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Let me get something out of the way before I begin. I am not one of those people who claim that Psychiatry is a fake science. During my final year of medical school, I decided to do my Thesis on the psychiatric disorders associated with Alzheimer’s Disease and Minor Neurocognitive Disorder. I spent many hours in a Psychiatric hospital where I had the chance to observe and meet all sort of patients. So, trust me when I tell you this: There are some REAL, serious psychiatric disorders that destroy people’s lives or even cause their death. But Psychiatry has one major weakness. The diagnosis depends entirely on what the patient and sometimes the people close to him report. To make things worse, the method used to decide what is considered a disorder and what is not, is very questionable to say the least and its accuracy is highly debatable. Most psychiatrists seem to find it quite easy to hand around various diagnoses, which are usually accompanied by medications and follow-up visits. In most cases, this seems to create a vicious cycle which unfortunately leads to the worsening of the patient and the Pharmaceutical Companies responding by happily offering even more pills.
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The validity of Psychiatric Disorders was tested in 1973 by the psychologist David Rosenhan. In the Rosenhan Experiment, 12 healthy people (pseudopatients) claimed that they had experienced hallucinations and tried to see whether they would be admitted in various psychiatric hospitals. All 12 of them were admitted with the majority given a diagnosis of Schizophrenia. When they started acting normally and claimed that their symptoms were gone, the hospital administration tried to put them on anti-psychotic medication in order to allow them to go home. The publication of this experiment created huge controversy amongst the medical world.
Psychiatrists in the USA (and all over the world) depend on a ‘handbook’ called ‘The Diagnostic and Statistical Manual of Mental Disorders’ or DSM for short. This manual is often ‘revised’, resulting in the removal of some disorders and the addition of some new ones. But how does this happen? The American Psychiatric Association (APA) has a special ‘Board of Trustees’ who gather together and decide on what will be included in the manual and what will not, after ‘consulting their colleagues’ who have the task to prove that a new disorder has a place in the Holy Book of psychiatry. Probably you will have guessed by now, that many people see some very serious flaws in how the APA makes this manual. Not only that, but the neutrality and medical integrity of the ‘Board of Trustees’ has been questioned many times as it is a well known secret that its members have very close links to the Pharmaceutical Industry.
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Currently the DSM is in its 5th version (DSM-5). I decided to open my manual and make an article about the most questionable and sometimes ‘ridiculous’ psychiatric disorders which can literally be used to diagnose the entire earth’s population with a mental illness. I thought I was going to have a difficult task finding ten disorders – but I was totally wrong. I ended up with a list of 35 different conditions. I therefore decided to present 10 of them in two different articles. In this one you will find the first five most controversial psychiatric illnesses. An article with another five will follow soon. So please read and let me know how many of these disorders you think you could be diagnosed with.
BODY DYSMORPHIC DISORDER
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Let’s start with a disorder which troubles the lives of millions of people around the world, especially teenagers. If you are preoccupied with obsessive thinking that your physical appearance has a flaw and this causes you some distress, then you could be easily diagnosed with Body Dysmorphic Disorder. But don’t rush to diagnose yourself yet. In order to qualify for this disease, your ‘flaw’ must not be observable or appear slight to others. So basically, if others don’t see the defect that you see in your physical appearance then you might be suffering from Body Dysmorphic Disorder. In other words, you can have this mental disorder but if everyone else agrees that you have an appearance flaw, then luckily for you, you are just ugly. To verify this disease you need to perform repetitive behaviours such as checking yourself in the mirror and seek reassurance OR perform ‘mental acts’ such as comparing your appearance to others (!!!). I swear I did not make the last part up. It really is in the DSM-5.
ADJUSTMENT DISORDER
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This refers to anxiety following a ‘stressor’ such as a traumatic event in someone’s life. What most human beings would consider a normal emotional response to various life events, Psychiatry considers a disorder. Any emotional or behavioural symptom that causes ‘distress’ in a person’s life occurring within 3 months from a traumatic event, qualifies him for a diagnosis of Adjustment Disorder. But what does the APA consider as traumatic events? Marital problems, being dumped by your girlfriend, problems at work, going to school, getting married, parenthood, even living in a crime ridden area – all are cases which could potentially label you as a mental patient. Of course some more serious life events can be the cause, such as the death of a loved one. But in this case you can only be diagnosed if your grief ‘exceeds what normally might be expected’. For anyone who can’t cope with these unpleasant, but normal parts of life, the answer is psychotherapy and of course your complementary dose of diazepam.
