Big Pharma is turning eccentricity into mental illness.
May 17, 2013 6:14 AM Subscribe
Allen Frances, former DSM chairman, brings the DSM-V and Big Pharma to task: "Human difference was never meant to be reducible to an exhaustive list of diagnoses drawn carelessly from a psychiatric manual."
He makes an excellent point about diversity, particularly eccentrics, being beneficial for overall species survival:
"Perhaps the healthiest individuals were those who best balanced all these traits somewhere near the golden mean, but the best bet for the group was to have outliers always ready to step up to the plate as the particular occasion demanded."
He makes an excellent point about diversity, particularly eccentrics, being beneficial for overall species survival:
"Perhaps the healthiest individuals were those who best balanced all these traits somewhere near the golden mean, but the best bet for the group was to have outliers always ready to step up to the plate as the particular occasion demanded."
This post was deleted for the following reason: No big, but short opinion piece with "buy the book!" behind it is kind of not great post material. -- cortex
All the great characters in myths, novels, and plays have endured the test of time precisely because they drift so colorfully away from the mean. Do we really want to put Oedipus on the couch, give Hamlet a quick course of behavior therapy, start Lear on antipsychotics?
What.
posted by shakespeherian at 6:39 AM on May 17, 2013 [4 favorites]
What.
posted by shakespeherian at 6:39 AM on May 17, 2013 [4 favorites]
Do we really want to put Oedipus on the couch, give Hamlet a quick course of behavior therapy, start Lear on antipsychotics?
Things didn't work out so well for them or for anyone around them.
posted by Steely-eyed Missile Man at 6:41 AM on May 17, 2013 [2 favorites]
Things didn't work out so well for them or for anyone around them.
posted by Steely-eyed Missile Man at 6:41 AM on May 17, 2013 [2 favorites]
Actually, demiurge, Allen Frances has for years been sharply critical of DSM-V; check his DSM-5 in Distress series at Psychology today, the subject of a post from December 2011.
posted by mediareport at 6:41 AM on May 17, 2013
posted by mediareport at 6:41 AM on May 17, 2013
Great. So, I'm supposed to brush up my resume for the second time this year from an uncleaned apartment that I live alone in, because I need to be always ready to step up to the plate in case they need someone profoundly unhappy to fight aliens or some shit with my Crazy Power.
No, thanks, I like my career, my family and my propensity to pick up after myself, none of which I get without modern medicine. I guess I just won't be around when humanity calls in its darkest hour for chronic depressives to save them from Galactus.
Pretty disappointing curmudgeonry from someone who should know better. Maybe he's uncomfortable with the new scientific rigor coming into the field?
posted by Slap*Happy at 6:42 AM on May 17, 2013 [7 favorites]
No, thanks, I like my career, my family and my propensity to pick up after myself, none of which I get without modern medicine. I guess I just won't be around when humanity calls in its darkest hour for chronic depressives to save them from Galactus.
Pretty disappointing curmudgeonry from someone who should know better. Maybe he's uncomfortable with the new scientific rigor coming into the field?
posted by Slap*Happy at 6:42 AM on May 17, 2013 [7 favorites]
There is a difference between being happily colorful, and unhappily weird. It always seems like the normals love having their eccentrics in society to make their world more colorful, but I doubt they'd enjoy it so much if they had to live trapped in a malfunctioning brain.
posted by gjc at 6:42 AM on May 17, 2013 [2 favorites]
posted by gjc at 6:42 AM on May 17, 2013 [2 favorites]
This article doesn't say much of anything, though, except 'Things have gone too far, they should go less far.' I guess I'm supposed to buy the book to find out why or how?
posted by shakespeherian at 6:43 AM on May 17, 2013
posted by shakespeherian at 6:43 AM on May 17, 2013
I don't think my labels changed who I am. Nor have my medications. But they made it easier to identify resources that have helped me--including the ones that aren't medications. What we need to get over is this idea that having a disorder in the DSM means that you are Broken Forever.
I definitely don't think everything requires a magic pill to make it better, but complaints about too many people seeking help always reek to me of bootstrap ideals. You don't need a diagnosis, you just need <insert thing society and your insurance company are not obligated to assist you with>.
And yes, dear god, if you're talking about me, as a human being who deviates from the mean, I don't know how to say this loud enough: I DO NOT WANT TO BE OPHELIA.
Without help, I do not have access to basic human dignity.
posted by Sequence at 6:43 AM on May 17, 2013 [4 favorites]
I definitely don't think everything requires a magic pill to make it better, but complaints about too many people seeking help always reek to me of bootstrap ideals. You don't need a diagnosis, you just need <insert thing society and your insurance company are not obligated to assist you with>.
And yes, dear god, if you're talking about me, as a human being who deviates from the mean, I don't know how to say this loud enough: I DO NOT WANT TO BE OPHELIA.
Without help, I do not have access to basic human dignity.
posted by Sequence at 6:43 AM on May 17, 2013 [4 favorites]
From the article:
With an assist from an overly ambitious psychiatry, all human difference is being transmuted into chemical imbalance meant to be treated with a handy pill.
Who would have thought that Big Tobacco, once so seemingly invincible, could be taken down so quickly? Big Pharma is clearly riding for the same kind of fall — this emperor really does have no clothes.
Wow, OK. This guy sounds like an extremist.
