Editor’s note: The opinions expressed here are those of the authors. View more opinion on ScoonTV.
America has a mental health crisis that continues to grow despite the staggering number of therapies and medicines that are widely available. Life for most of us is not any harder than it has been for previous generations. We have more access to technology and medicine that in theory should make us happier. Our mental health should be gradually improving with the more access we have. We are doing things our forefathers could never dream of. Yet, we are less happy in this country than we have been in 50 years.
Our current mental health condition is based on a few factors. The first factor is that mental health patients are widely overdiagnosed within the mental health field because of the way different disorders are classified. What qualifies as a mental disorder keeps growing and/or changing. As a result of the overdiagnosing, treating these disorders has led to the overmedicalization of patients. That truly does not lead to curing patients.
Overdiagnosis within mental health fields has become the unspoken norm. For example, a study conducted at the Johns Hopkins Bloomberg School of Public Health found that only 38.4% of people deemed clinically depressed met the 12-month criterion to be diagnosed as such, despite most of the participants already being on psychiatric medication. A 2019 report from the John Hopkins Early Psychosis Intervention clinic suggests that approximately half of the people referred to the clinic for schizophrenia did not actually have the disorder. A 2013 report examined multiple studies that indicated the overdiagnosis of bipolar disorder.
These are just a few studies to highlight the overdiagnosing of disorders, but it is not exhaustive. Many professionals and scholars know there is a problem, but there has yet to be a major audit or overhaul as an industry to clean up the way patients are diagnosed.
The main cause of overdiagnosing patients comes from the use of “The Diagnostic and Statistical Manual of Mental Disorders” (DSM). This guidebook, which was created by a group of psychiatrists, is the holy book of psychiatry. Mental health professionals use the definitions and symptoms in this book to diagnose their patients based on the book’s recommendations.
But the book attempts to pathologize normal everyday feelings people have into some sort of disorder. This can misrepresent many of the responses people have to adversity as mental illnesses. The more broadly the book defines psychiatric classifications, the wider the net is cast, and the more people are diagnosed with a disorder.
Dr. Allen J Frances, who headed the DSM-IV task force in 2000, summed this up perfectly in a 2009 article criticizing the task force for the subsequent edition (DSM-V). He said, “Undoubtedly, the most reckless suggestion for DSM-V is that it includes many new categories to capture the subthreshold (eg, minor depression, mild cognitive disorder) or premorbid (eg, prepsychotic) versions of the existing official disorders. The beneficial intended purpose is to improve early case finding and promote preventive treatments. Unfortunately, however, the DSM-V Task Force has failed to adequately consider the potentially disastrous unintended consequence that DSM-V may flood the world with tens of millions of newly labeled false-positive ‘patients.’ The reported rates of DSM-V mental disorders would skyrocket, especially because there are many more people at the boundary than those who present with the more severe and clearly ‘clinical’ disorders.”
Dr. Joel Paris, a psychiatric professor, encapsulates this phenomenon in his 2015 book “Overdiagnosis in Psychiatry: How Modern Psychiatry Lost Its Way While Creating a Diagnosis for Almost All of Life’s Misfortunes.” On page 13, he writes,
“Diagnoses are made rapidly – and often inaccurately. Instead of listening, and asking about current circumstances, psychiatrists focus on a checklist of symptoms, a kind of parody of the criteria listed in the DSM manual. Based on the answers to these questions, prescriptions will be written for almost every problem – and ‘adjusted’ every time a patient comes in feeling distressed.”
This leads to my next point; patients have been over-medicalized because of the overdiagnosing in the field. What’s worse is that there have been credible reports that some of these psychiatric drugs do little to help the symptoms of the disorders. There have been reports of overprescribing drugs to treat mental health when doctors should be looking at other options. There are articles from professionals about why antidepressants do not work in some cases and how the studies and literature have been curated.
These drugs have a strong influence on people’s minds. The fact that a large number of people in society are taking mind- and mood-altering drugs for conditions they don’t actually have is alarming. Psychiatric drugs have been touted as dangerous and high-risk. Some experts have said that they can do more harm than good. Sometimes these drugs have long-term effects and are even permanent. It seems that we are mentally regressing as a society. Instead of pausing to assess what is happening in the mental health world, professionals are pressing full steam ahead to stay in line with their industry’s recommendations. We are past due for these professionals to come together to address what is really happening.
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