You defeat yourself Mr. Dawdy when you use their language and terms. People don't 'have' depression, it's not a disease. If you think it is, I suggest you figure out how to find it on the autopsy table. Suggesting that BP2 diagnosees don't deserve to have their lives descend into a slow burning candle of psychiatric destruction lends others to believe you think its ok for BP1 diagnosees, as a fate. I would put it to you that there is millions of people who 'treat' their alleged 'disease' when this is a disease which has never even been proven to exist.

The only thing exists in the entire DSM is psychosis, and it heals itself when left alone. The only people in this world who end up with a lifetime of chronic disability related to mental illness are those whose initial psychosis is prevented from natural resolution by neuroleptics, and those whose psychosocial identity is wantonly destroyed and disfigured by the social ramifications of the label, combined with the self fulfilling prophecy of the prognosis, and the resultant hypervigilance and neuroses that develop as patients begin the process of overpathologizing their every mood and thought. Separating themselves from a person with some short term trauma, to lifetime mental patient. It is all artificial, and a terrible destructive symphony of human experiments showing us the brutal destructive power of psychiatry's power of suggestion and abuse of authority that can occur when a whole medical class of 'experts' suffer from dogmatism, indoctrination, and mindless biological determinism, and working in concert with a capitalist machine worth tens of billions. Nobody should place any validity in a single diagnosis psychiatry makes, and you trust this sector at your peril, and your family's peril.

If you want to spend at the very least, years in turmoil, take on a psychiatric diagnosis, at the very worst, years of torture followed by the disintegration of your brain and body and identity, followed by an early grave.

It is painfully, oh so ridiculously, wantonly painfully excruciating to see you struggle with the truth so publicly Mr Dawdy. You cling to cherry picked parts of the psychiatric paradigm, and i'd recommend you face up to the reality, you needlessly were dragged into this tragic underworld of 'mental health', and begin really facing up to the injustice done to you. You, on meds for what, 20 years, your family's, the world's views on whether you are a fit and proper person, to even breed, all marred, and on the basis of what, the DSM you describe above? And here you are, using psychiatric language in a way that validates 50% of what they do, and in the end, really, you seem to be tragically unaware, of the deep, holocaust level realities, of what is happening thanks to psychiatry in this age.

Yep, Lane is definitely on to something, as are you. Never tell a psychiatrist you have insomnia. You will be diagnosed as manic. Which is weird as the prescriptions for all of the sleep aids like Lunesta and Ambien soar. It strikes me as odd that some people can be diagnosed as having the non mental disorder, sleep disorder, and others, as manic. Maybe the difference is general practitioner v. pshrink...and of course maybe someone who is unhappy and can't sleep is really worried about something. If your loved one is a soldier in Iraq and you are unhappy and anxious because he or she is in a dangerous situation these days you're likely to get a bp2 diagnosis, unless of course you voice anger about the war and discuss politics in an animated fashion at the phrinks, then you'll have the phrink axis 2ing you with antisocial, histrionic or borderline, depending on your gender, age, race, sexual orientation, and appearance, and flipping a coin on your axis 1, bp1 or schizophrenia.

Meanwhile listening to the news reports about the rapper T1 it once again occurs to me that when a non black man commits a violent crime or gets busted with a warehouse of artillery the media speculates about whether he has a mental disorder, is a crazy dangerous maniac, while if the perp is black, the spin is just, "he's black," reminding me of the discrimination that both black and those labeled crazy suffer. Imagine if T1 had been a white rock musician at the emmys.

shoot me an email bill if you want to talk with me directly. you know where i am sure.

I'm interested to know where Bill is coming from.

