Saturday, May 25, 2013

10 Years in the Making -- The American Psychiatric Association's Newest and Most Controversial Classification of Mental Disorders

The group that gets to define mental disorders and how they should be treated holds tremendous power in our understanding about what is normal and what is not, as well as in the allocation of billions of dollars annually. In the United States, and for much of the rest of the world, the American Psychiatric Association (APA) has fielded this responsibility. 

The long-awaited fifth edition of the organization's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was just released this month. It will, according to the APA, be "used by clinicians and researchers to diagnose and classify mental disorders [and] is the product of more than 10 years of effort by hundreds of international experts in all aspects of mental health. Their dedication and hard work have yielded an authoritative volume that defines and classifies mental disorders in order to improve diagnoses, treatment, and research. [It] is the most comprehensive, current, and critical resource for clinical practice available to today's mental health clinicians and researchers of all orientations."

Meanwhile, for more than 40 years, the International Society for Ethical Psychology and Psychiatry (ISEPP) has been promoting safe, humane, life-enhancing approaches to helping people who are plagued with mental disorders. The APA and the ISEPP have frequently been at odds, with ISEPP often being the first major organization to identify or publicize dangers of psychiatric treatments such as electroconvulsive shock therapy, lobotomies, and various medications that ultimately prove to have disastrous long-term side effects. ISEPP's position is that pharmaceutical manufacturers are among the primary beneficiaries of the DSM, with the evolving editions having been "remarkable in expanding psychiatric labels . . . with no scientifically substantiated biological etiologies."

While our position at Innersource is to recognize the merit in both points of view -- a tremendous amount of valid research has gone into the APA's formulations -- we share ISEPP's alarm that the DSM-5 expands the number of conditions that can receive a psychiatric diagnosis and, more importantly, expands the number of conditions where psychiatric medication is considered the standard of care. For instance, $16.1 billion last year was spent on giving children anti-psychotic medication based on very questionable diagnoses, a development that our friend Bessel van der Kolk, M.D., has called "a national disaster!" 

ISEPP was joined last month by a giant, though unlikely, ally. No less than the U.S. National Institute of Mental Health (NIMH) took the drastic step of renouncing DSM-5 even prior to its publication. Many mental health insiders have been critical of the forthcoming version. The chair of the task force that produced the prior version summed up the problem: "Pretty soon everyone's going to have a mental disorder or two or three . . ." And for each mental disorder, of course, a drug can be invented and prescribed to treat it. Is it possible that psychiatry, which is dedicated to using science to help overcome human suffering, is being totally reshaped by non-scientific influences? Wake up and smell the coffee. Of the 137 DSM-5 panel members who have posted disclosure statements, 56% have reported ties to the pharmaceutical industry.

For the panels on "Mood Disorders" and "Schizophrenia and Other Psychotic Disorders" -- where pharmaceuticals are almost always involved in treatment -- nearly 100% had financial ties to drug companies. Meanwhile, NIMH controls much of the money the U.S. allots for research into mental illness and its treatment, and its radical move around the DSM-5 is a repudiation to the corruption that has teeth!

Also on the constructive side, we echo Dr. Christiane Northrup's prediction about health care in the future (from her foreword to Donna's Energy Medicine for Women): "... working with the patient's energy field will be the first intervention. Surgery will be a last resort. Drugs will be a last resort. They will still have their place, but shifting the energy patterns that caused the disease will be the first line of treatment. And before that, teaching people how to keep their energies in healthy patterns will be as much a part of physical hygiene as flossing or exercise."  

This holds true for mental health as well as physical conditions. Amen!