From his wiki:
The DSM IV was a more conservative revision requiring that changes be justified by a high threshold of scientific evidence drawn from literature reviews, data reanalyses, and field testing. Of the ninety-four suggestions for new diagnoses, only two were accepted—Asperger's and Bipolar II Disorder.... ... Rates of Attention Deficit Disorder tripled as a result of heavy drug company marketing starting in 1997—instigated by the introduction of new on-patent drugs and facilitated by the removal of federal prohibitions against direct-to-consumer advertising. Rates of Autism increased by more than twenty fold largely because the loose diagnosis followed its becoming a prerequisite for extra school services. Rates of Bipolar Disorder doubled largely because of drug company marketing.
The rates of some diagnoses doubled and tripled, mostly because of other market forces, and now ... what? Everyone's a liar who thinks they need medication? Only the flaming schizophrenics need drugs and the rest of us are us weak?
Pretty disappointing curmudgeonry from someone who should know better.
Agreed, ugh.
posted by polly_dactyl at 6:46 AM on May 17, 2013
With an assist from an overly ambitious psychiatry, all human difference is being transmuted into chemical imbalance meant to be treated with a handy pill.
Who would have thought that Big Tobacco, once so seemingly invincible, could be taken down so quickly? Big Pharma is clearly riding for the same kind of fall — this emperor really does have no clothes.
Wow, OK. This guy sounds like an extremist.
From his wiki:
The DSM IV was a more conservative revision requiring that changes be justified by a high threshold of scientific evidence drawn from literature reviews, data reanalyses, and field testing. Of the ninety-four suggestions for new diagnoses, only two were accepted—Asperger's and Bipolar II Disorder.... ... Rates of Attention Deficit Disorder tripled as a result of heavy drug company marketing starting in 1997—instigated by the introduction of new on-patent drugs and facilitated by the removal of federal prohibitions against direct-to-consumer advertising. Rates of Autism increased by more than twenty fold largely because the loose diagnosis followed its becoming a prerequisite for extra school services. Rates of Bipolar Disorder doubled largely because of drug company marketing.
The rates of some diagnoses doubled and tripled, mostly because of other market forces, and now ... what? Everyone's a liar who thinks they need medication? Only the flaming schizophrenics need drugs and the rest of us are us weak?
Pretty disappointing curmudgeonry from someone who should know better.
Agreed, ugh.
posted by polly_dactyl at 6:46 AM on May 17, 2013
No facts to be seen.
The fact is that 20th century pharmaceutical psychiatry was founded on theories of mental illness we now know to be incorrect, selects psychoactive chemicals for long-term human use based on these disproven theories and corrupted corporate "science" and then dumps those chemicals on people's brains without any understanding of their modes of action, and rejects or deemphasizes the reality of the mind and mental world.
posted by crayz at 6:47 AM on May 17, 2013 [1 favorite]
The fact is that 20th century pharmaceutical psychiatry was founded on theories of mental illness we now know to be incorrect, selects psychoactive chemicals for long-term human use based on these disproven theories and corrupted corporate "science" and then dumps those chemicals on people's brains without any understanding of their modes of action, and rejects or deemphasizes the reality of the mind and mental world.
posted by crayz at 6:47 AM on May 17, 2013 [1 favorite]
This very short Wired op-ed doesn't begin to capture Frances' critique. This post from December 2012 links more in-depth discussion at a variety of sites, including Frances' accusation that profits affected the publishing of the DSM-5 in ways that hurt patients:
The APA's deep dependence on the publishing profits generated by the DSM 5 business enterprise creates a far less pure motivation. There is an inherent and influential conflict of interest between the DSM 5 public trust and DSM 5 as a best seller. When its deadlines were consistently missed due to poor planning and disorganized implementation, APA chose quietly to cancel the DSM 5 field testing step that was meant to provide it with a badly needed opportunity for quality control. The current draft has been approved and is now being rushed prematurely to press with incomplete field testing for one reason only- so that DSM 5 publishing profits can fill the big hole in APA's projected budget and return dividends on the exorbitant cost of 25 million dollars that has been charged to DSM 5 preparation.
posted by mediareport at 6:48 AM on May 17, 2013
The APA's deep dependence on the publishing profits generated by the DSM 5 business enterprise creates a far less pure motivation. There is an inherent and influential conflict of interest between the DSM 5 public trust and DSM 5 as a best seller. When its deadlines were consistently missed due to poor planning and disorganized implementation, APA chose quietly to cancel the DSM 5 field testing step that was meant to provide it with a badly needed opportunity for quality control. The current draft has been approved and is now being rushed prematurely to press with incomplete field testing for one reason only- so that DSM 5 publishing profits can fill the big hole in APA's projected budget and return dividends on the exorbitant cost of 25 million dollars that has been charged to DSM 5 preparation.
posted by mediareport at 6:48 AM on May 17, 2013
I have no doubt that he is critical of DSM-V. He probably has some good arguments. None of those are in this article.
posted by demiurge at 6:52 AM on May 17, 2013 [1 favorite]
posted by demiurge at 6:52 AM on May 17, 2013 [1 favorite]
Right, I agree. So I dunno, let's argue about the arguments and evidence in his detailed critique rather than the opinions in this brief opinion piece.
posted by mediareport at 6:55 AM on May 17, 2013
posted by mediareport at 6:55 AM on May 17, 2013
With pharma hitting consumers via ads on tv, everyone in the world (true mental illness or not) has a diagnosis via DSM-IV. Some of us just know it.
posted by stormpooper at 6:58 AM on May 17, 2013
posted by stormpooper at 6:58 AM on May 17, 2013
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posted by demiurge at 6:33 AM on May 17, 2013