THE PARAPHILIAS
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I understand that this category includes some potentially illegal sexual behaviour. Paedophilia, Voyeurism, Exhibitionism and Frotteurism are all such examples. These are behaviours which can cause significant psychological and physical damage to victims and even though I do not agree with how we deal with such patients, I agree that medical attention could be beneficial. But next to these, the DSM –5 includes many other types of Paraphilias. BDSM, humiliation, beating and spanking, asphyxiation and sadism are all included in the Paraphilias section of the DSM-5. Any sexual attraction to nongenital body parts (you are in trouble feet lovers!!) or nonliving objects can also make you a candidate for this disease. Of course the DSM-5 clarifies that your sexual attraction must cause you some type of distress for a diagnosis to be possible. But I wonder...if you live in a society where you can potentially be diagnosed with a psychiatric disorder and be labelled as a mental patient just because your sexual desires are different to those of the ‘majority’, how can this not cause you any mental distress?
DELUSIONAL DISORDER
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This type of disorder is placed in the same section with Schizophrenia and other Psychotic illnesses. A delusion is a belief that the patient is strongly convinced about, despite strong evidence to the contrary. Now let’s say that someone for example is absolutely sure he is being prosecuted by aliens who want to harm him and therefore spends his entire day hiding in his basement, then I will agree that some sort of therapy can be attempted (but definitely not a pharmaceutical one – unless he is in immediate risk of self harm). But DSM-5 is again very unclear as to what qualifies as a Delusion. If you believe that someone is in love with you (erotomanic type) or that your lover is cheating on you (jealous type), then you could be given the diagnosis of Delusional Disorder. So next time you accuse your girlfriend of being unfaithful and she replies by ‘Are you crazy?’, then according to the DSM-5, her question can have a more literal sense to it than originally thought. You can suffer from the Grandiose type of this disorder if you falsely believe to have made an important discovery or if you simply think you have some sort of talent but you are actually just a normal, talentless individual. So if you think that you are a talented STEEMIT author, but you are the only one upvoting your articles or if everyone leaves the room every time you try to show off your vocal skills, then if I were you, I would be very concerned.
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Finally we have the Nihilistic type of this disorder which includes all the individuals who believe a major catastrophe or life changing event will take place. Of course this disorder raises some huge arguments about how humans perceive delusions. Remember, if a large number of people believe in a specific delusion then it immediately stops being one (*cough* Religion *cough*).
THE BIPOLAR DISORDER
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Probably every Psychiatry sceptic’s ‘favourite’ disorder, it has been heavily criticised as one of Psychiatry’s most controversial diagnosis. Not so much because the entire humanity could potentially fit the diagnostic criteria, but mostly because it is one of the most over-diagnosed psychiatric illnesses, with children being the latest ‘victims’. In the last two decades, the diagnosis of Bipolar Disorder in children has seen a 40-fold increase.
In the DSM-5 we have two main types of Bipolar Disorder, types I and II. To be diagnosed with Bipolar I, you must have a ‘manic’ episode followed or preceded by a depressive or a hypomanic episode. In this case a manic episode is defined as a period of ‘persistently elevated, expansive or irritable mood’ (I think I ‘ve had three such episodes at work today already). Your manic episode must be present for most of the day for at least 1 week. As mentioned in the DSM-5, increased energy, not feeling sleepy, talking more than usual, increased goal-directed activity and distractibility, all point towards a manic episode. A hypomanic episode is basically all of the above but in a lesser extend and lasting for fewer days. If before or after your manic episode you have a low mood, feel sad and empty, have decreased interest in activities, sleep for more hours and feel that you have low levels of energy, then congratulations – you are Bipolar! Now if your ‘manic episode’ wasn’t so serious then unfortunately it can only qualify as a ‘hypomanic’ one. But worry not! The APA still found a way to provide you with a mental diagnosis. If your hypomanic episode was again followed by ‘depression’ then you are still Bipolar, but in this case just a type II.
Now let’s imagine a patient going to the psychiatrist because lately he has been feeling very sad. The good doctor diagnoses him with depression and gives him a few anti-depressants. One of the most frequent side effects of such pills are periods of elevated mood and irritability, or as we mentioned earlier ‘manic episodes’. So now even if your depression is gone, you are given the diagnosis of being Bipolar. Your psychiatrist can keep the Pharmaceuticals happy now by adding lithium, antipsychotics and benzodiazepines to your prescription of anti-depressants. I think I have proved my point.
These are the first 5 of the most controversial psychiatric disorders in the DSM-5. Please have in mind that a certain extend of exaggeration is used in some cases in an effort to expose the ease by which almost half billion people worldwide have been given up to date a diagnosis of a mental disorder. Despite this, all diagnostic criteria mentioned in this article are 100% real and you can check them by reading the DSM-5. The author doesn’t not intend to insult or claim that real psychiatric disease is not possible. If you want to read the next 5 but also my final thoughts and conclusion on the subject of Psychiatry, please follow me @nulliusinverba. Part 2 is coming soon!!
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