Edward Hotspur

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Are Mental Illnesses Being Overdiagnosed?

Lately, there has been a surge of different diagnoses for seemingly normal behavior. It seems that ordinary behavior is being marginalized, compared to an objective standard of ‘normal’, for no good reason. But who is to blame for this? I think many people are.

1) Big Pharma
The pharmaceutical companies make drugs that help people. Ironically, they are also disincentivized to cure people. If they make a drug that cures someone of a mental “illness”, even if they charge an exorbitant amount for that drug, they only make a relatively small profit. However, if they make a drug that treats and/or improves the illnesses, they can make huge profits forever.

At the same time, they are disincentivized to cure rare diseases, for the same reason – small profit. They lean towards curing illnesses that many people have. And what happens when they have reached most of the people? When they have saturated the market?

They have to find new diseases, new illnesses. The power of suggestion is a tempting thing. That’s where these guys come in.

2) The Psychiatric Community
People visit psychiatrists and other mental health specialists in greater numbers now. The stigma of mental illness is gradually being removed. This is generally a good thing – but with a few side effects.

There are many issues that people bring to psychiatrists and psychologists that they can’t explain. They have no name for it. So when the mental illness of the month comes along, or big pharma makes a suggestion, it’s all too tempting to seize one of these as an explanation for otherwise normal behavior – especially in children. A child who has tantrums is diagnosed with “Disruptive Mood Dysregulation Disorder” instead of just ‘being a child’ – i.e., acting within normal parameters for a child.

I think there are other situations where this is true. If there is a traumatic event or situation, I think it is normal to react with sadness, withdrawal, and any one of a number of different human reactions. Everyone is different. This is why there can’t be just one drug to treat something, and can’t be a simple catch-all diagnosis to bestow on everyone.

3) The Media
2-3 years ago, it was all the rage to abstain from giving kids vaccines for fear it would cause autism. According to widespread reports, the onset of autism happened to coincide with the Mumps,Measles and Rubella, or MMR, vaccine. So of course one causes the other, right? Wrong. But the media reported on this as though it were true, because it was backed by science!

Unfortunately, nearly all of the evidence for this came from one study conducted by Andrew Wakefield. Wakefield was formerly Doctor Wakefield, but his license to practice medicine was stripped in Britain. He was the leading proponent of this erroneous claim – at least, until the ultra-idiotic Jenny McCarthy came along and amped this stupid claim up to eleven. She appeared on television and was actually treated as an authority, simply because she once took her clothes off and picked her nose on MTV 20 years ago.

Wakefield was found to have faked the data, and furthermore was found to have a financial stake in an alternative vaccine company, one that would have benefited greatly from the fooling of the public. And to this day, despite his claim being debunked, many stupid people still believe this is true.

At the same time, incidents of autism diagnosis have been on the rise for many years. This is in part because of improved detection methods, yes – but also an increase in massive media coverage, and in mental health professionals latching on to the label for lack of a better explanation.

This is just my opinion. I’d like to say that I’m not a Scientologist or something. I think the psychiatric community has merit and value. I also think many people legitimately need help, and in fact are helped by drugs they are prescribed.

I just think that two things may be at work here. First,psychiatrists and other mental health professionals are extremely reluctant to say they don’t know why or even if something is wrong, and they tend to grasp at labels that are virtually handed to them. Second, they seem to be equally as reluctant to say that there is nothing wrong, and what a person is feeling or acting out on is perfectly within normal parameters for human beings.

I am also not a doctor, so don’t take medical advice from me. I am merely suggesting that if you are currently taking something, and have been for quite some time with no “improvement” or change, please consider the possibility that there is actually nothing wrong with you. You are a normal human being. To use a metaphor, perhaps you merely need ‘reading glasses for the brain’, as opposed to ‘lasik surgery for the brain’.

Edward Hotspur

Update: CDC: 1 In 5 US Children May Have Mental Disorder

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42 comments on “Are Mental Illnesses Being Overdiagnosed?

