What used to be thought of as normal grieving, a sensitive personality or an emotional reaction to an unanticipated situation seems to become more and more routinely viewed as a “mental disorder.”
Once diagnosed, treatment often consists of nothing more than pill prescribing.
Sometimes responses to ordinary life events can be incorrectly diagnosed as mental disorders. Let’s look at a few examples…
“My husband passed away almost a year ago and I still miss him so much. There are times I feel like there’s not much purpose to my life anymore. We were married for 42 years. It’s tough to fall asleep without him at my side. And it’s tough for me to feel like cooking when I have to eat alone.”
This is a normal bereavement reaction. The proposed new Diagnostic and Statistical Manual code, however, states that these may be signs of a major depressive episode. Why? It’s as though our standard for bereavement is now quick, like everything else in our lives. Nothing to it! A piece of cake! Okay, mourn. But return to your old life in a week, a month, three months. You need more time than that? Well, perhaps you should take anti-depressants. Good for the drug companies. Not good for the bereaved individual.
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Yes, in answer to the question of the title to this post. Believe me in saying as a mental health provider for 20 years now, I see more and more people who want to medicate poverty, divorce, unemployment, chronic family discord, political dissatisfaction. People want drugs for anger, temporary cognitive struggles, situational anxiety, chronic insomnia unresponsive to 10 or more medication trials previously.
You can’t medicate life. But, as the failed notion of “biochemical imbalance” continues to be sold not only by 10 minute med check physicians, but more and more by cherry picking therapists and social workers overwhelmed by case loads, oh, and patients who do not want to expend any time for therapy, it is about pills for ills.
Careful what you wish for, dependency is not just about controlled substances anymore these days.
Therapy is the mainstay of mental health care. And it is about spending time, money, and energy to see progress and resumption of health and function.
Take the widow who says, “There are times I feel like there’s not much purpose to my life anymore.” Suppose she stops taking care of herself. She stops cooking and eating. She stops going out with friends, and she stops letting friends visit. Her son tells you he’s worried about her change in behavior and weight loss. Then one day she downs her entire 90-day supply of various heart and arthritis medicines because life just isn’t worth living anymore.
At what point should someone have decided her problem was serious enough to be treated?
As for referring the patient for psychotherapy, isn’t that just another treatment modality in the clinician’s toolbox? While I agree that medication shouldn’t be used as a do-everything quick fix, if the patient is a candidate for psychotherapy, why shouldn’t medication also be considered?
And this is be part of our downfall as a society.
When a condition is severely affecting functioning or basic health, perhaps “medicalizing” a condition is necessary. Ideally therapy and life changes you be tried first. And people really need to accept the symptoms of grief.
While I agree that over-diagnosis and over-medication is possible, what about the inverse. Stigma is still a significant issue in mental illness. I ‘came out’ years ago about my depression — legitimate and significant, thank you very much — and was inundated with email from people who were apparently suffering terribly, but were too scared/ashamed to seek treatment.
Articles like this often go unchallenged because they support the widely held belief that people with depression or anxiety disorders are just whining and need only to pick themselves up by the bootstraps. In fact, articles like this reinforce the stigma suffered by millions of legitimate sufferers.
“When a condition is severely affecting functioning or basic health, perhaps “medicalizing” a condition is necessary. Ideally therapy and life changes (…) be tried first.”
Whether it is grief, higher sensitivity, introversion, continuous life events OR a chemical imbalance in our brain that lead to compromised health and imminent danger to our lives; ill mental health must be dealt with, and traditional society has become TOTALLY inadequate without diagnosis. Mental health services need to be there for people who are unhappy, because people who are unhappy will eventually drain the system through unemployment, addiction, crime or suicide.
I agree that drugs are not the answer, and that the mental health system has swung too far in the use of drugs; and so my question is
WHY IS THERAPY STILL SO INACCESSIBLE?
I had to attempt suicide and precariously live to tell about it before anyone would believe that I really needed help.
I had to be diagnosed with a personality disorder before people would stop telling me that I was simply choosing to see the negative, and that I just needed to (smarten up and) focus more on the positive.
Cases that aren’t extreme enough fall through the cracks every day. People have to PROVE that they are in crisis in order to QUALIFY for even a short series of counseling sessions; and if they fail to do so, they are turned away, and told that they are fine.
This has to change.
Therapy should be accessible to anyone, as the ultimate PREVENTATIVE measure for physical, mental and spiritual health issues.
AND, our universal human need for inter-dependency needs to become more accepted and embraced in the way that we interact with each other on a daily basis. People need to stop feeling ashamed for needing more support than current popular culture offers.
During seminry training and CPE quarters read a longitudinal study on grieving that noted that even after 24 months after the death of a loved one, mourners had more incidents of colds, minor falls, temporary disorientation than with subjects matched to the mourner on several personality scales but who were NOT in mourning themselves. A little medication is not a quick cure for necessary experience of grief and mourning with resolution over a fairly long period of time.
I wonder by what standard we decide that “society” is “over-medicated”. Just some subjective feeling that there are “too many” prescriptions?
Would we even talk the same way about heart medications? Would we declare that “society” takes too many heart “pills” (always have to use that word – faintly pejorative somehow, blurs the line between legitimate and illegitimate substances).