Originally published in Focus, June 2013.
The international war raging between the titans of psychiatry and psychology may not seem like “local” news. However, tens of thousands of local Victoria citizens have been seriously injured and now desperately need caring attention.
The stage was set 20 years ago, with the fourth edition of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM), the “bible” of mental illnesses. In recent years, Dr Allen Frances, who chaired that DSM-IV’s task force, has been writing publicly about his mistakes and regrets, and warning about the upcoming DSM-5. Frances has apologized profusely about how the DSM-IV led to diagnoses of ADHD, depression and bipolar spreading through the general population like flu bugs. And Frances recently lamented that DSM-5, finally released this May, is similarly “a reckless and poorly written document that will worsen diagnostic inflation” and “increase inappropriate treatment” as it defines normal, common levels of concern about physical health problems, grieving over a loss, and mild forgetfulness as mental illnesses requiring psychiatric drugs.
Frances’ credibility has lent weight to a broad movement against DSM-5. For example, a petition launched by the American Psychological Association and so far signed by thousands of heavyweights of mental health from around the world warns that the DSM has not been subject to independent scientific reviews and is “dangerous” to the public. Everyone, they argue, “should avoid use of DSM-5.”
Subsequent media coverage has been largely critical or even mocking of psychiatry’s seeming desire to diagnose, drug, and profit from every aspect of the human condition. In late April, mounting public embarrassment finally led even the US National Institute of Mental Health, the US government’s psychiatric funding and research arm, to distance itself. NIMH Director Dr Thomas Insel criticized the DSM-5’s “lack of validity,” and its diagnostic criteria based in backroom negotiations and “not any objective laboratory measure.” The government, Insel wrote, would henceforth be “orienting” its funding more towards genuine neuroscientific research.
The British Psychological Society then issued a call to throw out the whole notion that any mental-emotional distresses should be labelled as “diseases” or “illnesses” at all. The BPS argued we should be looking at and responding to all the social, economic, biographical, psychological, and biological stresses that influence people’s mental states.
Dr David Kupfer, chair of the APA’s DSM-5 task force, struck back and eventually the NIMH and APA issued a joint press release declaring themselves collaborators and not enemies in the proud marching forth of psychiatric science. However, along the way Kupfer was forced to concede, “In the future, we hope to be able to identify disorders using biological and genetic markers that provide precise diagnoses…Yet this promise…remains disappointingly distant. We’ve been telling patients for several decades that we are waiting for biomarkers. We’re still waiting.”
Kupfer’s confession, of course, was still one-half lie. What most psychiatrists have actually been telling the media and public for years is that there’s abundant evidence that depression, schizophrenia, bipolar and ADHD are biologically-based diseases which require primarily chemical treatments.
How many people are consequently taking psychiatric drugs here at home? When reading UBC’s 2008 RxAtlas examining drug use in BC, I was struck by some high numbers. I submitted requests for more data to the BC Health Ministry and discovered that between 18-25 percent of BC citizens are taking one or more psychiatric drugs. I was stunned. I didn’t write about these findings because I needed more data to be certain—data I was blocked from accessing. But recently, studies elsewhere in North America have found similar levels of psychiatric drug use in the general population, suggesting BC’s numbers are likely not far off.
So that means a staggering 65,000 to 90,000 people in the capital region are apparently taking one or more psychiatric drugs that used to be reserved for a tiny percentage of the population. Most of these drugs are known to cause dangerous side effects and long term damages, from diabetes, suicidal-homicidal ideation, cognitive decline, memory loss, emotional numbing, and kidney failure to permanent motor dysfunction and comas. Yet how many of these tens of thousands of people—likely persuaded during intimate meetings with their physicians that their most inner personal challenges were “diseases” requiring life-long treatment with daily psychoactive chemicals—will now be told all of that was just a lie?
Talk to your doctor.