The boundaries of mental illness

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Isn’t everyone a little mentally ill? This seems to be the prevailing idea on my FB feed via memes. One of these memes says, ” relax…we’re all crazy, its not a competition”. When I see this I feel annoyed but at the same time I wonder is there a clear boundary between normal and abnormal? As someone who has experienced psychotic depression, OCD and Dysthymia I’m annoyed because that large of a spectrum invalidates my difficulty to a large degree. I think these people mean well because they are trying to include me as normal but on the other hand  saying that I don’t have much to complain about. Continue reading “The boundaries of mental illness”

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Joanna Moncrieff and the anti-psychiatry movement

Recently I visited the Mad in America website and commented on an article and video by Joanna Moncrieff. Moncrieff is a downloadpsychiatrist in the UK who has written a number of books against the use of drugs and the idea of a bipolar spectrum. Since we both appeared to have the same opinion regarding the efficacy of antidepressants I thought some exchange might be interesting. In a comment, I wrote that I wish I had taken medication sooner than I had and that anti-psychiatrists appear to be  in a hurry to normalize mental disorders despite the lack of evidence for many of them one way or the other. In response a man replied that I hadn’t paid attention to the previous discussion and how disastrous all psychiatric drugs/labels are. Here is an excerpt from her article.

Professional interests drove the transformation of antipsychotics from special sorts of tranquilisers into so-called ‘magic bullets’ back in the 1960s. It was this idea that antipsychotics constituted a sophisticated and targeted treatment, rather than a chemical suppressant, that obscured their unpleasant, mind-altering effects, thus enabling the pharmaceutical industry to expand their use over recent years

Now, I can see pluses and minuses to psychiatry however the people on this site are quite black and white. I am willing to bet for every story of someone harmed by psychiatry there is at least one who feels like he/she was saved by it. It is true that many people are being treated with drugs they don’t need and perhaps mislabeled but there certainly are people who desparately need drugs and some name to describe their problem. For some reason we expect psychiatry to perform on par with other medical specialties even though we still know very little about the brain.

Is Bipolar disorder over diagnosed?

Bell-curve-SD-Precent-SSJoanna Moncrieff believes that psychiatrists are over diagnosing Bipolar disorder. Bipolar disorder used to consist of extreme mood swings, hallucinations, bizarre beliefs and dramatic changes in energy which all occurred over weeks to months but now many “normal” people are receiving the label.

The manufacturers of rare antipsychotic medication have set about changing the meaning of this once rare and distinctive condition, expanding its boundaries beyond recognition so that ‘bipolar disorder’ has become a label that can be attached to a whole myriad of common personal difficulties, who then become legitimate targets for antipsychotic treatment.

I tend to still favor the idea of a mood spectrum since many traits in nature tend to be distributed in a bell curve like fashion. Extroversion/Introversion is one example of this. In the Myers and Briggs indicator extroversion/ introversion preferences are being tested for and when researchers looked at distibutions of scores of various preferences, most had a bell curve distribution. In this distribution most people fall on the borderline and the test somewhat arbitrarily says you are either an introvert or an extrovert.

I can see mood disorders being distributed in a similar fashion except this time perhaps the dichotomy would be instability/stability of mood. Many people would fall in the middle with a mild mood disturbance. What is questionable though are those Bipolar II individuals who border the “normal” area and one tail of the curve. Moncrieff would like to absorb the Bipolar II individuals into the normal part of the curve which would make Bipolar all or nothing however nature is rarely this black and white.