3/23/13

Psychiatrys bible, the DSM, is doing more harm than good - Washi

Sign In Register

Jobs

Real Estate Rentals

Cars

Print Subscription Today's Paper

Discussions

Going Out Guide Personal Post

Politics Opinions Local Sports National World Business Tech Lifesty le

OPINIONS
Home > Collect ions > Bipolar Disorder

Psychiatrys bible, the DSM, is doing more harm than good

By Paula J. Caplan, April 2 7 , 2 01 2

About a year ago, a young mother called me, extremely distressed. She had become seriously sleep-deprived while working full-time and caring for her dying grandmother every night. When a crisis at her sons day-care center forced her to scramble to find a new child-care arrangement, her heart started racing, prompting her to go to the emergency room. After a quick assessment, the intake doctor declared that she had bipolar disorder, committed her to a psychiatric ward and started her on dangerous psychiatric medication. From my conversations with this woman, Id say she was responding to severe exhaustion and alarm, not suffering from mental illness. Since the 1980s, when I first made public my concerns about psychiatric diagnosis, I have heard from hundreds of people who have been arbitrarily slapped with a psychiatric label and are struggling because of it. About half of all Americans get a psychiatric diagnosis in their lifetimes. Receiving any of the 374 psychiatric labels from nicotine dependence disorder to schizophrenia can cost anyone their health insurance, job, custody of their children, or right to make their own medical and legal decisions. And if patients take psychiatric drugs, they risk developing physical disorders such as diabetes, heart problems, weight gain and other serious conditions. In light of the subjectivity of these diagnoses and the harm they can cause, we should be extremely skeptical of them.
Ads by Google

File for SSI Disability Find Out If Y ou Qualify For Social Security Benefits. Free Evaluation! SocialSecurityLawFirms.com/Benefits

Psychiatric diagnosis is unregulated, so the doctor who met briefly with the aforementioned patient wasnt required to spend much time understanding what caused her heart to race or to seek another doctors opinion. If he had, the patient would have realized that her bipolar diagnosis wasnt necessary or appropriate. Neither on her ER trip nor in later visits to therapists did anyone explain how sleep deprivation impairs the bodys ability to handle pressure. In our increasingly psychiatrized world, the first course is often to classify anything but routine happiness as a mental disorder, assume it is based on a broken brain or a chemical imbalance, and prescribe drugs or hospitalization; even electroshock is still performed. According to the psychiatrists bible, the Diagnostic and Statistical Manual of Mental Disorders (DSM), which defines the criteria for doling out psychiatric labels, a patient can fall into a bipolar category after having just one manic episode lasting a week or less. Given what this patient was dealing with, it is not surprising that she was talking quickly, had racing thoughts, was easily distracted and was intensely focused on certain goals (i.e. caring for her family) thus meeting the requisite four of the eight criteria for a bipolar diagnosis.

Ad

We

A w

articles.washingtonpost.com/2012-04-27/opinions/35450916_1_bipolar-disorder-psychiatric-ward-psychiatric-drugs

3/23/13

Psychiatrys bible, the DSM, is doing more harm than good - Washington Post
Psy chologists seek authority to prescribe psy chotropic m edications
March 21, 2011

When a social worker in the psychiatric ward advised the patient to go on permanent disability, concluding that her bipolar disorder would make it too hard to work, the patient did as the expert suggested. She also took a neuroleptic drug, Seroquel, that the doctor said would fix her mental illness. Over the next 10 months, the woman lost her friends, who attributed her normal mood changes to her alleged disorder. Her self-confidence plummeted; her marriage fell apart. She moved halfway across the country to find a place where, on her dwindling savings, she and her son could afford to live. But she was isolated and unhappy. Because of the drug she took for only six weeks, she now, more than three years later, has an eye condition that could destroy her vision.
Ads by Google

Space in Va. group hom es scarce, som e m entally ill languish in state care
June 26, 2012

Find More Stories About

Bipolar Disorder

MyFax Online Fax Service

Send & Receive Faxes Through Email. Only $10/Month, Get a 30 Day Trial!
www.My Fax .com/FreeTrial

This patient is well-educated and white, and before her illness, she was wealthy. Research reflects that she was more likely to be diagnosed as mentally ill than a man in her circumstances. Racism, classism, ageism and homophobia can also affect who receives a psychiatric diagnosis. It would be less troubling if such diagnoses helped patients, but getting a label often hinders recovery. It can lead a therapist to focus on narrow checklists of symptoms, with little consideration for what is causing the patients suffering. The marketing of the DSM has been so effective that few people even therapists realize that psychiatrists rarely agree about how to label the same patient. As a clinical and research psychologist who served on (and resigned from) two committees that wrote the current edition of the DSM, I used to believe that the manual was scientific and that it helped patients and therapists. But after seeing its editors using poor-quality studies to support categories they wanted to include and ignoring or distorting high-quality research, I now believe that the DSM should be thrown out.
Ads by Google

Coping With Depression?

