The Decline of Western Psychiatry

[Açucarzinho583]

Psychiatry has always been European. All syndromes and mental illnesses were very well explained until 1980. After the 1980s, the United States was extremely behind in psychiatry. A member of the American Psychiatric Association, Robert Spitzer, noticing that people didn't understand psychiatry, didn't know what syndromes were, etc., invented something similar to a questionnaire with questions and answers to guide them. This questionnaire is more or less like this: "How often have you felt sad?" and then you check the boxes, add up the points, match it with the protocol, and get a specific diagnosis.

Instead of psychopathology, which is the foundation of psychiatry, a manual was created that came with a booklet for the sale of medications. If a certain diagnosis is made, prescribe a certain medication. The pharmaceutical industries loved this because it led to an expansion of diagnoses that continues to this day. Meanwhile, psychopathology is practically dead.

As a result, we now have fashionable diseases. It started with bipolar disorder; suddenly, everyone was bipolar. If your dog dies, for example, and you have the misfortune of seeing a psychiatrist from this lost generation, you might leave with a bipolar diagnosis and a prescription for antidepressants. Then came ADHD, Attention Deficit Hyperactivity Disorder, another one that everyone supposedly has. After that, burnout, and now today's trend is autism. If you're introverted or shy and go to a psychiatrist today, you're at risk of receiving an autism diagnosis.

 

[willitpass]

American psychiatry actually relies on a book called the DSM. We are currently on to the revision number called the DSM-5, which was recently updated in 2022. This is a diagnostic code book that is honestly primarily used for insurance purposes. A clinician will not be able to care for you and your insurance pay for it unless you have at least one diagnosis. So unless you want to pay out of pocket for every session, they essentially have to at least say you have something, like generalized anxiety disorder, so that they can treat you.

While medications are often prescribed based on a diagnosis, that is not the only factor. If you and your doctor decide that medication is necessary, they will use a medication that is known to be effective in other patients with that disorder first. If you have major depressive disorder, odds are prescribing you something for schizophrenia isn't going to do much. There still is quite a lot of controversy surrounding the efficacy of many, many psychiatric medications, but trust me when I say clinical trials on alternatives are alive and well.

I don't know any statistics in regards to whether or not there are truly fashionable diagnosis or not. I think some of that is people out in the community overusing and self diagnosing. I don't know that there was a time when everyone was labeled bipolar by psychiatrists, I think it just became a common phrase among people that if someone was up and down to say they were bipolar. Similarly, it is very common right now for people to self diagnose autism and ADHD. I am absolutely the last person to defend our mental health care system. It is beyond broken and has left me with irreparable trauma, however I don't think the DSM is to blame. Many providers actually hate the DSM and only use it because, as I stated, they have to in order to treat you. Overall I think the problem lies more in an ever present belief that the mentally ill can be taken advantage of. That they are not capable of being in charge of themselves and that they can be abused because no one will believe them. Stigma is the problem in my opinion.

 

[divinemistress36]

Psychiatry is a joke and has made me more mentally ill. Lets electrocute and causes seizures to your brain for depression and ruin your memory

 

[GuessWhosBack]

If your dog dies, for example, and you have the misfortune of seeing a psychiatrist from this lost generation, you might leave with a bipolar diagnosis and a prescription for antidepressants.

If your dog dies, you wouldn't go to a psychiatrist, would you? My point here being, the people who go to psychiatrists know there's some problem they have to address.

Now I know crooked psychiatrists exist and seem to be the norm, which says a lot about the field. I have dealt with one first hand, who (surprise surprise!) just turned out to be a rapist and domestic abuser and is now facing trial. This psychiatrist took advantage of many, many senile citizens and over-medicates young patients too. Usually you can tell a psychiatrist is up to no good by how eager they are to offer you different expensive treatments and hook you up with their network for clinicians without barely knowing you or your medical history.

With respect to your comment on autism, I have noticed that a lot of therapists seem eager to start by investigating autism as a potential diagnosis, especially if you're an adult male. Because god forbid an adult male seeks out therapy, we must waste half of our sessions trying to poorly sneak in questions to screen for autism. I just went through this with my therapist. They're not as coy as they think they are. First time I caught him doing it, I told him immediately that I know he's trying to figure out where I lie on the spectrum. I told him to please not waste time because my issues are more pertinent. Despite having no sensory issues, no problems reading social cues, no problems communicating, sufficiently varied interests, I still had to sit through a bunch of sessions wasting time chasing a false diagnosis.

