> a real medical professional, nutritionist, fitness trainer, etc
Family practitioners also commonly prescribe antidepressants and the like. I'd say there is still wild debate about what is a healthy diet. Until recently (and maybe even still) most nutritionists would prescribe something aligning with the Nixon-administration-guided carbohydrate pyramid. Anything a fitness trainer guides you to do is likely less effective than the basics (squats, deadlifts, running).
There is substantial B.S. in all of the professions you mention. The least one can do is find the person dishing it in the right realm.
If a person has schizophrenia, it still massively behooves them or their family to seek the aid of a psychiatrist. A hot mess of conflicting theory and pseudoscience, yes, but it's all we have.
https://en.wikipedia.org/wiki/Psychiatrist
Psychiatrists are medical doctors.
Psychiatrists are the same kind of medical doctor as every other medical doctor.
2. Psychiatric illnesses are defined based on "fallible subjective judgments". Medical illnesses (pathologies) are defined based on objective biological tests.
These criteria are, to some degree, subjective and also easily gamed since in many cases doctors are relying upon noisy / potentially flawed input from patients (i.e., it's possible to game the system to get adderall, etc). However, the DSM, in providing these criteria and the number that need to be expressed to constitute a disorder, are establishing some measure of objectivity. While it is certainly imperfect, it's far from the state of affairs in the 40s/50s and definitely not purely subjective.
More objective / less noisy and biased criteria would certainly be welcome, but they don't really exist and that's been a major goal of NIMH as late. Some people have attempted to predict the presence of mental illness using fMRI scans, with limited success:
http://fcon_1000.projects.nitrc.org/indi/adhd200/results.htm...
However, even without reliable diagnosis via fMRI, I've noticed some psychiatrists using tasks from psychophysics to aid in diagnosis. Unfortunately they aren't always as savvy as scientists with respect to test-retest reliability, but it's a start.
1) Medical doctors (including psychiatrists), police, social workers, judges, and other trained personnel all can lock someone up for a brief time (and with all sorts of legal protections and due process) if:
a) They are a danger to themselves or others.
b) They are unable to care for themselves.
Please tell us your alternative plan for dealing with those issues.
2) I'd love to be drill a hole in your well-protected cranium and stick a needle in your brain to obtain a sample to diagnose major depression, schizophrenia, or PTSD. Just a small sample, ok?. Let me know if you're ok with that. And if you think there are "objective biological tests" for most common illnesses that are diagnosed and treated, day in and day out, by physicians, I'd invite you to accompany me to clinic where, off the top of my head" we'll see tons of upper respiratory infections, real chronic pain without any demonstrable pathology, "ear infections", etc. This is the bread-and-butter of primary care physicians, and we don't order "objective biological tests" in order to diagnose and treat "medical illnesses" - in many cases because the tests simply don't exist, or are too expensive or too invasive.
But perhaps you'd care to explain to the sufferers and their families that we can do nothing for them without your "objective biological tests".
Sure it's okay, post mortem. Many scientists have tried this. Unfortuntely, you would not be able to make a conclusive diagnosis, because the science isn't there.
Please. Give us your plan for relief of suffering while we sit around twiddling our thumbs waiting because "the science isn't there."
The history of the entire field of medicine (including psychiatry, which is as much science and medicine as any other medical specialty) is a march from partial understanding based on classification of symptoms to other measures. The brain, hidden away behind bone and blood-brain barrier, has been called the most complex object in the known universe.
That machine and it's foibles is a little more complicated than finding a buffer overrun or swabbing your throat for strep.
"First, do no harm". Stop the dehumanization and torture that goes on in many mental institutions:
https://www.reddit.com/r/AskReddit/comments/29gr27/redditors...
>The brain... the most complex object in the known universe
This is the honesty I'm looking for. It is disingenuous for psychiatry to claim to be "just as scientific" as medical pathology, because medical pathology has far fewer variables to control for, whereas the mind has virtually infinite variables to control for.
2. Many aspects of diagnosis are subjective, even when tied to objective measurements. For example, cutoffs for high blood pressure, diabetes, and hyperlipidemia.
2. A behavioral record is no less objective than a biological one. Facebook and Google make a ton of money this way; if you want to offer a biological alternative, no one is stopping you.
2. It is the opinion on the behavior as being good or bad that is subjective
Now, you can argue about what outcomes are good or bad, but that's a different issue.
In any event, these things aren't as different from other areas of medicine as you think.
For example, you're full of microbes at the moment. Some of them might make you feel a little off sometimes, some of them might make you incapacitated, and sometimes it might depend. The decision to seek care and/or intervene is a subjective decision, based on your subjective appraisal of how you're doing, and a provider's appraisal. Does that mean that infectious disease medicine is subjective?
Subjectivity enters into all medicine at some point, via ethical decisions about whether and/or how to intervene. Because ethics involves some level of subjectivity, it's unavoidable.
