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New Mental Health Disorders, Coming to A Neighborhood Near You—Dysfunction and Diagnosis Enough For Everyone!

Doctor with inkblotWhen bad things happen, like the shooting at Newton or in Aurora, our country revisits the idea of “mental health.” The truth about mental health care is that it is a fairly new field and as such, has yet to grow into itself. Theories abound and medication for what a group of guys in lab coats deem to be a mental illness is often worse than the condition it’s supposed to treat.

We live in a climate that does not fully support mental health. I am not just talking about the ability to talk to a psychologist or have your M.D. write a script for Prozac or Zoloft. I mean that we live in a country that is not conducive to the health of the psyche. We hold little value for personal silence, reflection or the contemplation of life. The community that we all crave is being taken over by inane relationships on Face Book, that we convince ourselves are real. We seem to have lost the ability to make eye contact, because thumbs are flying over the keys of our i-phone hoping beyond hope to somehow “connect.” And all the while, advertisers mark us to sell us the products that we need to make us full and better people—something to whiten our teeth, shine our hair, thin our thighs, make us look cool. And maybe, just maybe if we use some of these products we will attract the friendships, intimacies and relationships that are part and parcel of being a healthy human.

In recent weeks a new manual, a bible really, of disorders, dysfunctions and illnesses has been released by the American Psychiatric Association. It’s called a “Diagnostic and Statistical Manual of Mental Disorders.” In this book, with these codes, you have a mental disorder if you grieve for too long and your therefore you may require Psychiatric Intervention. Translation: a drug for what ails you.  Similarly with restless leg syndrome, caffeine withdraw and premenstrual dysphoric disorder. Under the guidelines of this new manual, over 50% of the population would require medication for something, and that is good news for the pharmaceutical industry which takes a certain kind of perverse glee in people staying sick and profit margins staying fat.

It’s as though every emotion can now be considered pathological and your lack of happiness is treatable through the chemistry of Big Pharma. There is no normal anymore. Worse, no “quirky” normal. For anyone who is familiar with the suffering and loss of life, familiar with the harmless nuances of “everyday”neurosis, there’s a diagnosis, a handy code for the insurance company, and a new pill coming your way, courtesy of Pfizer. Navigating the rough events within our lives, teaches us to be more compassionate and often more grateful individuals, a process denied us by brain drugs.

This is the last stripping away of any real mental “health” as far as I am concerned. When we start putting the reactions and emotions of people into categories and boxes to be “treated” instead of assuring and reassuring folks that the challenges of life are what being human is, we have forgotten that we are supposed to evolve and mature throughout life as a result of the rough patches. The common thread, not talked about, that weaved its way through the perpetrators of Columbine, Virginia Tech, Newtown and Aurora, was that they were all medicated. The best intention of helping by the psychiatric  industry can and does create a kind of chemical brain soup, courtesy of the drug companies that surprises us with consequences that we cannot yet predict.  A refillable prescription for an SSRI (selective serotonin uptake inhibitor like Prozac), chased by a cocktail of Abilify, a popular anti-psychotic, takes about 10 minutes of face time with your M.D. who may not be trained by anything other than the Big Pharma literature that a perky drug rep dropped at his or her front desk.

Unfortunately, unlike the things that we can put under a microscope to determine the need for antibiotics, no one can put mental health diseases or disorders under the same kind of scrutiny, so the medication of such things is a roll of the dice. I am not against medication. Some people are in such a bad state that medication may help, and I do not think that anyone should have to suffer; but I do think we medicate too much and too often, for too many things– and in too many instances we medicate when it is not needed. Even the best medication is often a band-aid that does not address core issues. It’s interesting to note that there is a diagnosis for “too much grieving,” but I wonder if some of the problem is that we live in a country where people don’t get to, or don’t know how to grieve, and the lack of the grieving process will then manifests itself in symptoms. A pill cannot teach you how to grieve or how to let go.  These are life lessons that should be far removed from medication.