After him suggesting I take several pre-diagnostic tests, scoring very low overall on the likelihood to be autistic on each of them, do you know what he said? "You have to keep in mind that the autism spectrum is very vast, and ranges from people who cannot speak to brilliant geniuses. I don't think these tests were designed for people like you in mind."

Bruh.

 

[Açucarzinho583]

American psychiatry actually relies on a book called the DSM. We are currently on to the revision number called the DSM-5, which was recently updated in 2022. This is a diagnostic code book that is honestly primarily used for insurance purposes. A clinician will not be able to care for you and your insurance pay for it unless you have at least one diagnosis. So unless you want to pay out of pocket for every session, they essentially have to at least say you have something, like generalized anxiety disorder, so that they can treat you.

While medications are often prescribed based on a diagnosis, that is not the only factor. If you and your doctor decide that medication is necessary, they will use a medication that is known to be effective in other patients with that disorder first. If you have major depressive disorder, odds are prescribing you something for schizophrenia isn't going to do much. There still is quite a lot of controversy surrounding the efficacy of many, many psychiatric medications, but trust me when I say clinical trials on alternatives are alive and well.

I don't know any statistics in regards to whether or not there are truly fashionable diagnosis or not. I think some of that is people out in the community overusing and self diagnosing. I don't know that there was a time when everyone was labeled bipolar by psychiatrists, I think it just became a common phrase among people that if someone was up and down to say they were bipolar. Similarly, it is very common right now for people to self diagnose autism and ADHD. I am absolutely the last person to defend our mental health care system. It is beyond broken and has left me with irreparable trauma, however I don't think the DSM is to blame. Many providers actually hate the DSM and only use it because, as I stated, they have to in order to treat you. Overall I think the problem lies more in an ever present belief that the mentally ill can be taken advantage of. That they are not capable of being in charge of themselves and that they can be abused because no one will believe them. Stigma is the problem in my opinion.

You defend American psychiatry based on the use of the DSM, but you fail to recognize deeper issues within the diagnostic and treatment system. This means that more people are classified as having a mental disorder, even if their symptoms might be normal within a particular context. For example, prolonged sadness after the loss of a loved one might be diagnosed as major depression, or typical concentration difficulties in children might be diagnosed as ADHD.

The idea that medications are prescribed based on diagnoses made in collaboration with the patient does not address the criticism that many of these prescriptions are guided more by standardized protocols than by a thorough analysis of the patient's psychopathological state.

If your dog dies, you wouldn't go to a psychiatrist, would you? My point here being, the people who go to psychiatrists know there's some problem they have to address.

Now I know crooked psychiatrists exist and seem to be the norm, which says a lot about the field. I have dealt with one first hand, who (surprise surprise!) just turned out to be a rapist and domestic abuser and is now facing trial. This psychiatrist took advantage of many, many senile citizens and over-medicates young patients too. Usually you can tell a psychiatrist is up to no good by how eager they are to offer you different expensive treatments and hook you up with their network for clinicians without barely knowing you or your medical history.

With respect to your comment on autism, I have noticed that a lot of therapists seem eager to start by investigating autism as a potential diagnosis, especially if you're an adult male. Because god forbid an adult male seeks out therapy, we must waste half of our sessions trying to poorly sneak in questions to screen for autism. I just went through this with my therapist. They're not as coy as they think they are. First time I caught him doing it, I told him immediately that I know he's trying to figure out where I lie on the spectrum. I told him to please not waste time because my issues are more pertinent. Despite having no sensory issues, no problems reading social cues, no problems communicating, sufficiently varied interests, I still had to sit through a bunch of sessions wasting time chasing a false diagnosis.

After him suggesting I take several pre-diagnostic tests, scoring very low overall on the likelihood to be autistic on each of them, do you know what he said? "You have to keep in mind that the autism spectrum is very vast, and ranges from people who cannot speak to brilliant geniuses. I don't think these tests were designed for people like you in mind."

