Self Help Now: A community blog

Dr. Jacqueline B. Sallade offers ideas for maintaining your mental health.

The Problem with Psychiatric Diagnoses

Written by Dr. Jacqueline B. Sallade, Community blogger | Jul 30, 2013 9:16 PM

The motivation of the writers of the DSM5, the psychiatric diagnostic manual included a developmental perspective and acknowledgement of the process of slowly getting to understand someone's distress. So far, so good. Unfortunately, like physicians, mental health professionals need to diagnose quickly in order to receive insurance reimbursement. Herein lies much corruption.

As I write frequently, misdiagnoses abound because doctors don't ask, don't listen and don't understand. An estimated 30% of people with borderline personality traits (emotional instability, frequent dramatic moodiness, relationship problems, immature judgment) receive the label Bipolar because it's reimbursable. So, they take wrong meds and don't get right therapy.

Anothrr injustice comes when docs label childhood coping mechanisms as disorders which carry a lifelong stigma and a whole set of repercussions. So, the anxious, angry, defiant child who reacts to circumstances and tests limits becomes ADHD, ODD, or worse and learns to rely on meds and see himself as sick. His life pattern changes from then on.

Who hasn't been depressed sometimes? There's a big difference between Depression and depression. Same with anxiety . It has to be ruining life in an unbearably painful way to count as a legitimate diagnosis. Find the locus of pain, rather than matching a list of complaints with an easy label for money. Look at the whole person, accept her defenses, find what's happened in his life, and deal with it.

As for insurance, there's always "Other Disorders or Conditions That May Be a Focus of Clinical Attention." So why did a team of tenowned docs waste spend years and money categorizing distresssed people with so many overlapping and arbitrary labels which often correlate very little with biomedical factors anyway?

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