That’s right. You don’t 'have' any of these so-called ‘illnesses’ or ‘diseases’ because they don’t physically exist. I’ve quoted the Chair of the DSM-IV Task Force before, and I’m sure I’ll quote him again: ‘There are no objective tests in psychiatry’ (Frances, 2014, p. 229, emphasis added).

There are no objective tests in psychiatry: not for schizophrenia; not for depression; not for ADHD; not for PTSD; and not for any other psychological ‘disorder’.  

Now, that does not mean that the things people experience or ways they behave which many laymen and psychiatrists describe as symptoms of discrete ‘disorders’, are not real. It does not mean that. But they are experiences/behaviors, not physical ailments.  

Being Precise With Words 

If someone were to tell you that they ‘have’ sadness, anger or happiness, you’d no doubt think their phrasing a little odd. That’s because we feel sadness, despair, happiness, joy, anxiety, anger, etc. These are emotional states that we experience. Describing experiences as something constant and intractable is neither valid nor useful. 

PTSD stands for ‘post-traumatic stress disorder’. The use of the word ‘disorder’ is superfluous. What is wrong with saying “I experience post-traumatic stress” rather than I have post-traumatic stress disorder? 

You may think it pedantic of me to argue against describing experiences as ‘illnesses’, ‘disorders’, or ‘diseases’, but this issue is far from trivial. How we describe our world of experiences fundamentally shapes our interpretations of those experiences, and ultimately how we view (and often judge) ourselves. 

Don’t Biomedical Explanations Decrease Stigma? 

Many consider the ‘disease-model’ (Kinderman, 2014) approach to mental health useful for reducing stigma by teaching people to view mental ‘disorders’ as no different from other physical ailments such as cancer or diabetes. As I’ve already explained, unlike cancer and diabetes, there are no laboratory tests to distinguish a ‘normal’ individual from a mentally ‘disordered’ one. For example, here's a list of the laboratory tests for diabetes. You won't find any such list for mental 'disorders'. Anyway, to address the view that biomedical models of mental health reduce stigma, a meta-analysis by Kvaale, Haslam, and Gottdiener (2013) is instructive.    

The researchers found that although biogenetic explanations of mental health issues can reduce blame among people diagnosed with a mental ‘disorder’ and their families, they ‘induce prognostic pessimism and negative stereotyping regarding dangerousness’ (Kvaale et al., 2013, p. 790). The concern is that such pessimism could lead to self-fulfilling prophecies whereby people resign themselves to their current psychological state, becoming less willing to enact positive changes in their lives.    

It has also been proposed that biological explanations of mental health issues lead to increases in clinicians’ empathy for their clients. However, Lebowitz and Ahn’s (2014) findings contradict this view:   

Biological explanations have been thought to make patients appear less accountable for their disorders, which could increase clinicians’ empathy. To the contrary, biological explanations evoked significantly less empathy. These results are consistent with other research and theory that has suggested that biological accounts of psychopathology can exacerbate perceptions of patients as abnormal, distinct from the rest of the population, meriting social exclusion, and even less than fully human. (Lebowitz & Ahn, 2014, p. 1, emphasis added)   

Who benefits from a reduction in blame?   

Let’s start with an obvious one: ourselves.    

Change is hard. Really, really, really hard. The ‘actor-observer effect’, a well-established phenomenon within social psychology (Greenberg et al., 2015), tells us that when we fail, we prefer to look for extraneous causes to explain our undesired circumstances, rather than in the mirror. In contrast, when we achieve success, we have no problem taking full responsibility for our accomplishments. Thus, when we feel depressed, anxious, or stressed, we’re prone (whether this is learned or innate is a topic for another time) to find a scapegoat. “The world has to be against me in some way. Why else would I have failed?” “It wasn’t a lack of effort that led to my poor grades, it was that damned teacher who doesn’t like me.” We’ve likely all had similar conversations with ourselves – I know I certainly have.   

Attributing mental health issues to brain imbalances may also benefit family members wishing to avoid responsibility for past transgressions. “If your problems are all a result of the inner-workings of your brain, then how on earth could my parenting have anything to do with it?” With regards to schizophrenia, the truth is, as James (2016) inconveniently (for abusive parents) points out, that although it tends to run in families, one of its main ‘causes’, sexual abuse, does too.    