Bruh.

That was just an example. But there are people who feel so devastated by the death of their dog that they go to a psychiatrist.

 

[willitpass]

You defend American psychiatry based on the use of the DSM, but you fail to recognize deeper issues within the diagnostic and treatment system. This means that more people are classified as having a mental disorder, even if their symptoms might be normal within a particular context. For example, prolonged sadness after the loss of a loved one might be diagnosed as major depression, or typical concentration difficulties in children might be diagnosed as ADHD.

The idea that medications are prescribed based on diagnoses made in collaboration with the patient does not address the criticism that many of these prescriptions are guided more by standardized protocols than by a thorough analysis of the patient's psychopathological state.

I don't defend the American psychiatric system. I actually despise it and refuse to ever step foot near it again. However I don't believe the issue comes down to the DSM. Are there shit psychiatrists who just prescribe without taking the individual patient into account? Absolutely. But a decent psychiatrist will assess the patient and their symptoms, consider their diagnosis, and then decide which medication is most likely to work both based on their personal symptomology as well as what medications are most commonly effective in other patients with similar symptoms. To be quite honest, medications are far more flawed than just prescribing them based on a diagnosis, as there is increasing evidence that many medications are ineffective in large populations of people, but that is not a DSM problem. That is a pharmaceutical problem that is actively being addressed through clinical trials of new medications.

Even an amazing psychiatrist can prescribe the wrong medication. If someone has an infection, the doctor will prescribe an antibiotic that is most likely to treat it. If it doesn't fix the infection, culture and sensitive tests can be run to identify the exact bacteria and what specific antibiotic will kill it. In most cases, the infection is then cleared up. In psychiatry, there are no such tests. The doctors are really shooting blind. A good psychiatrist can have an idea of what will work best, but that doesn't mean it will work. I believe the problem lies more in ineffective medications than in the doctors prescribing them based on current evidence based practice.

I despise the American mental healthcare system with my whole heart. I will never see a therapist again. If they ever want me to take meds again they'll have to pry my mouth open and shove them down my throat. If I ever am threatened with an inpatient stay again I will CTB in an instant. I fucking hate the entire broken system. But I don't think the majority of psychiatrists are prescribing out of malice, I think they are doing the best that they can with a broken system full of outdated treatments. I think everything needs reformed.

 

[CatLvr]

I read a book years ago titled "Manufacturing Victims" by Dr. Tana Dineen. Talk about an eye-opening treatise on the psychological medical community.

 

[Açucarzinho583]

I don't defend the American psychiatric system. I actually despise it and refuse to ever step foot near it again. However I don't believe the issue comes down to the DSM. Are there shit psychiatrists who just prescribe without taking the individual patient into account? Absolutely. But a decent psychiatrist will assess the patient and their symptoms, consider their diagnosis, and then decide which medication is most likely to work both based on their personal symptomology as well as what medications are most commonly effective in other patients with similar symptoms. To be quite honest, medications are far more flawed than just prescribing them based on a diagnosis, as there is increasing evidence that many medications are ineffective in large populations of people, but that is not a DSM problem. That is a pharmaceutical problem that is actively being addressed through clinical trials of new medications.

Even an amazing psychiatrist can prescribe the wrong medication. If someone has an infection, the doctor will prescribe an antibiotic that is most likely to treat it. If it doesn't fix the infection, culture and sensitive tests can be run to identify the exact bacteria and what specific antibiotic will kill it. In most cases, the infection is then cleared up. In psychiatry, there are no such tests. The doctors are really shooting blind. A good psychiatrist can have an idea of what will work best, but that doesn't mean it will work. I believe the problem lies more in ineffective medications than in the doctors prescribing them based on current evidence based practice.

I despise the American mental healthcare system with my whole heart. I will never see a therapist again. If they ever want me to take meds again they'll have to pry my mouth open and shove them down my throat. If I ever am threatened with an inpatient stay again I will CTB in an instant. I fucking hate the entire broken system. But I don't think the majority of psychiatrists are prescribing out of malice, I think they are doing the best that they can with a broken system full of outdated treatments. I think everything needs reformed.

The worst part is that most psychiatrists aren't good. They will prescribe useless medications.