Iatrogenic disease: do medical labels make you sick?

Inconvenient yes, funny sort of, but pathological? No. It is all part of normal. Oldies laugh about their mistakes, one lady giggled “I’m going daft!” Forgetfulness is worse for a person living alone because there is no-one to check, question, correct, remind, comfort, remove psychological hazards. For oldies forgetting is normal behaviour, so derogatory labels like ‘Alzheimers’ can do harm, add stigma, just like other words denoting intellectual, racial or other differences.

Abandon psychiatric categories?

DSM-5 was reported in The Guardian Weekly by Jamie Doward: ‘the American Psychiatric Association’s increasingly voluminous manual will see millions of people unnecessarily categorised as having psychiatric disorders.

For example, shyness in children, temper tantrums and depression following the death of a loved one could become medical problems, treatable with drugs. So could internet addiction … A disturbing picture emerges of mutual vested interests, of a psychiatry industry in cahoots with big pharma’, and Doward quotes Jon Ronson: “Is it possible that the psychiatric profession has a strong desire to label things that are essential human behaviour as a disorder?” ‘And now, in a significant new attack, the very nature of disorders identified by psychiatry has been thrown into question … the UK’s Division of Clinical Psychology (DCP), which represents more than 10,000 practitioners … published a statement calling for the abandonment of psychiatric diagnosis and the development of alternatives that do not use the language of “illness” or “disorder”.

Mary Boyle, emeritus professor at the University of East London, believes the DCP’s statement marks ‘a dramatic shift in the mental health debate: “The statement isn’t just an account of the many problems of psychiatric diagnosis and the lack of evidence to support it, it’s a call for a completely different way of thinking about mental health problems, away from the idea that they are illnesses with primarily biological causes”'.

Not surprisingly this has given rise to considerable debate about the nature of psychological ill-health.

Paul Farmer, chief executive of Mind said receiving a diagnosis can be extremely helpful, can provide people with appropriate treatments and access to other services. But consultant clinical psychologist Lucy Johnstone said:

Strange though it may sound, you do not need a diagnosis to treat people with mental health problems … there is no evidence these experiences are best understood as illness with biological causes

On the contrary there is now overwhelming evidence that people break down as a result of a complex mix of social and psychological circumstances – bereavement and loss, poverty, discrimination, trauma and abuse.

Growing older

A person who does not go to work or for other reasons is alone every day, with few opportunities for conversing, laughing, joking, reminiscing with others, can easily feel stressed, sad, lonely. This is not pathological but normal in the circumstances.

Everyone deteriorates with age or when in unhealthy circumstance so one way or another needs human support more than a diagnostic label, especially one with a sad reputation like ‘Alzheimers’.

All humans have to adapt to new circumstances throughout life. Growing old is about learning to compensate, adjust, physically and mentally, to decreasing strengths and abilities. You read your mental-physical state and adopt strategies accordingly.

A technical label like ‘Alzheimers’ may boost a physician’s esteem but can have the opposite effect on the patient, who may feel put down, no longer in charge of his own life, his own body, his own mind, way into the future.

He may prefer to hide the label than ask for help.