Nobody is locked up simply because they are diagnosed with a "mental illness" which is what you apparently want people to believe - you edited your parent comment, where you claimed that a diagnosis of schizophrenia was grounds for 5150. It's not.
2) No, there is no opinion about "good or bad" in diagnosing mental illness. The almost ubiquitous criteria is significant impairment - which almost always is an impairment the patient themselves identify (not someone else) and are seeking help for.
Please let's you and I spend some time together in the emergency department. Last week we had a patient there who'd been brought in against his will by the police, and who claimed that the chip implanted in their brain was telling him to remove his eyes and everyone else's eyes with the spoon he carried in his back pocket.
He'd already removed his left eye, with the spoon he carried in his back pocket.
Please tell us your plan. I'm sorry that I can't find a throat swab to assist us.
Or perhaps we could have lunch down at the dementia care facility, where the neurologists would love you to tell them they're not legitimate medical doctors because they don't have a throat swab for dementia yet, and because they "lock up" dementia sufferers with a few signatures at the request of dementia-sufferer families so they, the dementia patients, don't walk onto the freeway. They actually lock people up protectively before "the crime" of actually walking onto the freeway.
Imagine that.
Aren't a few signatures (even sans diagnosis) all that's needed to place children in what in effect is protective custody?
There's good psychiatrists and bad psychiatrists, good and bad psychologists, and the pharm industry has done a lot of good for society as well as harm.
I'm not even sure where to start. Take, for example, psychologists: a lot of whatever progress has been made in mental health comes from psychology (quantitative measurements, moving away from monolithic, homogenous diagnostic categories, lots of research, even neurobiological research--hell, the head of federal mental health research recently was a psychologist with a neuroscience research focus); the pushback is often from entrenched MD political groups who play off the "trained doctor" stereotype. Pharm research, too, often complains about the overly simplistic disease models, but are required by the FDA to follow them in clinical protocols, further entrenching them (a different former head of NIMH has complained about this). Psychiatrists often are screwed by the health care industry, trying to care for the most ostracized segments of society (see the recent GOP health care bill, which basically gutted mental health care services completely).
These sorts of discussions are always frustrating, because they're full of armchair, backseat scientists who are all too-happy to declare bad science, etc. without any solutions themselves. Behavioral health is a very challenging subject, and slapping on physics, chemistry, or mech engineering as some kind of perfect model just doesn't work. The irony is that it's more challenging than those fields in a lot of ways; if someone could just drop down from their physics throne and solve all the mental health problems, it would have been done already. It's been tried, believe me, and what usually happens is they grossly underestimate the complexity of what they're getting involved with.
Pych doctors more than willing participants in the prescribing of stimulants and mild euphoriants. They get rich also doing so - 4/5 $200 appointments an hour is common, and if you look at the highest paid public employees in some states you'll see state-hired prison and other psychiatrists towards the top below university basketball coaches.
69% of psychiatrists defining mental illnesses and their treatments in the DSM-5 reported having financial ties to big pharma.
Some people need help to learn what foods to eat properly because their parents never taught them how or they just have bad eating habits.
You don't need a nutritionist to tell you to stop eating junk/processed food. All other diet advice are pure b.s. as there's no scientific answer to what "a proper diet" is. What is "healthy" and what is not changes on a similar rate as weather broadcast i.e. see a recent turn on fat.
Which vitamin or mineral deficiency leads to psychosis? (With a link to this scientific proof please)
Both can cause mental symptoms (retardation for example). But both are rare.
2. You don't seem to understand what ADD and depression are. They're vastly more serious and prolonged than the sort of candy-induced, momentary fit-throwing you're suggesting.
Here's an example regarding hyperactivity and sugar: http://jamanetwork.com/journals/jama/article-abstract/391812
i'm inclined to agree, but i'd also like to temper your use of the "f" word: it's a work in progress.
sure they've had decades to sort it out, but psychiatry is complex material. general shamanism has been replaced by its modern equivalent which is actually significantly better in quite a few different dimensions and can actually provide relief to some patients. if the science of psychiatry is incomplete and flawed and terrible, fine-- i agree entirely.
but if it can provide relief to the median patient-- even if it's only a little bit of relief-- so long as that relief outweighs the medication's side effects, it's worthwhile. and we won't get better without constantly trying things out and learning what works.
>usually do more harm with debilitating "side effects" to their drugs
this doesn't always follow. not all patients experience side effects, and most of those side effects are less debilitating than the disease symptoms which they are replacing. sure, there's the much shushed SSRI-induced sexual dysfunction (which may be permanent for some), the forcefully ignored antipsychotic-induced tardive dyskinesia (permanent and somewhat disfiguring).
but then there's also the upshot: many side effects reside with time, and in some contexts treatment can actually address the underlying condition.
remember, the psychiatrist's metric for successful treatment is that the patient stops reporting their detrimental symptoms.
for most conditions, there is a drug which will accomplish that end with acceptable casualties.