Monday, April 29, 2013

Don't Worry, Be Happy

There's been quite a media hullabaloo over the the revamped DSM-5, the so-called 'Psychiatrist's Bible', and the way it demonizes normality.
For instance, grief is now considered a mental illness...if it lasts longer than a fortnight.. You read that right: If your life partner up and dies on you, you'd better be over it in two weeks or else you're mentally ill. If your child dies, don't be such a Debbie Downer: hey, in two weeks you can start trying for another one!
Or let's say you've got cancer. If your doctor thinks that your cancer is bothering you a little too much (because after all, it's only cancer), presto! You've got cancer and you're sick in the head.
Then there's 'Disruptive Mood Dysregulation Disorder', which is what your kid has when he throws a temper tantrum. I'm sure pills for that 'disorder' will be forthcoming and that may please some harried parents. But most of us -- including, you'd hope, most psychiatrists -- recognize that kids are not little adults and that their moods are dysregulated and disruptive on occasion because they're, um, kids.

To their credit, many professionals are boycotting the DSM-5 on the grounds that it makes damn near everybody, including the psychiatrists, mentally ill. But it's still going to be the go-to reference for the American Psychiatric Association. This bothers me on several levels. (I'd like to tell you it enrages me but you might decide I'm crazy).

First, of course, it means that I'd pick up any number of mental illnesses as if by magic. Hell, just the other night I found myself crying for no reason I could readily discern. While I'm pretty sure that's fairly common, its very commonality doesn't seem to shield it from classification as a mental disorder any more. I'm down at least as much as I'm up and a lot of times I'm just meh and if I'm not happyhappyhappy all the time, somebody somewhere is going to conclude I'm sick and need medication? That's enough to give me a case of disruptive mood dysregulation disorder.

Second, and much more critically, I'm sure Big Pharma is welcoming this new manual with open arms. Feeling down? Pop a pill. Been a week since the funeral? Pill time! Can't reason with your two-year-old? Shove a pill down her throat.
I'm a guy who has to be motivated to take muscle relaxers or acetaminophen. Spare me your goddamn happy pills, okay?

Third, and most alarmingly, this will inevitably make life even more of a living hell than it already is for the fairly large number of people out there are are suffering from actual mental illnesses.

I know and love quite a few of them. The misconceptions people have about the mentally ill are soul-destroying. All but the most debilitating cases of mental illness go without notice. Odds are very good that a friend of family member of yours has a diagnosed mental illness. We don't treat physical illness as a lessening of the person, so why are we so quick to judge mental illness that way? And what happens to chronic depressives when grief is suddenly a mental illness?
A probable answer to that lies in the ADD/ADHD controversy that is seeing more and more kids on Ritalin because they won't sit still in class. Gee, when I was growing up, it was the kids who did sit still in class -- like me, for instance -- who were treated as if they were buggo.
But there is such a thing as Attention Deficit (Hyperactivity) Disorder. As overdiagnosed as it undoubtedly is, there are definitely legitimate cases of it out there. I'd imagine their illness is belittled at every turn. "Oh, it's all in your head".

It's all in your head. If I could expunge one phrase from the English language, that'd be right up there near the top of the list. Every time I hear of someone saying that I want to find them and punch them repeatedly in the face as hard as I can, and then inform them sweetly that the pain they're feeling is all in their head.
This goes for physical illnesses too, of course, the invisible ones like fibromyalgia and lupus and chronic migraine and chronic fatigue and so many others that have been misdiagnosed over and over as mental illnesses. "You don't look sick to me!" If you hear that often enough, I bet you start questioning your sanity just a wee bit. Why won't the world acknowledge this illness, which is part of who I am? We're told over and over not to appear weak. Do you have the slightest inkling of the amount of inner strength it takes to get out of bed for some people? To go to work and carry on a normal life? To stay on a relatively even keel in the face of physical and/or emotional pain so monstrous it would reduce most of the it's all in your head people to quivering wrecks?
People living with these diseases and disorders are heroes in my eyes. If that makes me crazy, then you can send the men in the white coats to lock me away.

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