I took some time to read the articles and then took too long in considering this post; it booted me out and have taken even more time to think about this since then. There is just so much in these articles, where to begin but have to be briefer this time; and yes, this is briefer, heaven help us.

From all the years of treatment and research....

The DSM is a merely a collection of observations and a tool. It is not definitive and cannot be used categorically to diagnose. It is merely a guide. As our knoweledge grows and changes so does it but at too slow a pace. So any provider that I have that thinks of it as a Bible is not the provider for me. I know it is needed as billing tool but should only be used as a guide and only that. We are all too different and too many exceptions to categorized one way or another. Is also a two-fold reason not to take too much stock in a diagnosis, it is too general to apply specifically and they have to have some way to label us for billing (so the closest one will do, so the docs can get reimbursed of our insurance benefits.)

Our knowledge is growing and changing, but the field as a whole is not organized and there is not consensus, very fragmented. There is also that fact that the system is caring for humans with such varying issues and being run by humans who cannot always accept limitations in their knowledge and accept failures in care. We are limited in our knowledge of the mind. I have had one provider in all of my years actually say, "I can no longer help you, but will help find someone can further your care." I wish there was more of it. It is not easy to accept limitations and failures for either party but would make the world a better place. Some times it is just due to lack of acceptance or losing hope that prevents someone either patient or provider to move on; some times it is unfortunately not wanting to transfer the patient b/c they'll lose income (there is some of this, though less for this reason as it is not a get rich field in the first place.) Providers as a majority really do care and want to help, it just seems either that just can't either accept or can't see that they aren't helping, or carrying a false hope that what they have been doing will somehow change things even though it hasn't been working (when treatment has been going on for some time.) Not to say that patients are always the best helpers in their own treatment; they don't always follow everything that has been asked of them either.

On another note, I have had unbiased, anonymous genetic testing that found markers for inherited mental illness. I have had brain scans that show a chemical imbalance. When they say it is not real, even if one did not have these things verified, anyone who has lived it knows it to be real. It really pisses me off. Chemical therapy is vital in such cases. However therapy cannot be overlooked. We are not taught skills growing up in western countries to deal with the lives we currently lead. Now whether illness is triggered by these lives b/c the tendency was there or caused by it, I am not going to debate but definitely influences both the chemical and emotional instability with mental illness and we do not have coping skills to deal with life as it currently exists.

The more I read about the successes of the various therapies based in eastern and western schools of thought applied to current times, CBT and DBT seem to influence mental illness more than any other therapy even chemical. Chemical is required for some illnesses but not alone; it must be combined with therapy as well.

The influence pharmaceutical companies have over chemical therapies is significant but must be kept in check with the discretion of the providers and the education of the patients in their care. There is little regulation for their activities otherwise. We need their R&D for the medications to treat and they are the forerunners in this working with the docs; however influence beyond that must be monitored and unfortunately there is very little so we must pay attention.

Our treatment options are limited at this time but are better than they have ever been, yet still need to improve. The need is too great for mental health care and growing. Why is that I wonder, lifestyle and life choice or genetics or both? The system does need to get better organized to better help us and accept what it does and what it does not know, stop pretending and promising what it cannot deliver. I continue to have hope that a treatment will always help. Now I know that even if it doesn't, it does not mean that I failed or that the provider failed, (I know for what they know, they really believed and tried); it just wasn't the right one for me.

It is vital in this process, as difficult as this may be, to educate and advocate for ourselves in this somewhat warped system that doesn't always have our interest at heart but instead the dollar as the bottomline. Only we can speak for ourselves and what care seems to be the best for us. If it is not working, only you know that after giving it a chance and then have to try something else. You are your best advocate in this system, educate and advocate.