Big-Pharma   

The pharmaceutical industry has developed an ingenious way to tap into our need to offload our dissatisfaction with various aspects of our lives. You aren’t depressed because you were beaten, or verbally abused, consistently tell yourself that you’re unworthy of respect and affection from others, or make no effort to understand your history and reform or discontinue toxic relationships, no, you just have a few too many (or too few) neurotransmitters floating around in your head. But fear not, we have the cure. There’s no need to make any lifestyle changes, just take these pills and you’re feel right as rain.    

This giant con perpetuated by big-pharma and enabled by the American Psychiatric Association (APA) and other government institutions around the world, continues to wreck the lives of millions of people by convincing them that they have little power to improve their present circumstances. 

Diagnostic Inflation

‘[A]ll of our diagnoses are now based on subjective judgments that are inherently fallible and prey to capricious change.’ (Frances, 2014, p. 12)   

Whitaker (2010) chronicles the sordid history and present state of psychiatry in his seminal work, Anatomy of an Epidemic, in which he shows how the number of Americans now receiving government benefits for mental ‘disabilities’ has sky-rocketed over the last few decades. This diagnostic inflation is, in-part, the result of the ‘out-of-control psychiatric diagnosis’ (Frances, 2014) that the APA’s (2013) Diagnostic and Statistical Manual of Mental Disorders, enables.      

“Teacher, Leave Them Kids Alone!”   

Are you aware that in order to get paid, ‘a doctor [in the US] must make an approved diagnosis’ (Frances, 2014, p. 85)? These perverse incentives are one of the reasons why children in the US consume 3 times more stimulants than the rest of the world combined (Whitaker, 2010). As I mentioned in my lecture, The War on Children, 10% of children in the US are now considered to have ADHD. And there are now at least one or two children in every classroom, on medication. These diagnoses are primarily the result of teacher complaints. Being bored, disruptive, or lacking the desire to participate or complete homework assignments are now considered symptoms of a mental ‘disorder’ by many teachers. This is Soviet-style madness.

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Here are some of the adverse effects of Ritalin and other ADHD medications:    

• Physical problems include drowsiness, appetite loss, lethargy, insomnia, headaches, abdominal pain, motor abnormalities, facial and vocal tics, jaw clenching, skin problems, liver disorders, weight loss, growth suppression, hypertension, and sudden cardiac death.  
• Emotional difficulties include depression, apathy, a general dullness, mood swings, crying jags, irritability, anxiety, and a sense of hostility toward the world.  
• Psychiatric problems include obsessive-compulsive symptoms, mania, paranoia, psychotic episodes, and hallucinations. (Whitaker, 2010)     

Even if you were to maintain the belief (utterly unsupported by the evidence) that ADHD is an innate ailment, the astronomical rise in its diagnosis over the last few decades could not possibly be the result of genetic variations in the general population.   

I will be addressing genetic research in the next part of my series on schizophrenia but for now, suffice it to say that ‘thousands of studies on hundreds of putative biological markers have so far come up empty.’ (Frances, 2014, p. 11)   

Childhood is a now a Mental ‘Illness’   

The annual cut-off date of birth for entry to school in British Columbia, Canada, is Dec. 31. Therefore, children born in December are typically the youngest in their grade. Research by Morrow et al. (2012) reported the following: 

• Boys were 30% more likely and girls 70% more likely to be diagnosed with ADHD, if they were born in December rather than January.
• Boys were 41% more likely and girls 77% more likely to be given medication for ADHD if they were born in December rather than January.   

In 21st century America, kids are no longer permitted to be kids.      

More Perverse Incentives   

PTSD is the easiest mental health diagnosis to have labelled ‘service connected’ (Dobbs, 2009). This allows veterans to receive up to $3,000 in monthly disability benefits. These financial incentives discourage recovery efforts and exacerbate mental health issues:  

‘[U]nlike a vet who has lost a leg, a vet with PTSD loses disabil­ity benefits as soon as he recovers or starts work­ing. The entire system seems designed to encour­age chronic disability.’ (Dobbs, 2009, p. 68)   

‘Sadness should not be synonymous with sickness’   

If, following an awful event such as a bereavement, you happened to experience a depressed mood, loss of interest in everyday activities, and a few other things (e.g. a diminished ability to concentrate) for a period of 2 weeks, the APA (2013) considers you to have major depressive disorder (MDD). In the past, these experiences would have been understood as a natural reaction to a terrible loss, but not anymore.    