This morning I made my list for achieving good mental health, because I am one of those individuals who left to the devices of modern-day psychiatry would probably be medicated. I deal with a life where anxiety comes and goes; where fear is sometimes way too familiar a companion; and where sorrow can overcome me. But I honestly do not think I am alone in this. I think that what I have described is just part of being alive and that it’s less a disease or dysfunction, and more the nuance of being sensitive, creative and struggling for awareness. So, here is the list that helps me:

1. Distinguish between depression and sadness. Sadness is part of the messiness of life and depression keeps you from getting out of bed. Sadness does not need medication. Sometimes you hurt and sometimes you feel good. That’s just the stuff of life.
2. Make friends. Set aside time to get a coffee or go for a walk with someone and listen to their story…share your own. We all need a tribe to which we feel we belong.
3. Exercise. A good, brisk walk, will get the endorphins going and can help snap you out of a melancholy mood.
4. Don’t drink too much. Alcohol is a depressant.
5. If you don’t have an animal, volunteer at a shelter. You’ll meet potential friends and animals are great healers.
6. Nurture a creative outlet: dance, art of any kind, writing. Express the light and the dark. A lot of good art takes form in the shadow.
7. Avoid self-diagnosis and instead rely on something inspirational. I have a few books that I dive into when I get blue. These days I like reading David Steindal-Rast, who has made and entire career of promoting gratitude. Good stuff.
8. Reach out to the world. I have found that a little volunteer work goes along way in soothing a troubled heart.
9. If you are having a rough time—belly breath for ten minutes. It’s good to develop some kind of meditation or prayer practice that gives you a place to let go your burdens and reclaim your breath. When you breath just in your upper chest—it’s like panic breathing, so deep belly breathing can literally lower your blood pressure and make you feel calm.
10. Don’t get too lonely, too tired or too hungry. Did you know that the symptoms of depression look just like symptoms of exhaustion?

So probably none of that will revolutionize mental health care, but it seems worth mentioning that there are too many diagnosis and too many pills and life was never meant to be a smooth, one-dimensional ride without strife.

Author:

Novelist, essayist, blogger, wife, dog-mommy, dancer, dreamer, grateful.

19 thoughts on “New Mental Health Disorders, Coming to A Neighborhood Near You—Dysfunction and Diagnosis Enough For Everyone!

  1. The whole idea behind the Doctors nowadays, as far as I’m concerned, and this is my personal opinion and that of many others, is to not let the person die but not make them totally well. They want to keep people in a space where they have to keep coming back, and them….well… profiting from the misfortune of someone else. Our society has created this! And we have permitted it! Studies have shown that 80% of disease is due to stress, and unresolved issues that we have no knowledge of how to handle because the solution has always been, take a pill. We have the capacity of healing ourselves but we need the awareness, the tools, the motivation, and determination to do so. If we take the route of the pill, it is the path of least resistance and the consequences are exactly what we are seeing now. If we choose to investigate, reflect, and search out the knowledge that has been lost thru the years that is what would be best for us, then we can begin to heal ourselves without any chemical substance. By getting to the root of what has caused the ailment to begin with, we can start to heal ourselves and eradicate the problem from its root not placate it with a pill which will not address the issue and that will keep us reliant upon it.

  2. I agree that the precursor to disease is stress! Seems like that would be a good place to begin health education–how do you deal with your stresses? Thanks for stopping by and commenting. I appreciate you.

  3. Brilliant post. Stress and anxiety are the true killers – they destroy SO much, and alter so many normal functions in such negative ways. I hold out hope, but I do not believe that I will ever see a true change in mental health treatment in my lifetime. Peace . . .

  4. Gret post. I know the struggle with anxiety. a few years ago, I wa struggling and my GP refered me to a Psychiatrist because I needed some time off work and the Insurance co. wanted a referal. The Psychiatrist diagnosed me as Bipolar and wanted me to go on Lithium. a drug that requires periodic blood tests because it can damage the liver. I refused. I am no Doc, but I am not bipolar. I wonder how many people are drugged in error with the wrong meds. It is a sad state we are in.

