The Ted Community did contribute to the discussion and there comments can be found at:
http://www.ted.com/conversations/13829/does_psychiatry_have_a_financi.html
Does psychiatry have a financial interest in expanding the definition of mental illness?
Does both the pharmaceutical industry and the psychiatry profession have strong financial interests in convincing the public that drug treatment is safe and the most effective treatment for mental illness,
The National Institute of Mental Illness reports that currently only 36 percent of those who suffer from mental illness actually seek and receive treatment but they would still like to expand the definitions. What and why should be a concern to everyone.
There is no question that among the medical profession, psychiatry is the most scientifically primitive. The latest revision to the America Psychiastric Association's Diagnostic and Statistical Manuel of Mental Disorders (DSM-V) has drawn strong criticism. "Owing to criticism over the perceived proliferation of diagnoses in the current edition of the DSM, David Kupfer, M.D., who is the DSM-5 Task Force chair and is shepherding the DSM's revision, said in an interview: "One of the raps against psychiatry is that you and I are the only two people in the U.S. without a psychiatric diagnosis."
Dr. Daniel Carlet, an Associate Clinical Professor of Psychiatry at Tufts University admits, "We are no more than the most rudimentary understanding of the pathophysiology of mental illness and we have resorted to tenuous and ever-shifting theories of how ..treatments work."
"Psychiatry had a powerful weapon that its competitors lacked. Since psychiatrists must qualify as MDs, they have the legal authority to write prescriptions. By fully embracing the biological model of mental illness and the use of psychoactive drugs to treat it, psychiatry was able to relegate other mental health care providers to ancillary positions and also to identify itself as a scientific discipline along with the rest of the medical profession. Most important, by emphasizing drug treatment, psychiatry became the darling of the pharmaceutical industry, which soon made its gratitude tangible." Dr. Marcia Angell
http://www.nybooks.com/articles/archives/2011/jul/14/illusions-of-psychiatry/?pagination=false
"The Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association provides a common language and standard criteria for the classification of mental disorders"
http://en.wikipedia.org/wiki/Diagnostic_and_Statistical_Manual_of_Mental_Disorders
To use the medical model, I think that we are asking, "What is wellness?" We are all in a degenerative physical state, but we all learn to cope with our developed conditions. Wellness is therefore relative.
Health is very personal, and we usually get to make the choices regarding our quality of life, and this means that we get to make bad choices as well This is not true of mental health which is more socially driven, where one can be medicated against one's own will.
I state that psychiatry is "scientifically primitive," but medicine has an obligation to "do no harm." Can psychiatry's answer to the question of whether its practices meet this obligation pass the straight face test?
So if we were to look at this in a non-linear manner, what's actually broken: What are we not adjusting to that we need to medicate? Big Pharma is merely the commercial side of the equation. The War on Drugs is really a war against people who feel the need to self medicate, and if this does multiple the problem somewhat because the problem of addiction, from both drugs and alcohol, is probably hidden mental health issues as well.
My suggestion to the question, "What is broken?" is that we are social animals and yet we have allow he bonds of social institutions to break down. We put our children into Day Care and our elderly into nursing homes, we feel no real sense of belonging, we fear what will become of us
As Sherry Turkle notes in her TED Talk that we would rather text than talk. She says, "I believe it's because technology appeals to us most where we are most vulnerable. And we are vulnerable. We're lonely, but we're afraid of intimacy. And so from social networks to sociable robots, we're designing technologies that will give us the illusion of companionship without the demands of friendship. We turn to technology to help us feel connected in ways we can comfortably control. But we're not so comfortable. We are not so much in control.
Is this the roots of some of our mental illness, I believe it is, and medicating will not make things better for us. Real human interactions will. but there is no societal pill for us to swallow that will make it all better. We'll need to learn to be more authentic, more caring, more nurturing and more compassionate toward one another. Big Brother is not the government, it is your neighbors.
"Disability," as it applies to mental health, is a term that can define both cognitive disability, and emotional and behavioral disability. So let's ask, "How did depression, which was once viewed as an episodic illness become a chronic and disabling condition?"
The issue that I am raising here is that psychiatry has moved away from analysis and talk therapy, and one of the main motivations for this is that it is that it is just to easy to prescribe drugs. I think we have all seen the advertisement there suggest taking an additional medication,"ABILIFY," if our depression medication isn't doing enough for us. Does this make any sense? Should it even be allow to be advertised to us in all its cartoon wonderfulness? "I'll take the pills that surround me with sunshine and butterflies please"
http://www.abilify.com/pdf/treating-depression-hcp.pdf
Additionally, there is a general divide between the psychiatrist and the neuroscientist and we would do well to ask who is building the between the two. Your comments raises an important issue, that we should make the distinction between neurological disorders and psychological disorders, and that the two sometime overlap. The mind and brain can both be described as being based in the physical world, but explaining the mind, or mental illness, purely in physical terms, may not always be appropriate or useful. Do if we cannot identify medical causations for psychological condition that others views as a disorder, are we not just substituting being medicated and all its side effects with actual wellness?
There are several different points here to address:
a) the DSM is currently being revised, DSM-5, see the following for some explanation of the controversies surrounding the revisions:
"Bereavement, which has always been excluded from the mood disorders, will become a mental disorder. Mild forgetfulness will become a mental disorder ("mild neurocognitive disorder"). Your child's temper tantrums will become a mental disorder ("disruptive mood dysregulation disorder"). "
http://www.psychologytoday.com/blog/rethinking-depression/201110/the-dsm-5-controversy
2)Prozac should have taught us something. Placebo works. But in America, unlike Europe, it cannot be prescribe.
3) regarding criminally and mental illness, I can recommend the book by David Eagleman, "Incognito." There is also an recent this article by Eagleman from, "The Atlantic."
http://www.theatlantic.com/magazine/archive/2011/07/the-brain-on-trial/308520/
