Grrrr, we've even got Satel admitting there's no evidence mental illnesses are brain diseases and that the DSM is not reliable and yet we get nutcases like this arguing that social anxiety disorder exists as a distinct mental illness in children or that medication for this purported disorder is helpful or that children so labeled are likely to commit suicide.

Getting that label and subsequent "help" turned Cho into a mass murderer.

It's frightening when the facts and the statements of folks like Pies don't match.

The irony of Pies' remark is that in fact suicidality is much higher in those diagnosed with an anxiety disorder who are then given an antidepressant than it is in those with a depressive disorder who get that treatment. David Healy (and others, like Teicher I believe) have demonstrated this quite conclusively. The "latest evidence" Pies is referring to are those seriously flawed epidemiological studies that try to demonstrate some causation by looking at supposed correlations (which turn out not even to be there). Oh I get tired when these docs start getting arrogant and dismissive on us. Lane did come in for some attacks from the establishment but at least there were some other letters saying he was right on which I think he was. And, yes, therapydoc is right, no one should stop taking the drugs impulsively, but he sure doesn't get the greater implication of what this means -- i.e. they induce dependency, create lasting changes in the brain and are bloody dangerous tools for meddling with moods.

Well "Everyone Needs Therapy" in my opinion has no business being a social worker or therapist or whatever the person does, with such attacks on people it's representative of that person's Professionalism, if in fact they are a professional in the mental health world, and to remark that someone likes their "label" to gain SSI benefits--makes me sick. I do not know one case manager, social worker, therapist or psychiatrist to EVER say such a thing to anyone. As a matter of fact, SSI is not easy to gain and professional documentation is required and it's often case managers or social workers that HELP people gain that income while they need it. I guess this is when as a person, I consider the source and don't consider it a source to bother with.Everyone has an opinion, we all base it on experience and to share information and experience that can help others somehow is key here. Oh well.

You want to see malicious do a search at ENT on "borderline personality disorder." I saw this coming after we ran her off here last week. You're a crank Philip and Gianna's a psychobabbler, yes, let's talk about REGRESSION, by all means. Tool.

I like to think that despite the significant differences among mental health advocates, we all care deeply about improving the lives of a stigmatized population, that has no lobby group, and very little say in what is put into their minds and bodies. I may like to think so, but as the evidence shows, that would be nonsense.

Wow! ENT, that's pretty dramatic. Now the thousands who were going to stop their meds because of Phillip's blog have been saved from certain death...by you. They will surely read your plea and decide to continue their meds, and they will be saved! Excuse, me while I laugh uncontrollably. Get a grip, dude.

So, is Pie's saying if we dx children with social anxiety and not depression, then we need not worry about them committing sucide when taking an antidepressant? Lets just lable all kids as having social anxiety and forget about the black box warning altogether, sounds simple enough?

FP:

I just had to do the "borderline" search on ENT; but then again I'm the kind of person who hangs around car accidents and stares at odd-looking people on the street. I knew I'd hit the rubberneck jackpot when I read "Indeed... when it’s case material it is always a fusion, sometimes I even use scenes I’ve seen on television, sometimes I make them up. No case I have ever treated has been presented on this blog." (Emphasis added.)

Funny, I did miss the "loving and caring" subtext too, but perhaps that's just our "extremely poor judgment"?

The FDA has certainly over estimated the positive affects the anti-depressants are having on the teens while also under-estimating the suicidal side affects brought upon by the medication. This evidence is nothing more than statistics, but should bring to the FDA's attention that further investigation needs to be done.

Ruth--I, too, couldn't resist a search on ENT's blog for borderline personality disorder. His arrogance and condescension were painfully clear---the "expert" indeed. The comments from 'anonymous" following his posts said it all: "Humility is a trait I find invaluable in a good
clinician. Being able to say, "I don't know...I don't
have all the answers," is far more respectable to me
than clustering groups of people, making judgments
about other professions and generally writing very
freely about a wide range of mental health topics that
aren't always accurate and are knee-jerk reactions.
Many respectable, thoughtful, empathic people are
devoting their lives to doing research in some of the
areas you so flippantly make judgments about.

What you wrote here leaves a very bad taste in the
mouths of many mental health professionals, who,
approach their work with humility, and with tremendous
respect for their clients' pain. I hope in the future,
you will consider writing with greater respect and
sensitivity.

You wrote the word "me" and "I" several times in this
blog, indicating to me that this particular therapy
was really all about you. If words really do "hit as
hard as a fist," why not be more sensitive with your
words and who your audience might be? Have you
wondered if your own clients who are working so hard
at healing, might read your thoughts and think twice
about your belief in the human capacity to heal and
the level of respect and empathy you truly possess?
Protecting clients' welfare, and being respectful of
clients, is stated in the Code of Ethics in your
field...I question some of your posts and whether
you're meeting the standards of ethical practice in
your field." While I generally agree that "everyone needs therapy" (well, I would humbly say " could benefit from" instead of "needs", he is the kind of therapist/social worker I would avoid like the plague. I'm new to these blogs but I never detect that "I know everything"/smartass tone in Furious Seasons et al. What "anonymous" expresses is the kind of mental health professional whom I respect and would seek out.

