"Fake" mental illnesses

[gnomon]

I think one of the problems in society is a 'cry wolf' syndrome. So many people are prescribed medications for the slightest indication of any illness or diagnosed on a single observation that the general public has a hard time buying the validity of certain disorders.

I do as well. I'm seriously skeptical that the number of OCD people actually suffer from it. The same with bipolar, schizo-affective and pretty much all the rest. Also, high profile cases such as the woman who killed her children and the defense wavered between using post-partum and then bipolar depression as an excuse to move her from prison to a hospital. To a lot of people this seems like the guilty becomes the victim.

I could go on about other observations but let me just say that, even though I have been diagnosed with manic-depression with symptoms corresponding to schizophrenia as well I often find criticisms of the mental health industry valid. I've seen it first hand. I was lucky enough to have a psychiatrist who actually took his job seriously and did not hand out a diagnosis without long term observation.

 

[CDRaider]

Not that long ago, when a person claimed insanity in a trial, the prosecution then had to prove the person was sane which is near to impossible.

Now in the courts you have to prove the insanity. This moves the pressure from the prosecution to the defense.

Just a tidbit of info.

 

[michel]

ADD. Social anxiety disorder. Depression. OCD.

People often interpret some--if not all--of these as something that people need to just "get over", or that it's just "being picky", or "shyness".

Why is this? I see more commercials about mental disorders now than I ever have. To my recollection, there were none when I was growing up. But now it's "out" enough to be talked about in commercials. So why does ignorance still prevail about these and other often-misunderstood disorders?

I am going to play the "Devil's advocate" here. There are always two sides to any story.

Whilst the disorders you mention are real enough Jensa (and I should know!), everyone suffers, to some degree of malaises.

Sure, there is shyness; there is anxiety. Both are common in many people. A driver going for his driving test is bound to feel 'anxious'; it is only when a person suffers from anxiety to such a ndegree that the anxiety stops him from leading a normal life . Then, and only then, it becomes a 'clinical condition'.

We, in England, are becoming aware that many soldiers shot for cowardice in the First World War, were actually suffering from post traumatic stress syndrome.

Now, the families of those poor soldiers, who were shot as cowards and deserters, are getting the Government to give them pardons (a bit late).

Yes, there is still a stigma attached to something that people cannot see (like a broken leg, or arm), because people who have not suffered from any form of mental disorder can have no conception of what it is like to do so (just as I have no conception of what it is like to have a broken limb, because I have never had one). And, of course, as has been said, a broken limb is visible, whicst any form of mental disorder is not.

The only danger is that people who are not affected enough so as to be clinically ill get caught up in the current of the flow of mentally ill people; that is the only proviso.

 

[CDRaider]

I am going to play the "Devil's advocate" here. There are always two sides to any story.

Whilst the disorders you mention are real enough Jensa (and I should know!), everyone suffers, to some degree of malaises.

Sure, there is shyness; there is anxiety. Both are common in many people. A driver going for his driving test is bound to feel 'anxious'; it is only when a person suffers from anxiety to such a ndegree that the anxiety stops him from leading a normal life . Then, and only then, it becomes a 'clinical condition'.

We, in England, are becoming aware that many soldiers shot for cowardice in the First World War, were actually suffering from post traumatic stress syndrome.

Now, the families of those poor soldiers, who were shot as cowards and deserters, are getting the Government to give them pardons (a bit late).

Yes, there is still a stigma attached to something that people cannot see (like a broken leg, or arm), because people who have not suffered from any form of mental disorder can have no conception of what it is like to do so (just as I have no conception of what it is like to have a broken limb, because I have never had one). And, of course, as has been said, a broken limb is visible, whicst any form of mental disorder is not.

The only danger is that people who are not affected enough so as to be clinically ill get caught up in the current of the flow of mentally ill people; that is the only proviso.

:clap: EXACTALLY! You put into words what I've been trying to say. Thank you! Frubals on you!

 

[Jaymes]

Is anyone here familiar with the scientific literature behind these diagnostic classifications or the diagnostic criteria for them?

The Diagnostic and Statistical Manual of Mental Disorders says for OCD:

One must have obsessions or compulsions, or both.

Obsessions are defined by:

1. Recurrent and persistent thoughts, impulses, or images that are experienced at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress.
2. The thoughts, impulses, or images are not simply excessive worries about real-life problems.
3. The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action.
4. The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind.

Compulsions are defined by:

1. Repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly.
2. The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive.

