7 Reasons America's Mental Health Industry Is a Threat to Our Sanity
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If a measurement is a reliable one, then clinicians trained with it should be in high agreement on the diagnosis. A major 1992 study, conducted at six sites with 600 prospective patients, was done to examine the reliability of psychiatric diagnoses. Experienced mental health professionals were given extensive training in how to make accurate DSM diagnoses. Because of the extensive training, one would expect that diagnostic agreement would be much higher than in typical clinical settings. Herb Kutchins and Stuart Kirk summarize the study in Making Us Crazy (1997):
What this study demonstrated was that even when experienced clinicians with special training and supervision are asked to use DSM and make a diagnosis, they frequently disagree, even though the standards for defining agreement are very generous. . . . [For example,] if one of the two therapists made a diagnosis of Schizoid Personality Disorder and the other therapist selected Avoidant Personality Disorder, the therapists were judged to be in complete agreement of the diagnosis because they both found a personality disorder—even though they disagreed completely on which one! So even with this liberal definition of agreement, reliability using DSM is not very good.
Kutchins and Kirk conclude: “Mental health clinicians independently interviewing the same person in the community are as likely to agree as disagree that the person has a mental disorder and are as likely to agree as disagree on which of the over 300 DSM disorders is present.”
4. Biochemical Imbalance Mumbo Jumbo
Just as nothing was more important in selling the Iraq war in 2003 than the Bush administration’s certainty that Iraq possessed weapons of mass destruction, nothing has been more important in selling psychiatric drugs than psychiatry’s certainty of biochemical brain imbalances as the cause for mental illnesses.
Prior to psychiatry’s proclamation that depression was caused by too little of the neurotransmitter serotonin, few Americans were taking antidepressants. But by declaring that depression was caused by a serotonin imbalance analogous to diabetes and an insulin imbalance, depressed Americans became far more receptive to serotonin-enhancing drugs such as the “selective-serotonin-reuptake inhibitors” (SSRIs) Prozac, Paxil, and Zoloft.
SSRIs can make some depressed people feel better; however, alcohol makes some shy people less shy, but that’s not enough evidence to say that shyness is caused by an alcohol imbalance. The truth is—and scientists have known this for quite some time—that serotonin levels are not associated with depression.
Researchers have used a variety of methods to test the serotonin imbalance theory of depression, including comparing serotonin metabolites in depressed and nondepressed people, and depleting serotonin levels through a variety of means and then observing whether this resulted in depression. Elliot Valenstein, professor emeritus of psychology and neuroscience at the University of Michigan, reviewed the research in his book Blaming the Brain (1998) and reported that it is just as likely for people with normal serotonin levels to feel depressed as it is for people with abnormal serotonin levels, and that it is just as likely for people with abnormally high serotonin levels to feel depressed as it is for people with abnormally low serotonin levels. Valenstein concluded, “Furthermore, there is no convincing evidence that depressed people have a serotonin or norepinephrine deficiency.”
In 2002, the New York Times reported: “Researchers knew that antidepressants seemed to raise the brain’s levels of messenger chemicals called neurotransmitters, so they theorized that depression must result from a deficiency of these chemicals. Yet a multitude of studies failed to prove this precept.”
Yet even now, many psychiatrists and other mental health professionals continue to promulgate the serotonin imbalance theory of depression, and polls show that the majority of Americans continue to believe it.