  1. You make me want to cry and that’s no mood disorder either…there is power in your voice. Thank you. I was misdiagnosed once upon a time by some idiot….as Bi Polar. Ha! The pills NEVER helped, in fact they almost killed me so fuck psychiatrists that push drugs on people who are just “in love” or “weird” or “gifted”…..let’s make up a label for fraked up shrinks…like, I don’t know what? darling would you call them? :)

    • Edward Hotspur
      May 17, 2013

      Quacks? I don’t want to make you cry – but I wish shrinks realized that their patients can question physical diagnoses all day long, but mental diagnoses often go unquestioned because even the shrinks don’t know enough.

      • I wish they did too- and I am a psychiatrist. There’s not many of us left who do both active listening and critical thinking. It’s sad.

  2. Rachael Black
    May 17, 2013

    Here’s some background before divulging my thoughts on your topic:
    Have been a diagnosed Bi-Polar I (dysphoric mania, formerly called ‘mixed state’) for 15 years. For 23 years prior to that my diagnosis was Chronic Clinical Depression. I’ve been in analysis, therapy, and/or cognitive behavior counseling since the age of 14, and have been on prescription medication since my early 30’s. Oh, and my father a psychiatrist. Explains a lot heh.

    I do agree that mental illness is grossly over-diagnosed in children and adolescents.
    Also believe that too many physicians are prescribing anti-depressants -because they are now so readily available- but NOT following though.

    The point of medication, for the majority of people with depression, is to stabilize that person thus enabling them to take advantage of therapy. Unfortunately you have Dr. Joe Shmo, a general practitioner or internist, prescribing the meds but not referring the patient to counseling. We now have god knows how many millions of people on anti-depressants who in reality need therapy or analysis.
    People are lazy. Most are not going to seek out another doctor, counselor, mental health specialist and follow up.

    Personally, I’ve attempted getting off meds several times over the years. Seems my neurons are beyond hope and the f**king medication is a life-long (and life saving) situation.
    I’d give anything to throw them all down the toilet.

    My father specialized in addiction medicine the last 25 years of his life. He worked to get patients OFF psych meds. Most MDs out there want the best for their patients, and if you’re incapable of footing the bill for the newer meds they will find generic alternatives. Also, I know of three pharmaceutical companies who offer patients virtually free medication if they qualify under the financial guidelines.
    Doesn’t solve everything -2 of my prescriptions are not covered by Medicare or the Pharm houses.

    People need to be their own advocates. Take advantage of every bit of help you can find. It IS a matter of life and death and it IS still a stigma. On the other hand, feel free to get a handle on your fucking kids. Have two friends with autistic children, and would not wish this on anyone.
    On the other hand my own sister was given Ritalin as a kid 40 years ago (would be diagnosed ADD-something these days) and was in reality a pissed off, ignored child who did not need medication. She had no illness.

    Hotspur I agree that mental illness is over diagnosed. Nothing pisses me off more than to hear some idiot Hollywood celeb or Colorado murderer blame their newly diagnosed ‘illness’ for their behavior.
    I call BULLSHIT.

    • Edward Hotspur
      May 17, 2013

      Thanks for not punching me in the face, which is the reaction I expected with this post. Shrinks can totally help people, but for a lot of shrinks, it’s a crapshoot, and sometimes even shrinks make the mistake of treating the mind like the body. Break a leg, then you get it set, rest, it’s healed, you walk again. A few weeks. The brain isn’t like that. If set improperly, or incompletely, it heals wrong or not at all, I think.

      I’m sorry that you and others have been used as guinea pigs for various drugs and treatments over the years.

      • Rachael Black
        May 17, 2013

        I was NEVER a guina pig and I sought out treat at age 14. My psychiatrist father then believed that nothing could possibly be wrong with HIS daughter.
        Without the medication I would dead. Two suicide attempts taught me that.
        You should educate yourself on the state of mental illness in this country. While I agreed that I feel there is over-diagnosis in the past 10 years I also know that far too many people have lost their lives due to fear of seeking help, or, stopping their medication and therapy.

        Do not generalize about psychiatrists and the role of providing help to those who are in severe pain. If you haven’t been there you cannot know.