In addition to these criteria, at some point during the course of the disorder, the sufferer must realize that his/her obsessions or compulsions are unreasonable or excessive. Moreover, the obsessions or compulsions must be time consuming (taking up more than one hour per day), cause distress, or cause impairment in social, occupational, or school functioning.

For social phobia:

A. A marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing.
Note: In children, there must be evidence of the capacity for age-appropriate social relationships with familiar people and the anxiety must occur in peer settings, not just in interactions with adults.
B. Exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally predisposed Panic Attack. Note: In children, the anxiety may be expressed by crying, tantrums, freezing, or shrinking from social situations with unfamiliar people.
C. The person recognizes that the fear is excessive or unreasonable. Note: In children, this feature may be absent.
D. The feared social or performance situations are avoided or else are endured with intense anxiety or distress.
E. The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person's normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.
F. In individuals under age 18 years, the duration is at least 6 months.
G. The fear or avoidance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition and is not better accounted for by another mental disorder (e.g., Panic Disorder With or Without Agoraphobia, Separation Anxiety Disorder, Body Dysmorphic Disorder, a Pervasive Developmental Disorder, or Schizoid Personality Disorder).
H. If a general medical condition or another mental disorder is present, the fear in Criterion A is unrelated to it, e.g., the fear is not of Stuttering, trembling in Parkinson's dsease, or exhibiting abnormal eating behavior in Anorexia Nervosa or Bulimia Nervosa.

For depression:

At least one of the following three abnormal moods which significantly interfered with the person's life:

1. 1. Abnormal depressed mood most of the day, nearly every day, for at least 2 weeks.
   2. Abnormal loss of all interest and pleasure most of the day, nearly every day, for at least 2 weeks.
   3. If 18 or younger, abnormal irritable mood most of the day, nearly every day, for at least 2 weeks.
2. At least five of the following symptoms have been present during the same 2 week depressed period.
   1. Abnormal depressed mood (or irritable mood if a child or adolescent) [as defined in criterion A].
   2. Abnormal loss of all interest and pleasure [as defined in criterion A2].
   3. Appetite or weight disturbance, either:
      • Abnormal weight loss (when not dieting) or decrease in appetite.
      • Abnormal weight gain or increase in appetite.
   4. Sleep disturbance, either abnormal insomnia or abnormal hypersomnia.
   5. Activity disturbance, either abnormal agitation or abnormal slowing (observable by others).
   6. Abnormal fatigue or loss of energy.
   7. Abnormal self-reproach or inappropriate guilt.
   8. Abnormal poor concentration or indecisiveness.
   9. Abnormal morbid thoughts of death (not just fear of dying) or suicide.
3. The symptoms are not due to a mood-incongruent psychosis.
4. There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode.
5. The symptoms are not due to physical illness, alcohol, medication, or street drugs.
6. The symptoms are not due to normal bereavement.

And for ADD:

Either (1) or (2):
A. six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:

1. often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
2. often has difficulty sustaining attention in tasks or play activities
3. often does not seem to listen when spoken to directly
4. often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
5. often has difficulty organizing tasks and activities
6. often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
7. often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
8. is often easily distracted by extraneous stimuli
9. is often forgetful in daily activities

2. six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:

1. Hyperactivity
2. often fidgets with hands or feet or squirms in seat
3. often leaves seat in classroom or in other situations in which remaining seated is expected
4. often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
5. often has difficulty playing or engaging in leisure activities quietly
6. is often "on the go" or often acts as if "driven by a motor"
7. often talks excessively
   
   Impulsivity
8. often blurts out answers before questions have been completed
9. often has difficulty awaiting turn
10. often interrupts or intrudes upon others

B. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years.

C. Some impairment from the symptoms is present in two or more settings (e.g., at school [or work] and at home).

D. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.

E. The symptoms do not occur exclusively during the course of a Pervasive Developmental Disorder,
Schizophrenia , or other Psychotic Disorder and are not better accounted for by another mental disorder (e.g., Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder)

 

[CDRaider]

Yeah.. the only problem with that is it discusses symptons only. I dunno, i've always had a problem with that kind of diagnosis although I understand the need for a standarization.

I think a social definition is more applicable because I am OCD about security. I need to make sure that things are planned in advance and that i have enough money and the like... a pyschologist would tell me (and has told me) I have mild OCD because its more of socially applicable disorder whereas it is not organic but functional. A psyciatrist would say i do not have OCD because I don't acutally preform and action (i.e.- locking a door).

I hope that makes sense.