>It can seriously mess someone's life up.
Treatment to try fix someone who is not thriving, is precisely because someone's life is already messed up. Yes treatment may make it worse, but it often makes it better and there are treatment algorithms where we use best practices of how to go from here, and what signs should we be mindful for often when the meds make things worse the doctor should be asking the right questions for there are warning signs when the med is making things worse.
Treatment's don't fix anything, they might lessen one issue and often give a host of other problems that are often more severe. I think more studying of iatrogenics is in order and more data about what "making it better" means -- as often the patient and doctor have different meanings. Again, because there's no physical symptom, you can't say "levels have returned to normal".
If you were feeling depressed but now you feel nothing, is that better?
What, precisely, would provide scientific backing here, if a vote by professional scientists doesn't count? A vote by academics? A committee of academics, appointed by a prior generation? A team at Harvard, because Harvard is the oldest? A committee appointed by the government?
Isn’t that a two-system measure? The person. And their society.
A gay man in Tehran won’t thrive, but the solution isn’t medicating him into submission.
> Definition of mental disorder
> A mental disorder is a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities. An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behavior (e.g., political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above.
Usually, three, because the specific “not thriving” criteria usually have a degree of subjectivity, so it's patient/society/clinician.
The nature of the scientific method is that we learn new things over time, and the nature of society is that we are all subject to various kinds of cultural pressures, most of which we don't even recognize. The meta-level goal of the DSM - describing those disorders which prevent someone from thriving and are properly treated by psychiatrists - seems sound, even if each edition always needs to be succeeded by a new one.
Depression meds just meant I was cool with my mind not working right.
I get some people are bipolar and such, but I think a lot of people have an underlying disorder they’re unaware of.
Had several years of only basic blood work run. Check kidney function and the sort. Mri were always clean.
This was across 20+ doctors. I had one that actually guessed correctly, but wasn’t his specialty. The specialist didn’t believe me.
Later I realized the specialist was using very outdated diagnostic criteria. As it turns out this is very common.
Drugs can certainly mess up someone's life (see my earlier post). But untreated mental illness can literally end your life (either directly, via suicide, or indirectly, via medical complications from body dysmorphic conditions)
Here's one of mine about ADHD: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1518691/
That's certainly not true. These things aren't understood very well, but it's not at all true that there's NO understanding of how brain chemistry and mental illness interact.
> It can seriously mess someone's life up.
In general drugs for bipolar are prescribed only once someone's life is already "messed up". You seem to be invoking something like the hippocratic oath, but please believe that's already a solid criteria in medicine. These drugs are prescribed because they are known to work (no, not always and not with any certainty, but that they work is not meaningfully disputed).
This is why it's so important to understand that psychiatric treatment must be a collaborative process. The prescribing physician is only making decisions with the consent of the patient, because the patient is the one who has to choose to actually take the medication anyway.
Those decisions are made based on the patient's description of their experience of the disease. A medication can only push you in a certain direction, and when trying to find the right direction, all the clinician has to go by is what the patient says they're experiencing.
If your psychiatrist is simply telling you what your problems are, and prescribing you medications without your say in anything, then what you are receiving is not treatment. And it will, as you say, seriously mess [your] life up.
This is in The Netherlands, where AFAIK we're not particularly known for overprescribing medication, and our health care provides caregivers with enough funds to not go for the 'easy' pill solution right away. I imagine it's quite a bit more an acute risk in the US.
Our treatment systems simply do not currently have an effective long-term way of handling patients that outright refuse to take their medication.
In practical terms, these days most people in that situation end up in prisons instead.
That's true for a ridiculously large amount of non mental illness diseases, too. In fact, I'd say the majority of non-microbial/cancerous diseases fall into this category. Off the top of my head, one example would be Alzheimer's, where recently what was thought to be the "underlying reason" for Alzheimer's (amyloid plaques) have been proven to be a later symptom, not the actual cause. [1]
Most autoimmune diseases also have similar problems. Turns out it's hard to figure out how the human body works.
I remember talking to a doctor and saying pretty much the same thing.
He looked at me, chuckled, and told me that I have no idea how much there is about so many 'medical diseases' that doctors don't know the 'underlying reason' for, and how many of the typical treatments are really just a "hey it seems to work without (too many) negative side effects, but we don't know why. ¯\_(ツ)_/¯."
A spectrum will be based on a society so over time "normal" can shift. I wonder how many times that has happened? I've heard the USA as a population is typically very extroverted compared to many other countries, so perhaps that's one case.
However, while these differences can't be rectified with medication or other therapies (yet), the side effects of these differences can be ameliorated by medication.
They unquestionably have a disease and often respond to drugs.
Bipolar cannot be identified by any physical means. Different doctors will tell you different things. I agree that gradient approaches are useful in most contexts, but I am very hesitant to use this when a drug can be prescribed (with knowing bad side effects) can be applied. It can seriously mess someone's life up.