Monday, November 30, 2015

From Disorder To Order

Human Spirit

“Chronic boredom — compensated or uncompensated — constitutes one of the major psychopathological phenomena in contemporary technotronic society, although it is only recently that it has found some recognition.”
Erich Fromm, 
The Anatomy of Human Destructiveness (1973)

When a machine is not working properly, it is viewed as being “out of order.” When a human being is not operating within expected and acceptable norms, he also is considered out of order. The psychiatric community says that he is likely suffering from one of a number of 250 mental disorders, all of which are enumerated in the American Psychiatric Association’s  Diagnostic and Statistical Manual of Mental Disorders (DSM), which is currently in its fifth edition, referred to as DSM-5. When this manual was first published in 1952, it listed 14 mental disorders.

The latest edition lists something called “Major Depressive Disorder,” which can now include depression while an individual is going through the process of bereavement. Gary Greenberg, an American psychotherapist, notes in an article  (“‘Dozens of mental disorders don’t exist’ and DSM-5 is ‘a fiction’ of ideology, U.S. therapist claims;” October 13, 2013), in The National Post:
“The exemption clause was an embarrassment because it challenged the idea that depression is caused by biology and led critics to demand that other external factors, such as divorce and redundancy, be exempt too,” he says. “So they got rid of it, which means that if you are depressed while bereaved you can be classified as mentally ill.” Not that bereaved people who are depressed shouldn’t be helped, he adds. “But is it really a medical problem?”
No, many would argue this is a human spiritual problem, which is outside the boundaries of psychiatry and the drug industry. While some think that the human brain operates in similar fashion to a machine, something that I do not subscribe to, the corresponding point here is that the human being, in being treated for a disorder, needs to be returned to a functioning order. Yet, the question to ask is whether even a highly trained mental-health clinician can diagnose a human in the same way one diagnoses a machine? The simple answer is “obviously not.”

Even so, to take this argument further, one can say with some persuasion that one cannot diagnose mental disorders in the same way as physical illnesses, that the brain is a separate and particular part of the human being, Thus, it is easy then to understand why a good part of the criticism directed at the DSM in particular and psychiatry in general is that it wants to treat mental disorders in the same way as physical disorders, which invariably leads to the prescribing of pharmaceuticals or drugs. Therapy, if it takes place at all, is often secondary or non-existent.

As does prescribing psychotropic drugs (“those that affect a person's mental state”) without proper evaluation by mental-health professionals; this is often done by primary-care physicians, says Brendan L. Smith in an article (“Inappropriate prescriptions”; June 2012) for the American Psychological Association. This might do more harm than good. Moreover, another important consideration is that what for long has been considered normal behavious is today deemed some sort of disorder, which greatly benefits the pharmaceutical companies. They do have seen their profits increase from the selling of drugs to “control” moods, many of which are now prescribed to children under the age of six.

Smith provides some important numbers to the argument:
The use of psychotropic drugs by adult Americans increased 22 percent from 2001 to 2010, with one in five adults now taking at least one psychotropic medication, according to industry data. In 2010, Americans spent more than $16 billion on antipsychotics, $11 billion on antidepressants and $7 billion for drugs to treat attention-deficit hyperactivity disorder (ADHD). The rapid growth of all three classes of drugs has alarmed some mental health professionals, who are concerned about the use of powerful antipsychotic drugs by elderly nursing home residents and the prescription of stimulants to children who may have been misdiagnosed with ADHD.
While it is not hard to see why pharmaceutical companies would like to encourage people to take their pills—they likely “believe” that they are effective and make nice profits in the process—it is up to the medical profession in general and psychiatrists in particular to act as gatekeepers. One has to wonder why, for example, one in 13 children in the U.S. are taking some psychiatric drug. This equates to more than 8 million children, including more than 2-million children on anti-depressants and more than 800-thousand on anti-psychotics. (For more, see CCHR, a U.S.-based mental health advocacy organization based in Los Angeles.)

Tom Insel, M.D., director of the National Institute of Mental Health (NIMH), argues in a blog post (“Director’s Blog: Are Children Overmedicated?; June 6, 2014) that if the numbers are increasing, then this describes a need that is being met;
The possibility that there is a real increase in the number of children suffering with severe emotional problems, just as there is a real increase in the number of children with diabetes and food allergies, is not even considered. Shouldn’t we be asking why so many children, at younger ages, are being seen for emotional and behavioral problems?
I agree; this fact requires further investigation; it might well be that something is not completely right with the current approach to mental health disorders. It would be easy to say that this might be some type of mental disorder! For now, let’s call it “Unnecessary Prescription Disorder.” But this is no laughing matter; seriously, I view a number of current factors are contributing in some way to an increase in the diagnosis of mental disorders, including poverty, loneliness, societal alienation, boredom, a lack of family permanence, a desire for immediate gratification, a superficial understanding of religion, a lack of general meaning or purpose, nihilism, and a loss of faith, whether in G-d or in the democratic process and governments.

Bettering one or more of these factors will decrease the number of persons who are diagnosed with a mental disorder. Of this you can be assured.