After years of medical debates, science breakthroughs, and a rise of drugs, the Psychiatric field still needs improvements. Here I discuss the remarkable influence of psychiatric drugs within American society. At first, the psychiatric practice did not fit under any medical profession due to its modernity. Psychiatry first described the “brainlessness” since it was before the creation of psychoactive drugs. This option quickly eliminated the prospect of further analyzing each patient. These drugs will only soothe the illness but do not resolve the problem. For instance, these doctors are no longer considered for the therapy, asking questions, and the curiosity of how the brain works slowly decreases. With the trust of a doctor, these drugs were like magic pills that supposedly will resolve these patients’ issues. Since the bible of psychiatry, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) has served as a manual to diagnose, and there was no longer much effort in finding out the implanted problem. Many of the DSM diagnoses were not validated implementing the rise of drugs as a result of turning a blind eye to their patients.
Unlike distinct specialties, where the private practice was the standard, psychiatry dawned within an institutional system intended to take care of people with critical and disabling mental disorders. A Henry E. Sigerist Professor of the History of Medicine Emeritus at the Institute for Health, Health Care Policy, and Aging Research at Rutgers University, in New Brunswick, New Jersey, Gerald N. Grob rules out the history of Psychiatry and the spring of the DSM. In his article the Psychiatry’s Complex History in the Health Affairs he explains the history and the present of Psychiatry. Ere the name psychiatrists, these doctors were the jurisdiction of alienists who dealt with alienated individuals—psychiatry in the nineteenth-century affiliates with asylums. The access to hospitals resided in rural areas, all far from these asylums, because the country did not consider their relationship. (Grob 2015) The role of the jurisdiction of alienists meant “compassionate caretaker rather than a true doctor.” Of course, one might assume since there were not many medical breakthroughs to help the sick, nevertheless the troubled minded. Their choice of therapies was the use of purges, cold packs, and restraint. All reinforced the separation of psychiatry from medicine because there was no study researching successful treatments.
Mental hospitals became simply custodial institutions heeding for patients without any hope of recovery. (Grob, 2015) In World War II, soldiers’ trauma which mostly was PTSD, began the transformation of American psychiatry after 1945. As these servicemen travel back home, their experiences reshape their everyday living because of the mental shock. Resolving and commencing this practice soon became a priority. Like medicine, one can diagnose based on symptoms, such as how chickenpox, the flu, and other visually physical conditions are analyzed. (Grob, 2015) Introducing the DMS became the guide to help evaluate what these patients are going through. The publication of the DMS in 1952 symbolized the triumph of psychoanalytic and psychodynamic psychiatry, even though none of its diagnostic categories were based on scientific evidence and practical research.
After three decades of training, students began to dominate the specialty within medical schools. The DMS gives these physicians the confidence to be overly optimistic about their patients about their psychiatric therapies. This state of mind occurs because there is a reliability to justify any practice with the DMS. Besides that, physicians have the right to prescribe anything under their license. Since doctors do not have to be questioned, it is effortless to continue prescribing different drugs. One may question if patients might worry. But not many patients are aware of the back story. Patients hold a trust that their doctor knows best. Being aware of their illness and a magic pill to solve the problem sounds like the best solution, in addition to the high advertisement of certain drugs and awareness campaigns of diseases. This setup makes it easy for physicians, patients, and pharmaceutical companies.The DMS must be revised and looked over solely by medical professionals. Due to its influence in these medical decisions. This primary psychiatric care leaves many open holes, especially for those with severe and disabling disorders. A manual cannot dictate these more complex patients’ conditions because everyone has different factors that influenced their mental state or disease. (Grob, 2015) Individuals with such disorders who are under these health systems die, on average, twenty-five years earlier than the general population. However, there are treatable medical conditions. Also (Grob, 2015) , too many people with mental illnesses are incarcerated rather than in treatment. Psychiatric care remains fragmented and uncoordinated because there is not a pretty organized system in this practice. People with these disabilities develop secondary problems that are preventable. Clinical trials have been exceedingly slow, and there is not much effort or desire to know more. All these claims and treatments did not undergo any experiments or research. Instead, these physicians diagnose by simple acceptance and theory, which brings in the power of pharmaceutical companies and compromised ties with psychiatric researchers. This corruption remains pervasive, and due to this association, there have not been any significant breakthroughs in pharmaceutical innovation in recent decades. As time progresses, the newer drugs are not more effective than earlier ones.