Millions of people take medicine they don't need for a diagnosis of MDD that they don't really have, on the false assumption of chemical imbalance (Frances, 2014, p. 155)     

Across the Pond 

Although the American Psychiatric Association continues to enable big-pharma’s drug-pushing, the British Psychological Society is markedly different in their view of mental health. I was pleasantly surprised by their two recent reports on bipolar ‘disorder’ and psychosis, with the former stating that mental health services ‘should not insist that all service users see their problems as an ‘illness’ and take medication.’ (BPS, 2010, p. 8). The BPS also has a much more conservative approach with regards to the notion of psychological experiences as brain ‘diseases’ or chemical ‘imbalances’: 

[N]eurochemicals interact with one another in complex ways, thus we cannot assume that just because an effective medication is thought to target a particular neurotransmitter, this brain chemical must play a key role in causing or maintaining the symptoms of mania or depression. Despite the advances that have been made in this field of science it remains the case that we have no way of directly and unambiguously measuring the sequence of neurochemical events that leads up to periods of depression or mania. Even if we did have such a technique, this would not allow us to say with certainty that this sequence of events actually causes the emergence of depressive or manic symptoms, rather than merely accompanying it. (BPS, 2010, p. 29) 

Professor Peter Kinderman (University of Liverpool) who co-wrote the BPS’s recent reports also delivered a superb lecture discussing the need for ‘a whole new approach to mental health and wellbeing’, which upon re-watching still moves me to tears.  

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Our Words Have Tremendous Power 

I want to acknowledge that throughout this article, I’ve written words such as ‘disorder’ and ‘illness’ in quotations. This is not to minimize or negate the seriousness of sensations people who have these words applied to them, experience. However, I simply refuse to speak in the language of the pharmaceutical industry and large proportions of the psychiatric community. I will not accept calling people’s experiences ‘diseases’ or illnesses’, no matter how foreign they may be to my own experiences.  

Finally, I do not deny that some people find it useful to think of themselves as having an illness/disorder. In fact, within the Steemit community I've seen several users including @lauralemons, @kaylinart, @cherry, @skum, and @karenb54 publish posts about their experiences with ADHD and depression. I would merely invite these and other people to examine whether their views on mental health are truly beneficial to their wellbeing, or whether such labels are an inhibitor to personal growth. Obviously, I could not possibly comment regarding their individual circumstances but the overarching purpose of this article has been to create awareness of the serious issues within the field of mental health that are so often overlooked (or intentionally hidden) by the pharmaceutical industry and psychiatric community.

Thank you for your attention.

‘Don’t ask what’s wrong with me, ask what’s happened to me’ (Jacqui Dillon)

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My name’s Jonathan, a graduate (MSc) psychology student who recently launched PsychologyTube: a YouTube channel devoted to discussing psychological issues from a critical perspective. I created the channel, in part, because I was dissatisfied with existing YouTube channels which tend to simply echo the information found in most textbooks. Thus, with PsychologyTube, I aim to engage viewers with ideas and perspectives that aren't usually covered by the mainstream.

Follow my work @invisiblegorilla

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. 

British Psychological Society. (2010). Understanding Bipolar Disorder. Leicester: Author. 

Dobbs, D. (2009). The post-traumatic stress trap. Scientific American, 300(4), 64-69. 

Frances, A. (2014). Saving normal: An insider's revolt against out-of-control   psychiatric diagnosis, DSM-5, big pharma and the medicalization of ordinary life. New York: William Morrow. 

Greenberg, J., Schmader, T., Arndt, J., & Landau, M. (2015). Social psychology: The science of everyday life. New York: Worth. 

James, O. (2016). Not in your genes: The real reasons children are like their parents. London: Vermilion. 

Kinderman, P. (2014). A prescription for psychiatry. Basingstoke, Hampshire: Palgrave Macmillan. 

Kvaale, E. P., Haslam, N., & Gottdiener, W. H. (2013). The ‘side effects’ of medicalization: A meta-analytic review of how biogenetic explanations affect stigma. Clinical Psychology Review, 33(6), 782-794. 

Lebowitz, M. S., & Ahn, W. K. (2014). Effects of biological explanations for mental disorders on clinicians’ empathy. Proceedings of the National Academy of Sciences, 111(50), 17786-17790. 

Morrow, R. L., Garland, E. J., Wright, J. M., Maclure, M., Taylor, S., & Dormuth, C. R. (2012). Influence of relative age on diagnosis and treatment of attention-deficit/hyperactivity disorder in children. Canadian Medical Association Journal, 184(7), 755-762. 

Whitaker, R. (2010). Anatomy of an Epidemic. New York: Crown.