By Valerie Minard
Remember when a childhood temper tantrum, grief over a loved one’s passing, or the euphemistic senior moment was considered a “normal” part of life’s challenges? Well, the recent update of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5)–the leading authority on mental health diagnosis and research– has changed all that. Now grief over a loved one’s death could be diagnosed as severe depression. Tantrums or senior moments could be characterized as some cognitive disorder.
But critics, like Gary Greenberg, a psychotherapist and author of “The Book of Woe: The DSM and the unmaking of Psychiatry,” says the APA has gone too far. He believes they are undermining the “normal” human condition with the label of “mental illness”– increasing the trend towards a pill-popping culture. According to Greenberg, the DSM is a “fiction.” The new classification gives psychiatrists “dominion over the landscape of mental suffering” thereby creating a culture where “countless millions are hooked on powerful antidepressants to cure a mythical “chemical imbalance, while rates of mental disorders in children, including autism, bipolar illness and ADHD, have rocketed.”
In his book, Greenberg claims that the DSM has created “false epidemics” of over-diagnosis and over-treatment. For instance, when the diagnostic threshold for bipolar disorder was lowered in 1994, to include people without full-blown mania, diagnoses for its treatment skyrocketed along with prescriptions for mood stabilizers and antipsychotic drugs. “Suddenly, everyone and his brother was bipolar,” Greenberg says.
Allen Frances, author of “Saving Normal: An Insider’s Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life,” a semi-retired psychiatrist who served as the chair of the task force behind the DSM-5, agrees with Greenberg. He believes the United States is at a dangerous cross road, where both political and financial interests are convincing people that they are abnormal.
While Greenberg’s criticisms may appear exaggerated, many point to the APA’s unhealthy relationship with the pharmaceutical industry. According to Dr. Lisa Cosgrove, Associate Professor of Counseling and School of Psychology at the Univeristy of Massachusets, more than half of the DSM task force team writers had “one or more financial associations with companies in the pharmaceutical industry….The connections are especially strong in those diagnostic areas where drugs are the first line of treatment for mental disorders.”
If the DSM lacks validity in the eyes of many professionals within the psychiatric community, perhaps the public needs to be more circumspect about what diagnoses they are willing to accept for themselves. Many of the mental challenges people face like a childhood tantrum, grief, or forgetfulness, which were considered a normal part of the human condition up til this year, are temporary and can be overcome. The added label of mental illness does not increase the hope of improvement but creates an added burden to be lifted.
According to Philip T. Yanos, and his colleagues, David Roe, Paul H. Lysaker “The impact of the experience and diagnosis of mental illness on one’s identity has long been recognized; however, little is known about the impact of illness identity, which we define as the set of roles and attitudes that a person has developed in relation to his or her understanding of having a mental illness….[We believe] that accepting a definition of oneself as mentally ill, and assuming that mental illness means incompetence and inadequacy, impact hope and self-esteem, which further impact suicide risk, coping, social interaction, vocational functioning, and symptom severity.” In other words, if a patient begins to define himself as mentally ill, it becomes a self fulfilling prophecy in which hope of recovery is lost.
Even nineteenth century spirituality/health author and Christian theologian, Mary Baker Eddy, understood the mental influence that a diagnosis had on a patient’s thought. In her book, “Science and Health with Key to the Scriptures,” she writes, “Doctors should not implant disease in the thoughts of their patients, as they so frequently do, by declaring disease to be a fixed fact, even before they go to work to eradicate the disease through the material faith which they inspire. Instead of furnishing thought with fear, they should try to correct this turbulent element of mortal mind by the influence of divine Love which casteth out fear.” The good news is more and more people are questioning the validity of a medical diagnosis as the final answer. They are seeking alternative forms of treatment and choosing to take charge of their own mental health. Two examples are Kelli Montgomery and Elizabeth Kellogg.
After her first child’s stillbirth, Kelli Montgomery had to deal with heartache and grief. Although her physicians immediately suggested antidepressants and sleeping pills, Kelli chose rigorous exercise, yoga and meditation. “‘You need to be on this medication or that medication.’ It was shocking to me that that was the first line of defense,” said Montgomery, 42, director of the MISS Foundation for Grieving Families in Austin, Texas. “From the time I was in the hospital to when I was seeing my general practitioner, that’s what they were insisting on.”
Her decision to choose non-medical means was partly due to her aversion to taking prescription drugs. But, It was also the result of listening to a growing number of mental health professionals who believe depression and other normal responses to life’s hardships are frequently mislabeled as disorders– requiring medication often with dangerous side effects.
Elizabeth Kellogg, a Christian, went a different route. She had a mental breakdown a number of years ago and was diagnosed with bipolar disorder. “The doctors said that the disease was incurable. That it would become more severe as I aged, and that medication would be required for the rest of my life to control the symptoms. The diagnosis was devastating,” Elizabeth said.
After becoming dissatisfied with the side effects of medication, she began to explore alternative treatments such as energy healing, regression analysis, hypnosis, exercise, acupuncture, nutritional supplements, chiropractic care, etc. But, she received only temporary relief. Finally, out of desperation she turned to prayer.
“I can now see that as I tried each different therapy,” Elizabeth said. “I was gradually losing faith in the healing power of matter and the human mind. It wasn’t long before I again felt the childlike trust in God that had guided me for most of my life. I began to believe that God still loved me. I stopped taking the medication and kept praying….I knew that mental illness would not be victorious over my life….I saw the impersonal nature of the bipolar diagnosis and knew it was not part of me or anyone.” Eventually fear was replaced by a sense of well being and her joy returned.
Indeed, people like Kelli and Elizabeth, are reclaiming their lives– beginning with refusing to take on the label of mental illness. They made a choice and fought for their mental freedom. They reclaimed their mental health. You can too.