And they are disorders. The science on this is very strong. You see "clusters" of similar conditions in millions of human beings, where each of these clusters/diseases have similar problems, and they share potential remedies.

The problems these disorders cause the individual are very real and unmistakeably negative. Sometimes this is muddied by people claiming schizophrenia, ADHD and bipolar disorder have "hidden benefits", especially creativity. Sometimes conspiracy nuts equate mental disorders with some kind of "dissident" behavior that has to be censors. It's not. These people suffer, and it's not only society that makes them suffer, but also their brain biology...

Would that were true! In fact the science is not very strong at all. We have descriptive sets of symptoms and we have classes of drugs discovered serendipitously that seem to help some sufferers, but despite 30+ years of effort we have little more than post hoc justifications for mechanisms of action and underlying causes.

The chemical imbalance theory has very little evidence going for it besides circular reasoning.

We are at the point in the science of mental illness where we go and categorize things -- this animal has a spine, gives birth to live young, and is warm blooded -- okay put it in this order. We need a Darwin, or at least a Mendel.

A lack of understanding why these drugs work does not mean that the diseases they are often successfully treating is "phony".

But there are two problems with the current consensus that I take issue with.

One is the that it's easy to medicalize normal human variation. Two years ago after an intense battle, I lost my mom to brain cancer. That same year, I lost three other people and had some other majorly bad things happen. At some point I talked to a therapist about depression. She agreed I matched the symptoms, but disagreed that I was depressed. I was grieving, and in her view I should work through it, no matter what other people thought.

I retrospect I can see she was right; I had work to do. But at the time, it would have been very tempting to take a pill that suppressed the symptoms. That's certainly what some people who told me I should be "over it by now" thought I should do. Our current society just doesn't have a lot of room for that.

The other problem I have is that we are putting things like depression all on the individual and some posited internal flaw. I think that's a lazy and disrespectful conclusion given the state of the art. For example, we are discovering that nighttime artificial light triggers depression in animal studies, and we know simulated extra daylight during the day can treat it in humans. For those people, their depression isn't a disease, it's an unintended consequence of our artificial environment. Daily pills to shift brain chemistry are one solution to the problem, but they aren't the only solution.

I think the disease model of medicine has been incredibly successful in improving human lives. But it has limits, and I think mental health is one area where we are overfitting the data to our model.

The people you're talking about aren't denying the existence of real disorders, they're denying the existence of phony disorders -- and there are plenty.

Asperger's, popular a few years ago, is now recognized as a myth and has been removed from the DSM. Until the mid-'70s homosexuality was listed among the phony mental illnesses, finally removed after much pressure was put on the practitioners of this pseudoscience.

> The science on this is very strong.

The science of this is practically nonexistent. Are you aware that the director of the NIMH, the highest-ranking psychiatrist in the country, has recently decided to pull the plug on the DSM, describing it as too unscientific to be useful? And that, by pulling the plug on psychiatry's "Bible", he pulled the plug on psychiatry's dubious standing as a science?

> The problems these disorders cause the individual are very real and unmistakeably negative.

No more real than the average placebo response, which as time passes is becoming the default assumption that must be taken into account and that cannot be categorically eliminated until science eventually enters the field.

There is a core of very serious cases, like schizophrenia and some bipolar sufferers, but those are not mental illnesses, they are physical ailments with psychological symptoms. Purely mental illnesses have no scientific explanation, no reliable diagnostic criteria, and no treatments -- which is why the DSM is being abandoned.

> Sometimes conspiracy nuts equate mental disorders with some kind of "dissident" behavior that has to be censors.

You mean, like the editor of DSM-IV, now a critic of the mental health field, who has just written a book arguing that the epidemic of overdiagnosis collides with natural diversity? Like that? Are you aware that nature thrives on a wide spectrum of behaviors, that such a spectrum represents the genesis of all future improvements in the species?