Oy vey. I'll be posting on the SSRI-suicide issue yet again soon, specifically regarding the comments of Dr. Pies, who seems either unaware of the easily attainable data on the topic or is dismissive of it. Sara's comment is spot on. Thanks for keeping the spotlight on this important topic Philip!

There's an interesting and thoughtful commentary about Chris Lane's NYT editorial on the blog of Reason Magazine (definitely not influenced by Big Pharma or psychiatric orthodoxy).

It says in part: "The problem is not that psychiatrists are overdiagnosing social anxiety disorder; it's that social anxiety disorder is whatever psychiatrists say it is."

Here's the link:
http://www.reason.com/blog/show/122650.html

As a result of my bipolar label, I lost my freedom, my job, some friends, my home and my marriage. Personally, I think I've been mislabelled but that doesn't change the fact that I'm unable to work at the moment (especially since I keep getting locked up in the loony bin) and it's either take the gimp cheque or live on the streets.

I have some sort of affliction, certainly, but it might be that society's affliction is much more severe than mine. In general, when you take something away from a person, the law says that person should be compensated. Keep those cheques rolling in. I'll let you know when I'm "cured."

Francesca, as someone who worked in the social security disability industry here in the US, it's my opinion that a)it's not you, it's them;), and b) as I testified in disability hearings, whether or not someone has symptoms others consider mental illness is not what makes person disabled, it's having a public record of that label, so of course if you have that label you should get a check if you are not working until society removes the bs stigma from people who attempt to get help from the mental health industry. As you know, there are many people with the label of bipolar, some who accept the label and some who don't, that work and are incredibly successful, but what unites those people with the rest of us with the label is that we all know the tremendous and tremendously unfair burden having the label puts on us.

In Texas, a person who is diagnosed with borderline personality disorder can't be a nurse or physician without going before the Board and proving yourself (which you can pretty much forget about). This question is asked prior to licensure. So, be very careful about pissing off your psychiatrist if you ever want to work in the health care field in Texas. Because if you get tagged with Borderline in your records, you're screwed.

Sally, do you suppose I could finally ease my nagging conscience by concluding that I get the cheque in payment for the label? That's my job. I'm bipolar and the government pays me $780 a month to stay that way. It's a good gig. If they want to cancel the gimp cheques, then they have to certify me *sane.* Canada Pension Plan people, I await your telephone call.

For someone to feel guilty about getting disability for any reason is wrong. It's the folk that make it necessary to make people apply for it that should feel guilty....I could go on for a long time about this.

A monthly disability payment is small compensation for the pain and hardship that psychiatry and a psychiatric label imposes upon someone. The biggest drawback of it is that the government can suddenly and arbitrarily decide you're no longer entitled to such payments (at least that has been the case here in the U.S. - it happened to me when I told them of a part-time job I had, and that I was no longer receiving mental health treatment).

Maybe you could look at your disability payments as a chance to become self-employed, Francesca. Use it as a chance to learn a skill that will let you earn money without having to be someone else's employee - maybe something like computer graphics, desktop publishing, or medical transcribing. I think that's what I'd do if I was still receiving disability payments.

its my observation that anxiety and depression like each other quite a bit, they tend to hang out together, one masks the other, they take turns, its like a dance party or something, but they're haven their party in someone's psyche, and thats the drag of it. a very un dsm perspective i suppose, but seems to me that give it enough time and dig under either one and the other is hanging out there. thats comment 1.
comment 2: perhaps social anxiety disorder is about societies anxiety and not the carrier's. perhaps society has anxiety because it is so manic that its hard to keep pace with things anymore but if we let ourselves slow down we'd notice what a mess it all is and the entire culture would sink into a deep dark depression so anxiety keeps the despair at bay. reminds us to shop so we can support our manic culture ... just doing what the man said.
comment 3: sorry. a bit of devils advocate in me today, but i do think so, on both counts.

I'll be apologizing to you both in my return-the-favor-of-the-links post in November. I had no intention of seriously arguing and certainly didn't intend to diss anyone, so much as to draw attention to these discussions. I linked to both of you respectfully. At least I wanted to do that. Sorry if it came off wrong. These return the link favor posts are supposed to be cute, but obviously you didn't think so. Again, I apologize.

Just to muddy the waters a bit - I've found many comments by the "therapydoc" to be among the most caring, well balanced and empathic that I've come across on the web - but perhaps that's because I'm "borderline".
Some people really are just trying to help...