[pachyderm]

I thought this was a good discussion of the whole DSM diagnostic process:

http://www.psychologytoday.com/blog/...-trouble-dsm-5

[spondiferous]

"DSM's approach is similar to attempting to salvage a house, falling apart because built on an unsound foundation, by adding to it a fresh coat of paint and new shutters. What is needed, in contrast, is to dismantle the structure, establish a solid foundation, and then rebuild the house on top of it."

Nuff said.

[ECHOES]

Consider, for example, medical (i.e., applied biological) specializations such as gastroenterology or pulmonology: is it possible to imagine a physician who would be unaware that the process of digestion is necessarily affected by the nature and quantity of food the stomach digests, or the process of breathing by the nature and quantity of the air inhaled? No, because this is what our organs do: they process intakes from the environment, and these intakes have at least as much to do with our health and illness as the structure and physiology of the organs which process them. Yet, we forget this when it comes to the brain and mental processing—the mind.

The environment of the human brain is far more complex than that of the stomach and lungs, or than the environment of the brains of other animals. Most of its intakes come not from the organic and physical world, but, instead, from the world of meanings and symbolic systems which convey them, that is, culture. If digestion can be defined as what happens to food in, and what food does to, the stomach, the mind, by analogy, can be conceptualized as what happens to culture in, and what culture does to, the (human) brain. It is very likely that most mental diseases (just like most gastrointestinal or pulmonary ones) come from the intake of the processing organ, rather than from the organ itself, i.e., it is likely that they are caused by culture. Mental health professions pay no attention to it, and no revision of the DSM will make them improve their ability to help the mentally ill.

Love this! I know the brain is a complex and fascinating organ, but I have never felt that mental health issues could be the result of brain functioning alone. I wonder who it serves to define it that way (insurance companies, pharmaceutical companies).

I also wonder about diagnosis itself. It seems that diagnosis is not only based on symptoms, but some kind of definition of 'normal'. If 'normal' is a circle, then what is abnormal is outside that circle. But how far outside? Just outside? Way outside? Where does the circle that surrounds the concept of 'normal' get drawn? Whose normal is it anyway? Mine? My therapist's? An appointed mental health academia person?

[Perna]

Originally Posted by ECHOES

but I have never felt that mental health issues could be the result of brain functioning alone.

I have never thought any of my physical issues were a result of that organ's functioning alone. They have no clue what causes high blood pressure, hypothyroid, my asthma, etc. If I had not figured out their lopsided use of antibiotics, I'd be dead now and I'm quite sure their antibiotic use in my gut triggered my asthma/lung difficulties now. . .

I don't think mental health practitioners are any less ignorant and unhelpful than physical health practitioners, they are just made more aware of their ignorance. I go to my physical health doctor every 4 months and he has not helped me in the 7-8 years I've been seeing him, just maintained the status quo; my mental health practitioner did help me in that period of time?

[Hellion]

Originally Posted by ECHOES

Love this! I know the brain is a complex and fascinating organ, but I have never felt that mental health issues could be the result of brain functioning alone. I wonder who it serves to define it that way (insurance companies, pharmaceutical companies).

While taking psychology courses in college I got the impression usually mental health issues stem from a combination of biological, environmental and social factors...I don't think its stated anywhere in psychology/psychiatry that mental health issues are only a result of biological factors.

Obviously mental issues are the result of brain functioning, but various causes go into making a brain dysfunctional. Like for instance chronic bullying throughout childhood combined with a genetic predisposition for depression might result in severe depression.....or maybe someone living a decent life starts feeling like crap all the time in which case it could be more biological than environmental or social. The brain is a very complicated place, as for the DSM it's used as a diagnostic tool but certianly not the only one...it would be unprofessional for a psychiatist to diagnose a disorder based on the DSM alone since it only gives a basic description of how the disorder may look and basic symptoms.

Not sure where the idea that the DSM is the only diagnoses tool comes from. Also the way some people talk about it it you'd think they're going to start rounding up everyone who's sad regardless of the reason and forcibly medicate them.....all because they came to the conclusion someone can still have depression even if they are grieving or that greiving/losing someone close might contribute to or trigger depression. As I've said if someone is greiving a loss and they know that they don't have to seek treatment.

Of course someone just grieving could receive a wrong diagnoses of depression, especially if they don't mention they are grieving a loss, but why go seek mental help if you know you're just greiving and there isn't something 'wrong' with you. Also before someone might be denied treatment due to being in a greiving process when I am sure there are some studies that show losing someone to death could worsen depression or maybe even trigger a depressive disorder those people shouldn't be denied treatment just because their grieving might explain some of it.

I guess I am also skeptical about if these reporters who write articles about the new DSM have actually read the book and the new edits or if they are just going on about a lot of hearsay because it makes for a good story...point is much of what we get is second hand information so how can anyone make an informed opinion on the new DSM in the first place?

[cool09]

I posted this link to a show I heard on "Science Friday" NPR couple mths ago. Director of National Institute of Mental Health, President of American Psychiatric Association and Psychiatrist were discussing why the DSM-V should and shouldn't be used as a guideline for mental disorders, why symptoms are the main focus and not the causes (in DSM-V), what needs to be done to further Psychiatry, how diagnoses (and treatment) are going to be "tailor-made" for the individual in the future, the track record of meds for mood disorders, etc. It was a great discussion and debate.

"Bad Diagnosis for New Psychiatry "Bible" (http://forums.psychcentral.com/curre...bible-npr.html)
Audio - Bad Diagnosis for New Psychiatry "Bible"

[pachyderm]

Listening to these "professionals" leads me once again to the thought that they have no real idea what "mental illness" is. They see it from the outside, and have not the kinds of insight that could guide their thinking. We have not advanced from Freud, who had the same criticism of psychiatry that I have also: they really have no clue what "mental illness" is or what causes it. They are still going around in circles looking for the magic cure.

[Hellion]

I don't get the impression anyone is looking for a cure, if they say that then they're lying. Even the professionals must know there isn't a cure, because there is not a single cause that can be fixed to make it go away since its usually created by multiple factors.