"Saving Normal" (Allen Frances): http://www.amazon.com/Saving-Normal-Out-Control-Medicalizati...

NIMH director Insel: http://www.nimh.nih.gov/about/director/2013/transforming-dia...

Quote: "While DSM has been described as a “Bible” for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been “reliability” – each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity."

Couldn't have said it better myself.

Face it: People with ADHD are way unhappier. And that isn't entirely the fault of society. If you are more impulsive, less able to take care of yourself or others, then it is really hard to imagine how you are supposed to feel as well as others...

So has Bigfoot. The difference between Bigfoot and a Grizzly bear is tangible evidence.

Want to prove that ADHD is real? Meet science's requirements, primarily a defined cause, unambiguous evidence, and falsifiability -- the possibility of definitively saying that a given person does not have ADHD.

This is not to argue that ADHD doesn't exist -- it is to say that this is not a matter of science, and until there's some science, anyone can claim to have ADHD, or PTSD, or Asperger's, or claim to have been raped by her father when she is in fact a virgin:

http://www.stopbadtherapy.com/retracts/beth.shtml

There will eventually be science where psychology now stands. But that process cannot begin until people begin to adopt a skeptical outlook appropriate to the subject's unscientific basis.

This is why the NIMH has decided to drop the DSM, and psychiatry along with it.

http://www.newyorker.com/online/blogs/elements/2013/05/the-s...

What about depression? OCD? Anxieties? Are they "physical ailments with psychological symptoms"?

No one knows, and anyone who claims to know is speaking without any scientific backing. This will eventually change, primarily because of a move away from psychology toward neuroscience, but this is not going to happen quickly.

I will say this. Eventually "mental disorders" will all be either abandoned or turned into treatable biological disorders, diseases with know causes, just like medicine. But that's not around the corner -- it will take years or decades.

A neuroscience operation was recently performed on a woman who was so depressed that her life was essentially over -- she was institutionalized, unable to function at all. In the procedure, a location in the brain called "area 25" was stimulated using criteria that had worked with laboratory animals.

When the electric field was applied, the woman's depression lifted instantly -- instantly. The procedure is still experimental and is not safe for ordinary cases of depression, but it shows where we're headed:

"A depression switch?" : http://www.nytimes.com/2006/04/02/magazine/02depression.html...

It is examples like this that explain why I and many other people are advocating a move away from psychiatry and psychology -- the resources being expended on those activities are being wasted, and are taken away from things that might work.

First, I never said any such thing. Asperger's was removed from DSM-5, not DSM-IV.

Second, Asperger's was removed from the current DSM, i.e. DSM-5. It was removed because, as one of the voting committee members said, "it's not a evidence-based term."

Asperger's wasn't "folded into" anything. It was recognized as a condition that was so vaguely defined that it could mean anything or nothing. What was folded in the the autism spectrum are those individuals who actually want continued treatment for something less romantic and more stigmatizing.

It wasn't Asperger's that was folded into the autism spectrum, it was those people who, after losing the chance to have a mental illness diagnosis in common with Bill Gates and Albert Einstein, still plan to have anything to do with psychiatry or psychology.

Maybe we can stop growing a monoculture of humans where the slightest deviation from the norm must be treated with some kind of drug.

Yes, yes, and vaccines are a pharmaceutical industry plot, and all the rest. I am really tired of this amateur-hour analysis from people who can't even be bothered to muster up a citation for their hand-waving argument.

I'm very glad I didn't have to go through this, because in Europe it is much more difficult to be recognized as someone having ADHD.

So I'm sorry for you to have suffered, but I can't say I'm not happy I didn't.

All of this said, I no I have no data to back this up, it's just a gut feeling.