While I can't necessarily agree with the tone that Bill adopts in his comment, I admit to having some sympathy for the point he makes. His ideas remind me of those I'm having as I read Comfortably Numb. So much of what Barber says is right on about big pharma, the FDA, our culture, even psychiatry. The only part of his book that gets rather murky is when he starts trying to distinguish between depression with a little "d" and Depression with a big "D". Just who really has the right to draw the line between psychosocial ills and "real" mental illness? Or worse to decide that maybe meds help those with the big "D" kind of depression but not the little "d" kind? How do we do that? Isn't it similar to saying kids and young adults up to the age of 25 can get suicidal but on your 25th birthday and beyond you'll no longer be at risk? We have to be very careful that we do not buy into the arrogance of psychiatry when we are talking about people who are suffering emotionally and behaving bizarrely. Just my two cents. I know it's hard to talk about these things without using some of the jargon but for the sake of those suffering (and "diagnosed") we ought to try. So yes, why is BP1 legitimate as a diagnosis but BP2 isn't? We need a whole new way of talking about and treating this behavior. There is a spectrum and drawing arbitrary lines in the sand between what's "normal" and what's "abnormal", what's "illness" and what isn't, may not be constructive.

Uh, Bill there's a lot more in the DSM than psychosis and where is your evidence it heals itself if left alone? when one writes about the psychiatric realm, there are no other words to use other than what is in place. Find a new word for psychosis, and make sure you prove that even exists, before you claim it can heal itself.

You've chosen ONE word. The most abstract and controversial one in the DSM to define, and you appear to have no problem with it.

I wonder why.

Those who put the incidence of bipolar 2 at 4-5 percent are using a debased set of diagnostic criteria, which is absurd and likely to cause a lot of damage. But most estimates I've seen for bipolar 2 still put its incidence at just over 1 percent of the population - about the same as bipolar 1.

Also, bipolar 2 in the strict sense - i.e., with symptoms that actually match the DSM criteria - is not so "soft." Bipolar 2 sufferers may have higher rates of rapid cycling and even suicide than people with bipolar 1, and tend to spend more of their time in depression. And people with bipolar 2 have an elevated risk of psychotic depression, which may not be as loud as psychotic mania but can be just as deadly.

I should add that I've been switched from an "anxiety" label to BP2, and am now tapering off of all of the drugs as a result of no diagnoses except human existence.

Public speaking, eating alone in restaurants, all of those social phobias are ones people have that are NORMAL, like stage fright...old fashioned practice of what scares you the most works. Everyone feels self conscience or shy at some point in their life, anxious, etc. geez I hope so, that's normal, it's not mental and or illness.

It's why they have Toastmasters classes and stuff.

I understand Bill's point about stigma, early death, don't get in their clutches, etc. But both my children were bipolar I and the psychosis was real. Though I now hate any drug, due to the murder of my son, I don't know how the "psychoses" my son had would have gone away on their own without intervention. Plus, to his credit, his life - until being killed- was not ruined. He had an indominable and brilliant spirit, great kindness, and overcame stigma. He was like a Gandhi person, and every time he was knocked down by symptoms, got up again. He had the most serious of bipolar one, and up until his being forced on Zyprexa, did well most of the time on lithium. Do not tell me I am struggling with what the system did, or what I did wrong. Enough of that. I live every day dreaming about harming psychiatrists and Eli Lilly personnel responsible for his death. And I also live with that agony for myself - for somehow not recognizing the symptoms of hyperglycemia. Be careful how you speak, Bill. I am sure you do not want to wreck any more people by being self-rigteous and hyper critical of innocent victims and their families.

What really bothers me, whenever anyone brings up social anxiety disorder, is that no one seems to think much of it as an actual disorder. It's always mentioned in connection with the "are we medicating normal human behavior?" discussion.

I find this very frustrating because I have social anxiety disorder and it has a real, tangible impact on my daily life.

I should note that I'm not necessarily endorsing medication on this. I'm already at the max dosages for several antidepressants for (duh) depression and, though the drugs haven't done much for the social anxiety, I don't think I could handle taking more.