        It IS an illness. Cancer or Diabetes (which is ALSO amazingly over diagnosed) does not make others turn away from you. take away your ability to socialize, to find a mate who loves you despite your bouts of depression, or whatever manageable symptoms you suffer from.

        I am weeping as I write this.

        Edward, I appreciate your piece as I do all of your writing. I understand your points of view, even without agreeing with them.

        Make no mistake, I am NOT a victim and without psychiatry, counceling and advances in medication would be 6 feet under now. As opposed to the amazing and amusing woman who writes a blog, plays keyboards in a local band, and lives for Burning Man.
        xo

        • Edward Hotspur
          May 18, 2013

          I never said anything close to “all psychiatry is a sham” – in fact, I said it genuinely helps people. I was talking about only the part that not only doesn’t help people, but could be harmful or dangerous.

          I guess I’m not sure which part of my post you disagreed with. But I think you are awesome!

          • Rachael Black
            May 18, 2013

            Thanks Edward,
            no, you never said shrinks are a sham. and I don’y know a one who thinks they know everything . Been lucky. There are bad docs out there just as with every other profession.
            Appreciated the opportunity you’ve given me to vent -grin-.
            I had to STFU reading another commentator on here; would recommend that THEY seek treatment. you can lead a horse to water eh?

          • Edward Hotspur
            May 18, 2013

            You can say whatever you like. I don’t want to start massive flame wars, but things need to be worked out sometimes.

    • aliceatwonderland
      May 18, 2013

      Great response. It is true – you can’t just blame any illness for behavior – we’re all responsible. And it can be overdiagnosed – but also underdiagnosed. Some want a magic pill (which an antidepressant is NOT) and others will not get help for anything – they’d rather suffer. It’s sad. I’m glad you’ve hung in there. I’ll have to check out your blog.

      • Rachael Black
        May 18, 2013

        Thank you Alice. So happy you got my point, and you mentioned something I was thinking but did not articulate:
        Mental illness is horribly under-diagnosed. Especially in people who mask it by self medicating with alcohol and/or drugs. Be well. Going to check out your writing too.

        • Edward Hotspur
          May 18, 2013

          That is an excellent point, Rachael. I was only talking about people who actually went for help when I said ‘overdiagnosed’, but if you don’t go, and choose to self-medicate, you’re part of a large underdiagnosed crowd.

  3. aliceatwonderland
    May 17, 2013

    I’m surprised you expected to be punched in the face. It seems all the rage to put down shrinks and medicines of any sort, especially those damn antidepressants. Sorry, but there still IS a great stigma against mental illness, and many, many people who could be helped by these drugs or by psychotherapy who won’t go because so many people say exactly what you just did. I’ve been on antidepressants for years. Do they always help? No. But they help enough that when I’m not on them or on a lot less – like say during a pregnancy – I want to kill myself.

    I understand you say you’re not a doctor, and it’s just your opinion and this is mine – but I also speak from experience. I agree with you on the autism stuff – it’s ridiculous and I know many people who still believe the vaccines are harmless. I am also cautious about prescribing any drugs for children. But please don’t paint psychiatrists and antidepressants as the villain – too many already do that. Too many shy away from help they desperately need. Drugs and psychiatrists saved my life – literally. If a shrink is bad, see ANOTHER, or see someone. If a medicine doesn’t work, try another, or try going without. I did try – and it didn’t work.

    I’m sorry – I’m just very close to this topic, and I’ve seen it dissed over and over on social media. Sometimes it feels a bit personal, even though it isn’t. This was, for the record, a well-thought out essay.

    • I think medication is fine, but why give a depressed person a pill that has a side effect of SUICIDE? Are you willing to feel this side effect so your not sad? I think if you want to justify dangerous medicine, you are agreeing that modern psychiatric medication is ok? Did you know that the FDA approves this crap without any long term research. I don’t care if you have mental illness or not, who is going to make sure the pills they push on us are safe. You are accusing people of having a stigma against mental illness? No, I am trying to keep sick people from becoming sicker on these meds. AND the side effects of coming off the medication “mimics” the symptoms you started it for in the first place, thus making you think “one needs to take the med” Scary shit. I’m “mentally ill” according to some shrinks so why is my life better now than when I had some crutch like long term pill for short term problems. It happened to me and frankly I’m kinda pissed about it. Have a crazy day!

