Misdiagnosing Mental Illness
Some So-Called "Psychiatric Diseases" May Not Have A
Biological Basis, So Do Drugs Really Help?
Commentary
By Nicholas Regush
Oct. 17 - Psychiatry has become a heavily drug-company
influenced edifice which often trumpets highly
speculative biological science.
There are signs many Americans are disturbed by the insidious
evolution of psychiatry as a shill for pharmaceuticals and a tool for
behavior control.
Two class-action lawsuits filed last month allege the American
Psychiatric Association and Ritalin's maker, Novartis
Pharmaceutical Corp (formed through the merger of Ciba-Geigy
and Sandoz) encouraged overdiagnosis of behavioral disorders in
children.
Congress also recently convened hearings about whether Ritalin
is overprescribed to children who are diagnosed as having
Attention Deficit/Hyperactivity Disorder (ADHD).
Is It Intrinsic or Culture?
These are children who purportedly have disorder-related
symptoms such as short attention span, impulsive behavior and
restlessness.
[Dr. Baughman:
Let there be no mistake-by 'disorder' they-all in psychiatry, all
in mental health, pediatric, neurology, family practice--mean 'disease.'
They mean the children are diseased-abnormal.
]
Some undoubtedly have these difficulties and need
some help, but these days it would appear that when a child too
often twitches in school, cracks a few jokes, or gazes off, bored
stiff, he or she can be slapped with an ADHD label.
This "diagnostic" enthusiasm has gone way off the deep end.
Now, finally, there are serious calls to investigate.
Part of the problem lies in psychiatry's disorder classification
system. I'm referring here to the American Psychiatric
Association's Diagnostic and Statistical Manual for Mental
Disorders, or DSM. It is at the core of modern-day psychiatric
practice and influences how the entire field of mental health deals
with patients and research.
Fidgeting Is a Sign of Illness
The latest DSM edition's description of ADHD is truly something
to behold. In the inattention category, for example, one symptom is
"Has difficulty sustaining attention." Another is: "Does not appear
to listen."
One symptom in the hyperactive/impulsive category is: "Fidgets
with hands or feet or squirms in chair." Another is: "Blurts out
answers before questions have been completed."
If these types of symptoms occur frequently and appear to be
severe, then the child has a good chance of being branded ADHD.
The problem is, some of the symptoms listed could point to a
wide variety of stimuli: Insufferably boring teachers. An out-of
touch-with-reality academic curriculum. This is, after all, the
Internet Age in which the flow of ideas and facts are fast and
furious. And what about learning patterns at home that might play a
role in how a child behaves at school?
To give so many children a drug such as Ritalin presupposes
that specific biological problems underlie ADHD.
[Dr. Baughman:
ADD was invented, in-committee, at the American Psychiatric
Association for the DSM-III, in 1980. Before it could be validated as
anything physical/biological, the same committee using a show of hands,
nothing like the scientific method, changed it to ADHD, for the 1987,
DSM-III-R. Next, they changed the diagnostic criteria for ADHD for the
1994, DSM-IV. Nowhere was science served. Each new construct served only
to cast a wider marketplace net. All the while, parents and the public at
large were being told it was a disease due to a chemical imbalance of the
brain. All the while, the only chemical imbalance of the brain was that
caused by Ritalin
]
And in psychiatry, this gets about as murky as you can possibly
imagine.
The recent orgy of drug-giving to so-called ADHD children is no
historical accident. It comes at a time when there is increasing
pressure within psychiatry to focus more attention in the DSM on
biological causes of disease.
Biology vs. Psychological Causes
Much of the history of psychiatry boils down to a duel between
those who have attempted to relate mental disorders to specific
brain functions (the biological approach) and those who have
attempted to explain disorders in psychological terms (the mind
approach).
As long as biological psychiatry had few treatments to bank on,
psychology more or less held sway. But that changed considerably
in the 1970s when moderately effective treatments for mental
illness appeared on the market. That gave biological psychiatry a
huge shot in the arm and it has grown in stature and power ever
since.
But here's the rub. The brain has proved to be far more vastly
complex than some of the biological enthusiasts have imagined. To
be sure, there has been progress, but much of what is considered
mental illness still is poorly understood and many drugs offer
scattershot rather than well-targeted treatment.
[Dr. Baughman:
Nary a single psychiatric disorder has been proved to be a
disease with a confirming abnormality within the brain-not one.
Nor--applying physical technologies to emotions and behaviors that have no
underlying physical abnormality, will they ever validate a single
psychiatric condition as a disease. Without proof that any are diseases,
psychiatry cannot claim that they are other than a product of the normal
person's environment. Nor do psychiatrists try to understand all there is
to know in their patient's life's histories.
]
And that often
translates into patients suffering serious drug side effects.
It is indeed very telling that psychiatry's disorder
classification
system, the DSM, still remains, as the section on ADHD shows -
primarily a manual of descriptions of psychological states and
symptoms - and not a manual pointing to disorders with specific
underlying biological conditions.
Assumed ADHD Is Biologically Caused
Yet, in the case of ADHD, for example, there is clearly an
unstated assumption that symptoms of inattention and
hyperactivity have some biological cause.
[Dr. Baughman:
psychiatry assumes this with only a sham biological literature
and with no hope or expectation of ever proving it to be true. Having
assumed that it is they force this misinformation on the parents/public as
fact even to the point of having legislators pass laws about it and judges
render decisions about it, all of which validates ADHD as a disease when
nowhere within science is a shred of validation to be found.
]
But the behavior that is
described may have non-biological or social causes, such as bad
parenting, poor schools and poverty.
There is certainly no indication in the DSM's description of
ADHD that the "disorder" can be viewed as arising from a difficult
or non-conformist relationship between an individual and his
culture.
In other words, rather than spotlight problems in the culture,
the
subtle message in the DSM is that ADHD is biological in origin
and therefore mental health professionals should opt for drugs to
quell some ill-defined inner disruption.
There is little in the way of worthy biological data available on
something termed "ADHD" to make a scientific case for so much
drugging of children.
Now, if either the current president of the American Psychiatric
Association or the chief science officer of Novartis would enjoy
debating me on this point, I'm sure we can arrange a public forum
and an Internet Webcast.
I'll even allow them to debate as a tag team.
Nicholas Regush produces medical features for ABCNEWS. In his
weekly column, published Thursdays, he looks at medical trouble
spots, heralds innovative achievements and analyzes health trends
that may greatly influence our lives. His latest book is The Virus
Within.
[Dr. Baughman:
Mr. Regush is getting there, but he still doesn't understand
that it isn't mostly, almost wholly a fraud-it is a total, 100% fraud.
no abnormality = normal = no disease
abnormality = disease
disease = abnormality
psychiatric condition = no abnormality (physical or chemical) = normal = no
disease
ADHD = no abnormality = no disease = normal (physically, chemically)
]