come down with" or "contract" or
"develop" some variation of depressive illness.

The association specializes in turning ordinary human frailty into
disease. In the last year, ads have been appearing in psychiatric
journals about possible treatments for shyness, a "syndrome" not yet
officially recognized as a disease. You can bet it will be in the next
edition of the Diagnostic and Statistical Manual of Mental Disorders,
or DSM-IV, published by the association. As it turns out, the association
has been inventing mental illnesses for the last 50 years or so. The
original diagnostic manual appeared in 1952 and contained 107 diagnoses
and 132 pages, by my count. The second edition burst forth in 1968 with
180 diagnoses and 119 pages. In 1980, the association produced a
494-page tome with 226 conditions. Then, in 1994, the manual exploded
to 886 pages and 365 conditions, representing a 340% increase in the
number of diseases over 42 years.

Nowhere in the rest of medicine has such a proliferation of categories
occurred. The reason for this difference between psychiatry and other
medical specialties has more to do with ideology than with science. A
brief peek at both areas makes this point clear. All medicine rests on
the premise that disease is a manifestation of diseased tissue.
Hepatitis comes down to an inflamed liver, while lung tissue
infiltrated with pneumococcus causes pneumonia. Every medical student learns this
principle. Where, though, is the diseased tissue in psychopathological

Unlike the rest of medicine, psychiatry diagnoses behavior that society
doesn't like.

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