      • aliceatwonderland
        May 18, 2013

        Uh . . . you too.

      • Edward Hotspur
        May 18, 2013

        That can happen, yes. I also wondered about a depression medication with a side effect of suicidal thoughts. It would be like if Pepto Bismal had a possible side effect of diarrhea.

        I would hope that a person on such a drug would be closely monitored. I mean, a leg being broken versus fixed is easy to discern – you don’t even need any other legs to make that call. I think that psychiatric drugs, though, compare brains and brain chemistry to some sort of objective standard of normal. which necessarily involves an average of many other brains. More difficult to determine ‘fixed’ in that case – especially since they might not even be 100% sure if it’s ‘broken’.

    • nobodysreadingme
      May 18, 2013

      Valid point here. No my antidepressants don’t always stop me from feeling depressed. they do stop me feeling so bad I want to top myself. I’ve tried that twice.

      • Edward Hotspur
        May 18, 2013

        Then they are working for you, on the whole.

        • nobodysreadingme
          May 18, 2013

          In the main, yes. But as i’m sure you’re aware it’s an episodic condition, and pernicious, and debilitating. I wouldn’t wish it on my worst enemy.

          • Edward Hotspur
            May 18, 2013

            Well, consider this – drugs are finite. In other words, if you have a mild headache, you take 2 ibu, but if you have a bad one you might take 3. I’m not sure there is an equivalent for mental health drugs, but there should be. If the body can fluctuate, why can’t the mind? So it stands to reason that there would be times you need more and times you need less, but you have Drug X at Dose Y for weeks or months at a time, not by the day. Thus it has uneven results.

            Make sense?

          • nobodysreadingme
            May 18, 2013

            Preaching to the converted here. I spent over 20 years in various guises in the pharma industry. Reversion to the mean, where some days are bad, some days are good, but in general there’s an average that the sufferer oscillates around, is a common property of lots of chronic illnesses, as well as some acute ones.It will happen whatever you do. the drugs need to simply tide you over the bad bits, but particularly with antidepressants their effects take a long time to build up, typically two to three weeks.

    • Edward Hotspur
      May 18, 2013

      Thank you. I’m not dissing the entire community. I did say:
      “I think the psychiatric community has merit and value. I also think many people legitimately need help, and in fact are helped by drugs they are prescribed.”

      I am just pointing out that bad or uninformed mental health professionals can do far more damage for far longer than bad physical doctors.

      • aliceatwonderland
        May 18, 2013

        True. Which is why you have to shop around – for both medical and psychiatric doctors. I have had some lousy ones in both categories and it’s a big pain to switch but I did. Sadly there aren’t many choices in some communities. Sorry if I misconstrued your words.

        • Edward Hotspur
          May 18, 2013

          You’re fine. The thing is, it’s a huge effort for people to go to ONE mental health professional, much less question their diagnosis and get a SECOND opinion. Pair that with the fact that mental health is a relatively young discipline – they had to work through lobotomies and electroshock therapies AS TREATMENT just 50 years ago – and it’s scary.

          And when the mental health issue of the month comes along, it focuses attention and funding on the wrong things too much. But you’re right – if you’re limited by choices, whether from geography or insurance limitations – it sucks. Doctors should be like every other business, with the best ones getting more business.

  4. aliceatwonderland
    May 17, 2013

    Still believe the vaccines are harmful, sorry.

    • Edward Hotspur
      May 18, 2013

      Based on what evidence?

      • nobodysreadingme
        May 18, 2013

        I’m glad to see you’re trying to nail this old chestnut about vaccines, Edward. I’m of an age when measles was common because there were no vaccines. I nearlt died of measles, and I was a lucky one. There is absolutely no evidence of a link between vaccines and autism. There’s a cast iron link between measles and death, brain damage due to fever induced encephalitis… I don’t need to go on, do I?.

        • Edward Hotspur
          May 18, 2013

          I don’t think so. It’s pretty clear that vaccines are far more beneficial than harmful. It’s equally clear that the evidence against it was cooked for financial gain by Andrew Wakefield, and that ‘evidence’ has been debunked conclusively.

