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Thursday, January 26, 2012

We Are All Insane Now

In last week's "Trendwatch" we made light of a debate among psychiatrists over whether to change the diagnostic criteria of autism.  Yesterday, the Times featured an article discussing another controversy that has arisen during the process of revising the psychiatrist's Bible, the Diagnostic and Statistical Manual of Mental Disorders (DSM): The debate centers on a change to the diagnostic guidelines for depression.

Currently, psychiatrists make an exception for "bereavement" when evaluating a person for depression.  In other words, feeling sad because your dog dies or because Newt Gingrich may be the Republican nominee for President is considered "normal" and not a sign of mental illness.  At least, not yet.  Members of the American Psychiatric Association are considering eliminating the bereavement exemption, the reasoning being that this will enable psychiatrists to make more accurate--and quicker--depression diagnoses.  Of course, if this change goes through, it goes one giant step further to pathologizing what most would consider normal human behavior.

Put it this way: Feeling sad when sad things happen is no more a sign of mental illness than feeling happy when good things happen.  If someone finds out that the cancer diagnosis he received was a false positive and then finds out that he holds the winning $100 million lottery ticket, should he go into therapy because he can't stop smiling?

Of course, maybe the idea is that only negative feelings need to be eliminated.  Sometimes it seems like mental health professionals want to eliminate sadness.  A possibly laudable goal, but if the only thing that matters is people feeling good, why not just legalize crack and let people smoke themselves to death in a haze of good feelings?

If someone is so depressed that she can't work or play or even get out of bed in the morning, this may be a sign of mental illness.  But if that same someone's mother just died, cut her some slack.  Let her experience her grief for a while before classifying her as diseased.

1 comment:

  1. Well said. It seems crazy to NOT be sad sometimes.