An American psychiatrist Allen J. Frances is part of the American Psychiatric Association, who is best known for supervising the development and revision of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-4). However, he is now a Professor and Chairman of Emeritus of the Department of Psychiatry and Behavioral Sciences at Duke University School of Medicine. In France’s report in Psychology Today, Can DSM-5 Correct Its’ Mistakes?, he explains the controversies of the DSM-5. Since the DSM-5 is so thoughtlessly done and included so many apparent mistakes, it forces change to be more urgent. (Frances, 2016) During the revision of the new version, the American Psychiatric Association (APA) tried to appease critics to guarantee that APA will consider these expositions before the publication. However, the DSM-5 was subject to constant revision. This source was not reliable, although it was the most influential piece in diagnoses, instead of putting in the research to fix the errors in the DSM’s diagnosis. The newer versions only add more diagnoses that continue to be invalid. (APA 2017) effort in improving care, two new disorders for children are disruptive mood dysregulation disorder (DMDD). However, although the DSM adds this diagnosis, there is not much information of its origin, solely a list of symptoms not backed up by research. Similar to almost all diagnoses within the DSM-5. For instance, Somatic Symptom Disorder is so loosely formulated that practically anyone with a medical illness can be misidentified as mentally ill if they complain of their symptoms more than the physician deems they should. (Frances, 2016) The DSM-5 does not incorporate more precise requirements for complex disorders. Frances having prior experience only demonstrates the lack of updates that were done onto the DSM-5. The DSM entirely rules out any other inference or possible different medical viewpoints. But without restrictions, it is far too easy for doctors to assume any possible outcome carelessly.
There are concerns regarding the integrity of medicine by researchers, investigative journalists, practitioners, ethicists, and policymakers. Lisa Cosgrove is a Ph.D. Professor of Counseling and School Psychology in the College of Education and Human Development in the University of Massachusetts Boston. In the International Journal of Feminist Approaches to Bioethics: The DSM, big pharma, and clinical practice guidelines: Protecting patient autonomy and informed consent Lisa Cosgrove questions how financial conflicts of interest (FCOI) in the biomedical field may be discrediting the integrity of scientific research—as a result, jeopardizing the patient’s care by having inaccurate knowledge on treatments. (Cosgrove, 2011)The collaboration with pharmaceutical companies is worth a sum of more than a hundred of million dollars. Specific alliances are for withholding notice on drugs such as conflicting side effects, overstating medications’ potency, or aggressive off-label marketing practices considered unethical to pass under the FDA.
As DSM is currently undergoing revision, FCOI timely is highly influenced by the APA’s economic growth. The DSM has impacted internationally on clinical training, clinical care, and programs of research. Because the DSM affects such wide-ranging regions as law, insurance claims, treatment interventions, it is critically important not to be compromised by industry influence. As a result, it creates untrustable conditions in the psychiatric field, but since not many are aware of this partnership, it allows the corruption to proceed. (Cosgrove, 2011) The organization that designs the DSM acquires ample drug industry funding, and all chairs who serve as diagnostic and treatment panel members also obtain profit from these companies. In light of the drug market, the number of people exposed to these drugs increases. As a result, data shows how highly problematic and potentially chronic side effects of these psychiatric medications. (Cosgrove, 2011) By extending the markets, more income is generated. Psychiatrists widen the limits of psychiatric disorders by including diagnoses in the DSM that may be invalid. But we cannot differentiate which ones because all of them are not proven. As a result, this allows pharmaceutical companies to appeal for FDA approval of psychotropic drugs whose harms may surpass the benefits. Drugs began to hold the most power over the patients and in Psychiatry.
