Overtesting, overdiagnosing and overtreating are unfortunately on the rise in our healthcare system. The biggest drivers of this phenomenon include the handbook published by The American Psychiatric Association titled the Diagnostic and Statistical Manual of Mental Disorders updated in 2013. This so called psychiatric bible converted millions of people into mental patients by arbitrarily increasing the definitions of existing disorders and adding new ones. For instance, normal concerns about physical symptoms now are considered as “somatic symptom disorder” or normal grief as “major depressive disorder.”
Another driver of this over diagnosing is the pharmaceutical industry, which earns billions of dollars by selling psychiatric drugs. Drugs in this category are among the top sellers for many drug companies.
A third reason is the fact that there are no laboratory tests that can definitively say that a person has a psychiatric illness. The diagnosis comes only after information gleaned in an office visit with a psychiatrist who tries to assemble all the information obtained in an interview with possible additional psychiatric testing. This forces the diagnosis to be subjective and may vary from one psychiatrist to another.
What is normal? Some severe psychiatric cases are unmistakable and can be reliably diagnosed but mild cases with normal ups and downs, stresses, disappointments, sorrows and setbacks are part of normal life and should not be diagnosed as a psychiatric illness. For example your son’s preoccupation with video games and science fiction can suggest autism or a normal young man in today’s world.
Unfortunately most psychiatric diagnoses are handled by rushed primary care doctors who have maybe 10 minutes to diagnose and prescribe to someone that they don’t know well. General practitioners write 90% of calming agents and antidepressants with little training in psychiatry or the meds they are prescribing. Writing a script is the fastest way to get someone out of their office. Patients also have a belief that the doctor knows best so the end result is that the patient obediently follows the doctor’s advice and both doctor and patient feel satisfied that something was done whether or no the problem was accurately diagnosed and treated.
What can you do to protect yourself from being diagnosed with a psychiatric disorder when you don’t have one?
- Observe your symptoms for a few weeks. Watchful waiting and several visits with your primary care doctor are important first steps for most with mild symptoms. Symptoms often go away on their own and most just need reassurance that these feelings are normal. Psychotherapy is also helpful focusing on problem solving and changing negative or nonhelpful thoughts. Important: If your symptoms are severe, chronic, or worsening or you fear harm to yourself or others, seek immediate psychiatric advice. Payment for these services can be difficult but some are covered by insurance, some are lower costs with teletherapy. Often a brief series of visits with the right person will have a significant impact on your symptoms and your life.
- Be skeptical and well informed. Do some research on websites from reputable places such as Harvard Medical School or the Mayo Clinic. There is also a government website called Medline. Do your symptoms meet the criterial of a mental disorder? Do they cause distress? How severe are they? Do they interfere with the activities of daily living? Keep a diary of your symptoms to chart progress and show a doctor.
- Get more than one professional opinion and include your family in the decision making. One usually goes to the doctor when the symptoms are at their worst with transient problems that may improve on their own.
- If you are on a psychiatric drug currently, you may not need it the rest of your life, but don’t stop taking it on your own or abruptly. Many meds cause withdrawal symptoms that can be dangerous. Going off these meds should be done gradually and only under medical supervision.
If you are among the “worried well” and need help with stress management, hypnosis might be able to help. Please contact me at 361-442-9590 or email at holtadams2002@yahoo.com I do not offer psychiatric diagnosing, testing, or treatment.