Ploni Almoni1

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  • in reply to: Medicating for “Mood Disorder” #2482127
    Ploni Almoni1
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    I wanted to humbly add my voice to those others thanking Mrs. ShalomSimcha for opening up this important thread.

    Perhaps (among many other things) it might be helpful to add the following:

    The problem of over-diagnosis of mental illness and over-medication of the “worried well” has been recognized by experts at the very pinnacle of the field, including Dr. Allen Frances, who served as chair of the APA’s task force overseeing the development and revision of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), which is widely used in the diagnosis of Mental illness. A simple google search of his name will turn this up: “He’s a strong critic of expanding diagnostic criteria, arguing it turns normal human responses (like sadness or shyness) into disorders, often driven by financial incentives and pharmaceutical marketing”.

    He argues that over-diagnosis of MI has led to “false epidemics” of ADHD, autism and Childhood Bipolar Disorder, among other conditions.

    Besides many scholarly articles on the subject, almost 12 years ago, he wrote a book for layman on the subject, aptly titled “Saving Normal: An Insider’s Revolt against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life”. Just check out Amazon.

    One would think that when the fellow in charge of writing “The” manual about diagnosing MI complains about his work, clinicians would take notice. Alas, very few of the clinicians I spoke to ever even heard about him. Mostly, the false belief that seems to prevail is that only fringe elements of society would find fault in the prevailing attitudes to mental illness.

    Another name worth mentioning is that of Dr. Tom Insel, who was Director of the National Institutes of Mental Health ( known as the largest research organization in the world specializing in mental illness), for 13 years.

    Almost 12 years ago, before Yom Kippur Dr. Insel wrote the following:

    “As it turns out, Mental Illness Awareness Week this year began with Yom Kippur, the Jewish Day of Atonement. Which begs the question: what do we (in the mental health community) need to atone for? There are so many answers. For some, it may be the culture of blame and shame perpetuated for years by clinicians who explained all mental illness as being caused by trauma and evil parents.
    For others, it may be the singular reliance on medication and modifying behavior rather than holistic care and the provision of skills.
    Others will name the paternalistic structure of mental health care, which can undermine rather than empower individuals and their families. …
    My own favorite atonement issue for Mental Illness Awareness Week this year is the lack of humility in our field. Mental disorders are among the most complex problems in medicine, with challenges at every level from neurons to neighborhoods. Yet, we know so little about mechanisms at each level. Too often … much of mental health care is based on faith and intuition, not science and evidence”.

    As noted earlier, both the book written by Dr. Frances and the blog post written by Dr. Insel are almost 12 years old. Unfortunately, very little progress seems to have been made over the past 12 years in rectifying the situation.

    May I humbly submit the following question: Perhaps ShalomSimcha, kingdavid, flamingOTD, and the other excellent commentors on this thread would like to get together (probably through an online forum) to further this discussion? Perhaps the mods of YeshivaWorld would want to facilitate such a discussion?

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