Pharmaceutical companies have cut research on psychiatric medicine by 70%. An award-winning social affairs writer and a Guardian data journalist, Mary O’Hara and Pamela Duncan analyze drug companies’ expansion and their influence on drug therapies today. Their article “Why ‘big pharma’ stopped searching for the next Prozac” highlights how psychopharmacological drug research programs have shortened because of these drug companies. Although research has shrunk in the US, prescriptions have escalated dramatically over the past two decades. (Duncan, O’Hara, 2017) Now adults taking antidepressants quadrupled the amount in the 90s. As a result, the drug industry profits in the tens of billions of dollars. Yet, these drugs are not the safest because, without the research, we become lab rats. There transpire many disputes about these antidepressant drugs and how they function. The protectors mold on the Brain’s serotonin levels to enhance the hormone levels. (Duncan, O’Hara, 2017) Yet, just like any other drug, these companies do not indicate this working. These drugs typically take months to work correctly, which often worsens the patient’s condition. Treatment of these drugs may work as a placebo effect because of the passing time. (Duncan, O’Hara, 2017) However, there is no evidence to back up these drugs, but these companies have the power to pass them through to facilities. We know little to nothing about its long-term safety or effectiveness. Ketamine blocks pain receptors but just like all new drugs, and it’s wise to be wary. Also, ketamine has opioid effects and is probably addictive. Without the research, we are not sure if the opioid properties or their impact on glutamate contribute to the effectiveness of the antidepressants.
As prescriptions become the initial option for psychiatrists, it becomes clear whence the proper solution is neurological. From the British Medical Journal, the article “In the Time to End the Distinction Between Mental and Neurological Illnesses” by P D White, H Rickards, A Z J Zeman, and Stephen Whitehead depicts how the study of mental disorders. The study reveals the dysfunction of the brain and how everyone has uniquely different brain activity. Meanwhile, neurological disorders interact strongly with psychological factors and often cause various symptoms; they are all diagnosed based on the DSM. As the DSM continues to control mental disorders, the psychiatric practice, and brain dysfunctions, furthering research on the neurological source of these disorders slows down. (Rickards, White, Whitehead, Zeman 2012) The Meta-analyses have shown that structural brain abnormalities are present in schizophrenia, bipolar disorder, depressive disorder, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder. In functional brain imaging, both normal and abnormal emotions have neural representations. Therefore it is pretty simple to analyze which is which, that is a start for a resolution to the problem of these mental disorders. Depression and bipolar disorders are visual in the meta-analyses. (Rickards, White, Whitehead, Zeman 2012)It can also visualize the altered brain activity associated with hallucinations and relating to schizophrenia, which shows the modified activation in the limbic and related brain systems. Can this make diagnoses valid? Of course, however, there has not been funded more research, and this is not the approach psychiatrists take before diagnosing someone with depression or Bipolar. In which both of these illnesses are often misdiagnosed due to comparable symptoms.
One aspect that rattles more debates is the effect of this corruption on children. In the New Hope Media, ADDitude magazine evaluates different news about ADHD. In the article “My Child’s Doctor Got It Wrong,” a Medical doctor from Wellesley College, Daniela Drake, considers how numerous inaccurate diagnoses compromise children’s futures. In the meantime, a child diagnosed with ADHD may never identify the cause of his problems. As years go by, children grow, and the daily consumption of ADHD drugs has a tremendous effect on their health and social life; as doctors ignore disabilities, their self-esteem damages at a young age. This is a struggle that no pill can fix. Most of these children who are considered to have ADHD symptoms have the behavior of an average child. (Drake, 2021) Children need to have at least six symptoms from either the hyperactivity and impulsivity criteria in the DSM. Older adolescents and adults over the age of 17 years must exhibit with only five. While the requirements have not changed from DSM, the manual provides different samples of the types of behavior children, older adolescents, and adults with ADHD might exhibit. (Drake 2021) Despite this, ADHD has not been under research to become validated. Yet ADHD drugs came first than the actual investigation for this illness. This does not mean there aren’t children who have hyperactive behavior that may need assistance. It just means everyone has to analyze individually, not where do they fit inside a manual. (Drake 2021) “No one in the healthcare system had suggested any diagnosis other than ADHD.” Drake had brought her son for a regular check-up, and at the end of the visit, the doctor declares the child has ADHD.
Nevertheless, Drake disagreed. As a child bouncing off the walls has Sensory Processing Disorder (SPD). Another child has visual developmental difficulties. Another had celiac disease. All were diagnosed with ADHD. About 5.3 percent of all kindergartners meet the screening criteria for the disorder. This conclusion does not imply those 5.3 present have ADHD. It is either another cause of behavior or ordinarily youthful and adventurous behavior. Children are very expressive, which makes ADHD so familiar. Many of us in healthcare are ignorant about these common problems that reflect the ownership that pharmaceutical companies have over our medical knowledge. (Drake, 2021) Children with ADHD have jumped 42 % in the last eight years. This percent amounts to 6.5 million children with ADHD, and 3.5 million more are prescribed medication by 28 % over the previous four years. Distracted kids have been around forever, but ADHD didn’t register up in the Diagnostic and Statistical Manual until 1980. If invalid diagnoses persist unchecked, it will permanently jeopardize a child’s capacity to function in the world.