No one looks at increases in cancer rates and decries them as an rising tide of overdiagnoses. Only when talking about mental health can people get away with this sort of shoddy reasoning. A few points:

First, the argument itself is faulty. By their very nature, diagnosis rates aren't able to support conclusions in either direction on the matter. An increase in diagnoses is not the same as an increase in misdiagnoses. There are multiple significant factors that can contribute to an increase in diagnoses over time (i.e. heightened awareness, decreased in stigma that would otherwise have prevented the patient from seeking treatment, better diagnostic tools, properly recognizing edge cases where ADHD was previously misdiagnosed, etc.). We've seen similar things with other illnesses as well.

Simply put, the question that you're trying to raise (but aren't) is more nuanced: what percentage of those diagnosed do not meet the diagnostic criteria? The two questions are quite distinct.

Second, we're not exactly working from a comparable baseline when we look towards previous years. Consider factors such as a broader recognition of ADHD symptoms, openness to not simply writing those same symptoms off as "that's the way the world works" or "kids will will be kids", and relative decreases in stigmatization of ADHD itself (e.g. "ok, this is different from those really bad disorders like... schizophrenia [gasp]"). Net result, increased visibility which damn well ought to lead to increases in overall numbers just as it would for any diagnosis, psychological or otherwise.

Third, there isn't much scientific evidence to support the idea that ADHD is overdiagnosed. Even in cases where patients don't meet the diagnostic criteria, there's a growing body of evidence that they nevertheless exhibit more symptoms than average. So even in those cases, they're quite different than your idealized vision of regular kids being fed a daily diet of all the psychopharmaceuticals they can swallow. If you're interested, here are a few articles you can start off from:

- http://www.cdc.gov/ncbddd/adhd/play2.html

- http://www.psychiatrictimes.com/adhd/problems-overdiagnosis-...

- http://jad.sagepub.com/content/11/2/106.abstract

- http://www.ncbi.nlm.nih.gov/pubmed/22956714

Anyhow, mental illness--regrettably--has a nasty assortment of baggage. For centuries the mentally ill were criminalized, marginalized, and locked away. Crazy or not crazy. And though we've moved away from a great deal of the worst of these excesses, many of them are still with us. Maybe one day we'll get our heads out of our collective asses.

Mental illnesses predispose for bad health care coverage...

I have neither said nor implied this anywhere.

Personally, I was lucky, as I was diagnosed as a younger age (Around 5th grade or 6th grade). Recently I took a college course on handling ADHD in college, and my professor also had ADHD, having had it for many years, struggling with it, and not ever learning about it until she was around 50 years-old.

I agree with those who say it may be over-diagnosed, but at the same time, it's frustrating to see people who have no understanding of the disease at all tell me that it's all in my head and I should just get over it and act like everyone else. Being a bit older, I've learned to simply shake it off and move on, but it tough being a kid struggling to do stuff that others seem to be able to accomplish no problem, and then be told that you're simply not trying hard enough and never get any access to education on ADHD and/or medication. It's no different then going up to someone with depression and telling them it's all in their head and to just stop it. It simply doesn't work that way, and pretending it does only makes those with the disease feel worse about themselves without helping them.

Any disorder or disease that requires a potentially addictive medication will inevitably have crooked doctors - this is seen as well with patients requiring Morphine or Codeine. This crookedness is a separate issue from the illness, and is not relevant in a discussion about neurobiology.

In the UK, I didn't have to pay anything for refills of concerta. In NZ, I only had to pay the GP who gave me a referral to a free psychiatrist for methylphenidate and dexamphetamine sulphate.

In both places, it has been a relatively long journey to get medication. They were keen to try to resolve my issues without drugs - it was about half a year between when I started seeing a psychiatrist and when they suggested medication.

This is from the CDC.

* 9.5 of all kids diagnosed with ADHD * 13.2% of boys * 22% increase of children with a parent-reported ADHD diagnosis between 2003 and 2007

Really? You think this is OK?

The American ADHD criteria are hard science, derived by looking at a syndrome of social failure and back-calculating diagnostic criteria.

The European approach, in contrast, is based on Freudian dogma. I.e., weapons grade malarkey.