Medicating Grief

The Diagnostic and Statistical Manual, or DSM, is the coding "bible" for those in the field of mental health and psychiatry.  Generally speaking it is the guide used to categorize "disorders" so you can get paid by third party payers.

The issue discussed in this article is not new to me because I have seen this model applied since the late 80s when I was working in community mental health.  The practice predates my experience.

I cannot think of a more inhumane treatment offered in health care.  To conspire to deprive people of the important participation in their grief is a grievous disservice. 

As Allen Frances, emeritus professor and former chairman of psychiatry at Duke University, writes : A startling suggestion is buried in the fine print describing proposed changes for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders — perhaps better known as the D.S.M. 5, the book that will set the new boundary between mental disorder and normality. If this suggestion is adopted, many people who experience completely normal grief could be mislabeled as having a psychiatric problem.

His complete article is here and I strongly encourage everyone to read this.

Another No Suprise News Piece: Doctors too lazy to properly diagnose

HealthierTalk is a website that publishes some of the articles I write that are not posted on Natural Health News.  This note is from their editor and it is certainly worth sharing with NHN readers.

To me, it is certainly no surprise because I hear this from so many people and see it with my clients. It is one of the key reasons when over a decade ago we created our sleuthing service.

Read related article

As we are moving into unchartered territory under health insurance reform, it is best to be well advised, and aware!

What would you say if I told you that your doctor was going to put you on heavy-duty anti-depressants...but not because you are depressed...simple because he was just too lazy to read? It sounds crazy right? Unfortunately--as a new study about to be published in the Journal of Clinical Psychiatry reveals--it's quite common.

Turns out that an astounding 75% of general practice docs...and an additional 25% of psychiatrists...are choosing to ignore their own guidelines when diagnosing major depressive disorder (MDD).

Those guidelines, set out in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), exist to give doctors the guidance they need and to protect us from being misdiagnosed and improperly treated. But, of course, they only can work if doctors follow them.

When a group of doctors were asked how often they are using the DSM-IV when diagnosing depression, the majority of them answered the multiple-choice question with "less than half of the time."

The author of the study, psychiatrist Dr. Mark Zimmerman, offered up the whiz-bang theory that doctors may not be using the DSM-IV criteria because it's very long and some may not be able to recall all of it.

Umm...excuse me?! He's got to be kidding. The results of the study would have been ridiculous enough on their own. But Dr. Zimmerman's observations send this one right past ridiculous straight to shocking.

Let's see if I can break this one down:

1. The criteria for diagnosing a person with a serious illness are just too long for doctors to recall.
2. And apparently it is too much trouble for them to actually pull them out and read through them when they can't remember them.
3. So, instead, my doctor embracing his laziness, chooses to throw caution to the wind, ignore the guidelines, and pronounces me "seriously depressed."
4. Out comes the prescription pad and, next thing I know, I am doped up on some serious medication(s) to treat my illness. Only problem is, I wasn't even depressed to begin with.

Zimmerman went on to helpfully suggest that perhaps we should shorten up the definition of MDD to assist the docs...who are blatantly ignoring the guidelines...to get their diagnoses right.

I suppose just expecting doctors to do their job would be too much to ask?

If you'd like to see what's in the DSM-IV you can take a look at it here. Better yet, you might want to be sure your doctor has the link.