What is normal? Normal, like the word love, has no true definition and will differ with every person you ask. Defined in the dictionary normal is “to conform to a particular standard” or “desired pattern”. I believe most people will say a normal person is one whom is free from defect, handicap and mental illness. Metallization is a social process through which a previously normal human condition whether is be behavioral, physiological or emotional, becomes a medical problem in need of treatment.
For example, not long ago being a shy person, “being reserved or having r showing nervousness or timidity in the company of other people”, was common and something most people experienced at some points in their lives. However, now shyness is out the realm of normal and made it’s way into medical books. A shy person may now be one who is suffering from “avoiding personality disorder” or a number of other anxiety-relation mental disorders that has to be treated with antidepressants. In Saving Normal, Dry.
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Allen Frances argues that a high percentage of people diagnosed with mental illness are actually normal. This widespread metallization of normality is leading to over-treatment and over-medicating of mental health issues. The biggest health threat that we face may be our health-care system. The Diagnostic and Statistical Manual of Mental Disorders, ADSM, has become the “bible” for physicists. It was first published in 1953 and since then has been revised several times. The ADSM is the go to guide for doctors, government and health insurers and also used in the law.
Being the chair of the ADSM-IV task force, Allen Frances had the inside scoop on how the psychiatric community classified and defined mental disorders and illnesses. He then goes to explain how the newest edition of the ADSM causes people to be diagnosed and prescribed drugs when they actually don’t need them. The ADSM-V has expanded criteria for diagnosis of certain mental or psychological conditions and added new conditions that redefine more people as having mental illness. Both of these issues lead to ‘normal’ people being labeled as patients in need of pharmaceutical treatment.
It is worrying that the decisions about ADSM-V categories are made by experts with financial ties to the industry that benefits most from a widened patient population. Having criteria that is too broad means that people who would do well without medication are being restricted drugs they don’t need and may possibly be harmed by. The problems with over-treatment and over-diagnoses as they relate to mental health are alarming. For example, the widespread diagnoses of mental health conditions such as bipolar disorder, autism spectrum disorder and attention deficit hyperactivity disorders, is appalling.
ADD used to be only diagnosed to a small percentage of children, but currently all matters of activeness and disruption a child shows in their classroom is being initialized. Some kids, particularly boys, are by nature more active than other. Childhood has now become an illness, what now passes for ADD is nothing more than normal variation or developmental difference. Two-thirds or more of active kids who have been mislabel ADD suffer unnecessary stigma, reduced expectations and harmful side effects from the drugs they’re on.
Metallization has increased the profitability of the pharmaceutical industry. Before you sell a drug you have to sell an illness. Therefore pharmaceutical companies now not only market drugs, but also they market illnesses as well. As relating to ADD, the misleading marketing by drugs companies to push their pills plays a big role in kids being assailable and mistreated once parents or educators view these advertisements. The rate of ADD in the United States has tripled to an inflated 11%. While the sales of ADD medications are approaching a profit of $10 billion a year.
As Frances believes the biggest person who is responsible for diagnostic inflation is Big Pharmacy.. As soon as the drug companies were able to direct to consumer marketing, advertisements now convinced people that they had some type of mental illness. This resulted in them asking their doctors, mostly primary care physicians who have little raining in psychology, about a variety of prescription drugs. The doctors, whom are easily influenced by the young, sales representatives, are given free samples from drug companies which further pushes the prescribing of expensive medications.
Primary care doctors prescribe 80% of psychotropic drugs and as mentioned prior have little training and/or little interest in psychiatry; in addition they spend little time actually evaluating symptoms. A majority of these doctors tend to favor pill solutions and some even build their practice on becoming known for passing out restrictions for whatever the patients wants. A consequence of diagnostic inflation leads to an increased cost for unnecessary drugs and psychiatric treatment.
Americans are now spending billions of dollars on psychiatric medications but according to Frances “We are ignoring the people who have severe psychiatric illness; so that, one-third of people with severe depression see a mental health clinician, two- thirds don’t. Two-thirds of people with severe depression get no treatment at all. At the same time, we’re way over-diagnosing people who have milder problems that would get better on their own. Diagnosis can cause more harm than good when not really needed. We are over-treating those who don’t need treatment, while neglecting those who do.
The ADSM-5 medicals things that happen in everyday life, which makes the pool of normal a small puddle. In ADSM-5 normal grief become “Major Depressive Disorder”; forgetfulness due to old age is “Mild Unrecognized Disorder”; temper tantrums are “Disruptive Mood Desegregation Disorder”; gluttony is “Binge eating” and the symptoms for adult ADD most adults will qualify for. As many people are told they are sick, fewer people are being told they are well. This causes an epidemic of diagnoses and creates the impression we live in a sick society.
Metallization may lead people to mistakenly believe that they should feel normal all the time despite the life stresses, worries or disappointments they may be going through. This may cause them to think that they have some type of mental illness that needs treatment when they are Just experiencing regular events or feelings that may people have. While these “normal” people are given ample treatment, this leaves those in actual the need of psychiatric help neglected. We have become a pill popping society. The misuse of legal drugs has now become a bigger public health problem than the use of street drugs.
Emergency room visits for overdose on prescription drugs is more frequent than for street drugs. Prescription drug mortality rate is 16,000 deaths a year which is more than heroine and cocaine death combined. Frances states our country is spending far too much on unnecessary and often tyrannically harmful health care and far too little on education. Referring back to ADD in children, a large sum of money is wasted on the expensive ADD drugs that would be better invested in smaller classroom sizes and more facilities for physical activity that allow hyper-active children to blow off steam and wear their hypnoses out a little.
There should be a better way of understanding and handling normal difference in one’s activity, we shouldn’t be spending so much money on medical treatment and exposing children to stimulants which have serious long-term side effects. Psychiatric treatment can be very efficient and effective when practiced correctly within appropriate boundaries. Failing diagnoses can result in a lawsuit, but however there are no consequences for over-treatment and over-diagnosis. Diagnostic inflation leads to individual harm and high costs, both economically and socially.
Because multiple powerful forces are promoting diagnostic inflation, it will most likely be hard to change it but education is key. People should be educated on disease mongering and be more skeptical and not eagerly believe what experts say. We can learn from Hippocrates rules of thirds: 1/3 gets better on their own, 1/3 don’t respond to treatment and 1/3 really benefit from it. Medical experts should make it their goal to be able to tell them about and those who can benefit should be the only one’s treated.