Addiction
March 3, 2020
Mental health conditions are common in the United States. In fact, according to a report from the National Institute of Mental Health, about one-fifth of adults in the country have a mental illness, which is equivalent to 51.5 million people. Mental health conditions like depression and anxiety are diagnosed using the Diagnostic and Statistical Manual of Mental Disorders (DSM), which lists dozens of mental health diagnoses. While some people may have legitimate mental health disorders that require psychiatric treatment, there is also the potential to overdiagnose, because in some cases, symptoms like sadness or anxiety may be a normal response to life events. Overdiagnosing can affect both children and adults, which calls attention to the need for change.
One overdiagnosis that pertains specifically to children is ADHD. According to data from the Centers for Disease Control and Prevention (CDC), trends indicate that there have been increases in ADHD diagnoses over the past 20 years. In addition, multiple studies have suggested that ADHD is overdiagnosed and overtreated, and diagnosis of mild ADHD cases is also on the rise. In the book Overdiagnosis in Psychiatry: How Modern Psychiatry Lost Its Way While Creating a Diagnosis for Almost All of Life's Misfortunes, psychiatry professor Joel Paris argues that the issue of attention has been medicalized, with many children being diagnosed with ADHD, which is now a “catch all†diagnosis for any behavioral problems in youth. This has led to a rise in the use of stimulant drugs, which are beneficial for children who have a legitimate ADHD diagnosis, but can be addictive for some people. Some children may also experience significant side effects from stimulant drugs, when a simple change in routine or different behavioral management strategies could be enough to improve focus and attention.
Paris also asserts that depression, bipolar disorder, personality disorders, and PTSD are overdiagnosed. For instance, he argues that there is a difference between a depressive episode that meets the criteria for diagnosis and symptoms of sadness that are short-lived and pass with time. In addition, as he points out, the addition of bipolar 11 disorder to the DSM means that patients can meet criteria for a bipolar diagnosis without having a full manic episode, since bipolar 11 is characterized by a less severe form of manic behavior referred to as hypomania.
The problem, according to Paris, lies in the fact that we live in a consumerism culture, in which people go to see a doctor or mental health clinician for help, and expect to be provided with a diagnosis, and in many cases, a medication regimen. While there are certainly people who benefit from medications, this doesn’t change the fact that some people aren’t dealing with a legitimate mental health diagnosis, and are just struggling with temporary feelings of sadness or anxiety that come along with life’s challenges.
Paris isn’t the only one to call attention to the overdiagnosis of psychiatric conditions. Dr. Allen Frances, chair of a former DSM task force, has argued that the psychiatry industry is medicalizing normal life, which is full of ups, downs, and stressors. In his book, Saving Normal, Frances argues that people who experience normal emotions in response to life’s stressors are being labeled as mentally ill and provided with medication, when it is not necessary.
In Good Reasons for Bad Feelings, Dr. Randolph M. Nesse argues that negative emotions like anxiety and depression serve an evolutionary purpose. For instance, anxiety can warn us of impending danger, whereas low moods can prevent people from wasting energy pursuing unachievable goals. Nease and Francis, like Paris, offer an alternative explanation to modern psychiatry’s emphasis on diagnosing and treating mental illness.
Sometimes, experiencing negative emotions may not be such a bad thing. For instance, if you’ve lost your job, the fear you have about losing your home or being unable to provide for your children can propel you into action and give you the adrenaline needed to seek out a new job. Or, if you’re feeling sad after the loss of a relationship, the feelings of loneliness can motivate you to make some positive life changes to improve yourself and eventually attract a new relationship. Masking negative feelings that come from these normal life circumstances would mean missing out on some of what it means to be human.
There’s no denying that conditions like depression, anxiety, bipolar disorder, and PTSD exist. It’s why experts have spent years researching these disorders and developing diagnostic criteria and effective treatments. Even Nesse acknowledges that low moods can evolve into pathological depression. What’s important to remember, though, is that not every negative emotion or low period in life signifies a mental illness that requires psychiatric treatment or prescription medication. Sometimes, people simply need support to cope with symptoms like stress or sadness that arise from life on life’s terms.
It’s also harmful to label every negative emotion as a mental illness, as it can make people feel ashamed for feeling sadness in response to the loss of a loved one, or stress in the face of challenges at work. Part of the human condition is experiencing both positive and negative emotions, and blocking out the negative or calling it a mental illness can make people feel as if it’s never okay to be less than joyful.
In some cases, a supportive community of others who are coping with similar problems can be helpful. If you’re living with an addiction and seeking support, Ethos Recovery offers a sober living community for men in the Los Angeles area. We are here to help you begin a foundation for your sobriety, so contact us today to learn more.