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.
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...