See If These Signs Apply To Y ou. Find Help For Depression Now.
DepressionHelpNow.net

Continued

Next

Recommend

3.9k

Tw eet

200

FEATURED ARTICLES

2014 Subaru Forester 2.0XT Premium: A station wagon thats easy to love

Notes from a newly converted juicer

C.S. Lewis: A Life, by Alister McGrath

More:
Olive oils health benefits? Its a slippery question Obama grants pardons to 17 people for nonviolent offenses Why Isn't The Dodge Dart Selling? The Secret to Cleaning Grout in Tile Floors The best and worst small businesses to start in 2013 Food stamps put Rhode Island town on monthly boomand-bust cycle

articles.washingtonpost.com/2012-04-27/opinions/35450916_1_bipolar-disorder-psychiatric-ward-psychiatric-drugs

2/3

3/23/13

Psychiatrys bible, the DSM, is doing more harm than good - Washington Post

372
Comments
y a zm i n el gh a z w r ot e:
5/6/2012 4:17 PM EDT

This is precisely the reason I gave up on a career in mental health counseling after obtaining a Master's degree! Working for one year in the field showed me that diagnosis was the beginning and the end for any person, even children as young as five years old were receiving diagnosis of Bipolar Disorder. I mean seriously, can we really predict or say with absolute certainty that a child who was messed up by an alcoholic father and a missing mother is Bipolar because he has issues with authority and conduct??? What the kid needed was a normal. loving family that could set proper boundaries for behavior. Not a psychiatrist telling him he is Bipolar and then putting a FIVE YEAR OLD CHILD on medications to cure his Bipolar behavior! I wasted too many years studying for a degree in a field I was ashamed to be in. I had believed that counseling was about COUNSELING a person and helping him or her cope with the stress that life brings. Thanks to the DSM I never got to practice the way I would have liked to. Thanks to the DSM that five year old and countless like him will remain in psychiatric wards until they can graduate to other state institutions. Very sad state of the field of Psychology.

Sa sh a 7 w r ot e:
5/3/2012 8:52 PM EDT

The author here is makng a sweeping claim, that the DSM does more harm than good, and offering not the slightest bit of evidence to back it up. The story of one woman, who might not even exist, for all we know, is emotionally manipulative, but useless to any attempt at a meaningful discourse around these issues. Weak. So, so, weak. I expect better from the Washington Post. This is appalling,

Gr een goddess1 r espon ds:

5/8/2012 1:34 PM EDT

This is a short op-ed. If you want the evidence and a fully fleshed out argument, I invite you to read Dr. Caplan's BOOK, "They Say You're Crazy." She was on the DSM committee, she's seen it from the inside.

View all comments

Add y our com m ent | Reply to a com m ent | Recom m end a com m ent | Report an offensiv e com m ent

More from The Washington Post

Suspect accused of NY moms death, childs rape, beaten in jail, nose broken The Washington Post - National News Parents of murdered teen say convicted M ich. grandmother, 75, a monster, son vindicated The Washington Post - National News Carolyn Hax: A husband who gets angry when he feels disrespected Featured Articles From The Washington Post M iss M anners: Best friend forever may not be that for long Featured Articles From The Washington Post Sen. Rand Paul: Illegal immigrants should be allowed to obtain legal status Featured Articles From The Washington Post

Sponsored Headlines
10 Early Signs of M ultiple Sclerosis Caring.com

[What's this?]

10 Tips for Keeping a House Clean Despite ADHD Health Central 'Ghost Cruise Ship' Suddenly Appears in the M iddle of the Ocean CafeMom She Talks Too M uch: Could it Be ADHD? Lifescript.com Nature's Antidepressants: You Won't Believe What They Are! Health Guru

washingtonpost.com

2013 The Washington Post

Terms of Service

Privacy Policy

Submissings and Discussion Policy

Ad Choices

Index by Date

Index by Keyw ord

articles.washingtonpost.com/2012-04-27/opinions/35450916_1_bipolar-disorder-psychiatric-ward-psychiatric-drugs

3/3