  5. Beautiful post. I agree that we seem to try to “quick fix” a solution. Your list of ideas is very helpful. I think we are quick to forget that we still have some control over ourselves and I believe that actions like these will truly help everyone. These things take time, though. And that is something we seem to have the least amount of.

  6. I believe this problem is one of the most lethal offshoots of consumerism.These big Pharma industries and their enticing methods have us all believing in miracle drugs that are in reality nothing more than flying unicorns..Like you said, extensive medication for anything and everything is fatal! I hope your post helps people realize that they still have control over how they feel and think.Going back to the basics is what we need to do..Kudos!

  7. Oh, I so know what you are saying. At the present tme, I’m taking 2 drugs for depression, 1 for anxiety (5 a day), and1 to prevent hallucinations, I am taking maximum doses of every one. I should be a walking zombie with all those drugs in me. How would I know if I didn’t have one of these problems anymore?

  8. A wise post, and I agree with most everything you say. Still . . . Based on observation of people I have known well, or only in passing, I think it is equally true that many people have a real phobia about going to a doctor. People who desperately need help often have an unreasonable fear of taking any pill, for any reason.

    Everywhere I look, people are self-medicating with all the wrong things. Alcohol, illegal drugs, caffein, nicotine. These substances, or course, are not always bad. Alcohol and caffein, IMO, are fine, in moderation. A cup of coffee or tea may be just what someone needs to get through the day. A glass of wine might be perfect after a day of stress. It would be terrible if we stigmatized a cup of coffee or a glass of wine. Moderation is key.

    My point is that far too many people self-medicate with alcohol, sometimes out of fear of doctors or pills. Alcoholism to the point of physical decline and death is common. Buying a six pack of beer is as normal as apple pie, but taking Prozac is seen as a weakness.

    Your observations about the power of the pharmaceutical industry and the limitations of the 10-minute prescription process are right on! Health insurance coverage of mental illness is extremely restricted. For a person whose functioning is impaired by a mental illness, it can be nearly impossible to access competent mental health care.

    It is not true that all pain and dysfunction is “normal.” It is easy to deny obvious symptoms and pain, especially if it’s someone else’s pain. Let’s just have another beer.

    I agree that overuse of prescription drugs is widespread. At the same time, I think access to competent mental health treatment is extremely limited, and that DENIAL of mental illness is epidemic.

  9. John, I always appreciate your thoughtful and insightful comments! To be clear, I do not see Prozac as a weakness; that being said the META Studies on SSRI’s show that SRRI’s like Prozac have little effect. So now we add an anti-psychotic like Abilify to the mix and voila!– brain chemistry soup. The etymology of the word “physician” means one who gives “physiques” or remedies. The etymology of the word “doctor”means one who teaches. We have too many physicians who think that their “remedies” i.e. drugs, are the be all end all of “science” and too few doctors, meaning educators who work with the patient to find solutions for pain and suffering. These days, I think there is less a stigma about Prozac type drugs than there is a fear of getting onto a psych-med that few physicians have a real process for weaning down or off of.

    Too, it would be too simplistic and one sided to say that medication does not have a place in mental health care. Clearly it does. Mental illness that results in violence, hallucinations, voices that compel an individual to do harm to self or others can and does benefit from psychiatric intervention and closely monitored medication. But so much medication for the stuff of life that ails us, i.e. Prozac type drugs has made the profession a puppet of Big Pharma and has, in my opinion, thwarted the potential growth and development of psychiatry by turning it into a venue for drugs only. Or worse, these drugs are freely given out in 10 minute office visits with a G.P. without there ever being benefit of a psychiatric evaluation. It seems that we are passing these drugs out to too many people for too many things. In the city in which I live, I know of a psychiatrists who teaches patients meditation and breathing, and these forms of intervention are tried with talk therapy before any medication is considered. These are the kind of doctors that are needed in mental health care.

    Clearly, a larger dialogue is necessary, along with a more accurate definition of “mental health.”

  10. First, I am a lay person with absolutely no expertise in psychiatry or psychology, except my personal experience and observations.

