Remember when you were a child and threw tantrums at your parents. You either ended up getting coddled with some lollipops, got reprimanded or worse still, depending upon where you were born and during which decade, got spanked. Then tempers were only temper tantrums: socially embarrassing, annoying and sometimes extortive. Period.
You were not labeled sick.
Fast forward to 2013. Something is happening in the world of psychiatry and it is very worrisome. If your preteen kid starts to yell or exhibit frustration for around three or more times a week for a year, s(he) could be slapped with suffering from a fancier new condition called “disruptive mood deregulation disorder’. If you can’t wrap your head around what the heck this is. It is not easy. And you are not alone.
It is given that some kids need help in managing their behaviors and they should be offered help in every possible way. Not doing that would be fundamentally egregious and violation of fundamental right to live a productive and healthier life. However, clubbing every pre-teen who shouts and shows frustration into this category is really scary and smacks of disingenuousness.
Harassing pre-teens is not the only population that finds itself under the spotlight in a just-published DSM V (Diagnostic and Statistical Manual), a bible of psychiatry. There are others: Female orgasmic disorder, nail-biting, hair-pulling, minor neurocognitive disorder to name few. For example, Generalized Anxiety Disorder finds its upgrade in ‘Somatic symptom disorder’. Its definition is so wide that almost anyone who reports one distressing concern about his/her health can be thrown into this category. This only means that you, I, and everyone around us can be comfortably shoved under that category.
The question here is not about the value of revising and updating existing information to include solutions to problems of the modern life. That is worth appreciating. However, my worry, and there are many who share my concern, is that what are the intentions behind casting the diagnostic net so wide. Is it really done with sole harmless intent of healing or is there something else going on?
There are few factors which make this question worthy of asking. Let’s consider the following:
Around 70 percent of the experts (and in some cases, it was 100 percent) who contributed to the latest tome have financial ties to the pharmaceutical companies which manufacture drugs (or would do that in future) to be used in the treatment of disorders. Even if we give that these scientists are strong-minded and conscientious enough to let the financial ties distort their intentions, it is worth noting how monies and favors influence the human behavior at the subconscious level.
One, we know from research that when money is involved, people tend to behave selfishly. Second, people are more likely to return a favor in kind after being favored in one or the other form. There is a reason why big pharma spend tons of money on medical education. Otherwise, in capitalistic terms, it does not serve any purpose.
Put these things together and the scenario does not look that pretty. Also this has not happened first time and we have heard the similar story before. Remember cholesterol guidelines. Some experts on that panel tasked to put together those guidelines had financial ties with the makers of cholesterol-lowering drugs.
So the question is?
Are psych pills the new statins of the brain? Why are we bent upon over-medicalizing every bit of human experience, especially when psychiatrists are still fuzzy about the definition of what a ‘normal’ human being is?
It would be a great service to the medical science, especially psychiatry, if all these who contributed to this tome take time to examine their intentions to see if they are living by the ‘first do no harm’ tenet of Hippocratic Oath they took.
Parmjit Singh, PhD