Studies report that those who are isolated and lack social support are more likely to apply for benefits. The director of the Institute for Health and the Health Care Policy and Aging Research, David Mechanic, a René Dubos University Professor at Rutgers University, executes a study for the relationship between SSI and mental illness. SSI Supplemental Security Income is a Federal income supplement program funded for the disabled, similar to the unemployment program. The report of the Navigating the Disability Process: Persons with Mental Disorders Applying for and Receiving Disability Benefits Mechanic analyzes how patients with a mental illness constitute a large and growing proportion of SSI recipients in America. (Mechanic, 2002) About an increase of 34 percent receiving SSI is eligible because of having a mental disorder. Between 1991 and 1999, the number of people receiving benefits because of a mental illness grew by more than 100 percent for SSI. To this day, it is still increasing because the SSI compensations have not changed. It is somewhat unclear for the increasing numbers but essential circumstances such as diagnosing people with mental disorders. Another program that lacks finding the problem like psychiatry is the SSI program. Instead of implementing mental health programs, the number of people receiving benefits of mental illness cases increments. The person most likely inducing a person with a mental disorder to apply is a family member onto a child. This Involvement in mental health programs is for the benefits. Whether it is because of the economic situation a family undergoes, the children do not have to say during these situations. What plays in services is how easy it is for doctors to diagnose children with a mental disorder. Including the child or adult taking their prescription to prove to SSI for benefits has to be a harmful and destructive cycle of families crying for help. Yes, there are desperate times, and how the system is implemented, one would not be able to notice who truly needs help. (Mechanic, 2002)It is concluded that the most vulnerable and disabled persons in the U.S. population apply for these benefits. The report of the Disability Policy Panel of the National Academy of Social Insurance, commissioned by the House Ways and Means Committee, concluded after an exhaustive study: is that SSI programs do not pose strong motives for Americans with disabilities to seek benefits in place of working. According to the DMS, a new revision for the SSI programs will be conducting interviews to provide more comprehensive care and diagnosis to these families. Discussions that ask about their background, culture, race, ethnicity, religion, or geographical origin. (APA, 2017) However, this does not display any effort in evaluating diagnosis, only better documentation of patients. As the SSI continues to grant and as doctors continue to diagnose accurately, the cycle will proceed.
Bipolar disorder is often overdiagnosed, according to a review published in February 2016 in The Canadian Journal of Psychiatry. In the article “Why Bipolar Disorder Is Often Wrongly Diagnosed,” Health writer Jennifer Acosta Scott and American Board of Psychiatry and Neurology and medical doctor Allison Young analyze bipolar disorder in the medical field. Pharmaceutical companies promote bipolar drugs extensively as there is aggressive marketing to the physicians, expanding the notion advances. Besides the limited amount of time doctors spend with patients, it is difficult to have a proper diagnosis. (Scott, Young 2021) Patients who are misdiagnosed with bipolar disorder can develop other health problems due to the prescription of bipolar drugs. Some medications include atypical antipsychotics, which may establish the risk for high cholesterol and diabetes. Similar to the famous medication of lithium, that may cause thyroid and kidney problems. According to a study published in July 2011 in the British Journal of Psychiatry, up to 20 percent of people with bipolar disorder are mistakenly diagnosed with depression. Without proper treatment, the future of these patients will not be an easy challenge. Most patients face alcohol, suicidal thoughts, or drug abuse to cope with symptoms, according to The Journal of Clinical Psychiatry (2015). (Scott, Young 2021) The mixture of the symptoms such as mania, and living in a harmful environment, and the use of improper drugs may interfere with the patient’s everyday life. This is a ripple effect that most patients endure but are ignored.
These deceived patients are someone’s neighbor, friend, relative, and sadly someone’s child. We have turned a blind eye to these cases, in addition to how powerful our pharmaceutical companies are. The psychiatric field has to turn into a capitalist scheme instead of studying to help patients with mental dysfunctions. Although there are many routes to this problem, it is best to spread awareness to reveal the truth behind mental illness in America. Reliance on drugs has to backtrack our research in the sciences due to the illusion that a pill could solve the problem. Time-honored medical dictum physicians need to remember is first not harm.
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