      • aliceatwonderland
        May 18, 2013

        I can’t figure it out. Basically they are taught to fear all doctors so if it comes out that the shots are okay, then they assume it’s a cover up – the whole conspiracy theorist thing.

        • Edward Hotspur
          May 20, 2013

          You said you thought vaccines were harmful, so shouldn’t you be saying “we” instead of “they”?

          • aliceatwonderland
            May 20, 2013

            There’s some confusion here – I think that one comment was cut off from another. I was trying to correct myself. Earlier I said many people still thought vaccines were not harmful, and really I meant to say THESE PEOPLE thought they WERE harmful. These people being those who believe the Jenny McCarthy bunk. I believe highly in vaccinations. My kids have them, and I know the theory about autism links was disproved a while ago.

            Sorry for the confusion.

          • Edward Hotspur
            May 20, 2013

            Oh. Okay, then. Cheers!

  5. Daan van den Bergh
    May 18, 2013

    You bring up an interesting topic, and i think you’re right in many cases. The commercialization of health card is the biggest problem in my opinion. When I was diagnosed with dysthymia i was lucky enough to have found a therapist that got into the job to help people and he did. My wife, among other things, nearly escaped from a human trafficing organization and suffers of PTSD. She wasn’t so lucky. All her therapists are obviously in it for the money. They keep you sick, cause they don’t want to lose clients.

    I once had a conversation with a children therapist and she said with a smile on her face: “oh well, if there were no children with issues I’d be unemployed!’

    Besides wanting to murder her, it sure as hell makes you think about the world we live in…

    • Edward Hotspur
      May 18, 2013

      Yes, I can’t get behind that attitude. If she had made it a goal to put herself out of work, that would have sounded better.

      Without going into details, my job requires me to be aware of ways to recognize and combat human trafficking. I have talked at great length with someone who rescued people as part of a task force on human trafficking. This is one of the most tragic and damaging experiences any human can go through, and in my nonprofessional opinion, virtually any reaction someone would have to this would be a normal one.

      • Daan van den Bergh
        May 18, 2013

        I can’t agree more. The people that are in this business are monsters. Without knowing I was talking to one, I have spoken to many of these people in my past and they are stone cold. People are products to them. It’s unbelievably scary in retrospect.

        • Edward Hotspur
          May 18, 2013

          To be fair, in a lot of cases it might be detachment that enables them to do their jobs more so than actual cold-blooded thought. I mean, imagine experiencing numerous cases where a child has… well, you imagine it. I’m not saying it.

          Still, I hope there’s still some compassion in there somewhere.

  6. EagleAye
    May 19, 2013

    No doubt. I agree that pharmaceutical companies are “disincentivized” to provide a cure. Other diseases seem to be popping up like weeds. My fave is RLS (Restless Leg Syndrome). Yes, there is actually an expensive drug for this. I have found that avoiding sugars and caffeine at night and drinking herbal tea clears that up straightaway for a ridiculous fraction of the price. Once, drugs were a godsend, now they seem to be a curse.

    • Edward Hotspur
      May 19, 2013

      And the off-label use is pretty widespread. Every so often it makes sense, but most of the time it’s just trying to stuff a new market.

  7. seablackwithink
    May 19, 2013

    well said. ..and its not just mental illness
    anythimg pharma and lower eschelon md’s can sink their greedy hands in…it will be done.
    i have to take medicine to live but not for one minute am i believer when i pick up my Rx ‘s every month and see ” your insurance saved you 2,987 bucks.
    BS!
    and when their drug losses its patent droping the price closer to 10 dollars.
    ..what do they do? slightly alter one conpound…claim it works better..repat
    ent…and..JACK UP THE PRICE
    its such a dirty bussiness,,!
    what a circus,,!
    cottom candy….50 bucks or highest bid,,,

    • Edward Hotspur
      May 19, 2013

      Yes, and once the patent expires and any company can make the exact same drug, they start slamming the drug. Like it was soap or toothpaste or something.

  8. I’m pretty sure I have at least 5 mental disorders -

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