    Now then: HOW MUCH does the excellent psychiatrist in your city charge per hour? Do any HEALTH INSURANCE cos reimburse for this doc’s services?

    Restricting access to SSRIs from family docs would have the same effect as restricting access to contraceptives, for instance. It would have the effect of PREVENTING many people, especially people who can’t afford expensive psychiatrists, from obtaining needed medication.

    Explain “little effect.” Are all studies definitive? Sometimes SSRIs are wrongly prescribed by docs with little knowledge of psychiatry. But also, prescription of these drugs is still a matter of trial and error, even for competent psychiatrists. Importantly, for some patients, SSRIs do work. Sometimes they work wonders!

    The state of the science presents us with a DILEMMA. For a person suffering abnormal and painful levels of anxiety, depression, or OCD, prescribing drugs such as Prozac or Xanax often has little or no risk. At the same time, the benefit can be significant, even to the point of saving a life, or at least permitting a mentally ill patient to function. So the doctor and the patient have to DECIDE. No one else can stand in the place of the doctor and the patient.

    It’s not a perfect situation. If the SSRI doesn’t seem to have effect, it should be discontinued. Try something else.

    It’s true that many people take two or more prescription drugs for physical or mental illnesses. Many of these drugs do not have adverse interactions. Sometimes two or more drugs can work together better than one drug alone. I agree that taking multiple medicines should be done only with caution, authorized only by competent doctors, and ideally with the decision backstopped by competent pharmacists.

    Sorry for stating my opinions strongly, but I don’t have time to smooth off the hard edges. You should take what I say as opinion, not fact. I have seen many people suffer, and am aware of some people who have been helped. I believe no one should have to suffer because of prejudice against a particular treatment.

  11. You never owe an apology for strong opinions…at least not to me. I happen to enjoy your passion for the various subjects you write about. To be clear: I do NOT see any shame in needing or taking an SSRI. And I also stand by the fact that META studies (these are the large studies that overview all of the smaller studies) on SSRI’s state that the drug is not effective for dysthymia (low grade depression) and only works for very severe cases of depression. So my question remains the same: why are we medicating so many people for so many things? Further, I never suggested that doctor’s be limited to prescribing SSRI’s, but do believe that many doctors need a greater guideline that prevents them from just passing the stuff out because someone is having a tough time. So my prejudice is never toward the patient, but it is toward a Big Phama Industry that tells us all we need to do is take a pill–my post was intended to be “Proceed With Caution” thought provoking tale about how we might better deal with mental health, drugs or not. Obviously the conversation in this country needs to continue as there is a lot to be said!

  12. And your excellent observations, as well, my friend. I appreciate being challenged and yes, we do agree more than we disagree on this subject. Thanks for sharing your comments. I appreciate you. 😉

  13. Hi Stephanie
    Thanks for liking my blog a week or so ago. It’s been fascinating to read your post and the comments to it.
    I’ve got an article coming out in New Zealand either tomorrow or next Sunday in The Herald on Sunday. It’s about the demise of talk therapies. It’s a news story – so pretty short but it addresses some of the things you’ve talked about. One of the psychotherapists I interviewed said “If only they’d ( govt) put the money into mental health in the first place as prevention, then health would be better overall, and would cost the government a lot less.”
    At the moment in New Zealand several gov’t departments are cutting back on offering counselling, psychotherapy, or even cutting it out altogether.
    It’s a sad state of affairs and it brings me back to the homeless issue. This same ‘shrink’ told me that most of the govt’s metal health expenditure goes on the ‘most unwell’ which is about 3% of the nation i.e the ones in a ‘revolving door’ of streets – hospitalisation – medication – streets.
    I feel as a people ( in the West) we have access to so many life saving things. But so many of us feel isolated – and this is different to healthy periods of ‘being alone.’ In some ways, people have taken anti-depressants as an antidote to this, but it is not the panacea we think. The challenge is: how do we make ‘talking’ and being a part of the community more accessible? Who pays? It’s a tough one.

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