My anxiety was crippling and life-altering, until I learned how to control it by identifying what was at the base of my personal anxiety: fear. Being on Xanax for 9 years, I'm currently removing it, because with age I've learned coping skills and tools that help me overcome the once crippling social anxiety and severe shyness, and turn it around. Just my own personal story based on my own experience and life, I certainly cannot speak for anyone else's anxiety disorder. I learned that the energy I used was based on fear, so I took that energy and moved it forward, and I went from a quiet person, unable to function at the thought of being in public to a public speaker. Did all of that before Xanax even entered my life.
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re: sorrowful and your son: I would like you to have some hope, and to use my daughter who is still alive and only 20, being on antipsychotics since age 11; it is her spirit and never give up attitude that I know has helped her remain here; she took Zyprexa for 6 years and is now on a deadly antipsychotic Clozaril. She's here, and against a lot of odds stacked against her. She sounds like your son. She never gave up, went to high school on these drugs and never missed a day, even when people told her to go home. One of her honor student reports was one written about Gandhi; she volunteered hundreds of hours by age 17. She has actually trialed all of the antipsychotics, survived Haldol injections and a lot of crap. She is here because she is a symbol of hope and determination, and one can only hope her body doesn't give in to the drugs; and as you wrote you feel your son's psychosis needed treatment. I understand the anger about the lies Lilly kept from the public;[it causes grief for me too as you know] but the other drugs were/are just as dangerous. It's a crapshoot with that. And a very difficult thing for people to address, is how some ppl need these meds., maybe your son would still be alive if he had not used Zyprexa, but considering the other antipsychotics, it can still go either way. The risk to damage of a body is there using any one of those antipsychotics. Clozaril is a last resort drug, and my daughter is on it at a very young age. It has saved her life. Many people may question the quality of it. I'm just glad she's here, and I'm sorry you've lost your son.

Bill, you don't have to agree with Philip about every aspect of mental health to find the blog useful. I know I don't and I find it admirable that he shows us his hand, let's us know where his bias lies, while reporting objectively. This is not the norm in journalism, especially not in the mental health arena.

The idea that psychosis is the only real diagnosis in the DSM intrigues me. The problem is psychosis is such a vague and subjective term. On April 30, 2007, Philip posted an entry about the definition of psychosis.

Here's a quote from Lane that I find true, "Sanity must prevail: if everyone is mentally ill, then no one is."

Jonathan, everyone feels social anxiety in certain situations, some people feel it more than others.

While I don't like the DSM, it's helpful to think of it not as a catalog of abnormal psychology but as a catalog of normal psychology, sort of like how the Merck's Manual is used to list normal physical problems. Look in Merck's and you'll get a pretty good idea how someone is diagnosed with and treated for the common cold. When someone has a cold, they are not considered seriously and abnormally ill, though they do often need to change their routines somewhat to get well. Social Anxiety Disorder should be viewed more like a common cold of the psyche, something everyone gets sometimes, some more frequently and with more severe symptoms than others.

The problem is when the DSM jumps in importance and people begin being labeled as lacking full status as human beings if they exhibit certain behaviors or are thought to exhibit them. The classic example is homosexuality, long maligned by psychiatry as criminal behavior caused mental illness, finally accepted as normal behavior. Now people's normal responses to our society are getting labels.

Sally,

I know that everyone experiences social anxiety at some point, to some extent. Everyone gets depressed or sad sometimes as well but few would debate that there aren't cases that go well and beyond anything healthy or "normal."

Hell, maybe "common cold of the psyche" is an accurate assessment. But to take your analogy further: just because everyone gets the sniffles doesn't mean that there's no such thing as bronchitis.

Unless, maybe, what I'm experiencing is "normal" enough... you tell me: I've never had any kind of close relationship—not with friend or family or anyone. Even casual friendships are difficult. I don't have people that I socialize with on even a semi-regular basis. Outside of work, where I have no choice, I don't talk or interact with people. Don't bother asking about dating... I've been single for 6 years. On many occasions I'll literally turn and run away and hide if I see someone I know so I won't have to talk to them. The telephone and the doorbell make me panic... I never answer them. I'm even afraid to leave the house, even if just to get the mail, if I see any of my neighbors out. One summer I went weeks without talking to anyone. If someone is walking behind me I worry that they're thinking or making fun of how I walk. During one job I'd go months without picking up my paychecks (the actual checks, not just a stub) because going and asking for them was too scary.

I could go on and on. If that isn't severe enough to be considered a "disorder" then I don't know what is.

Thanks Stephany. My son would most likely still be alive because he would still be on lithium, which helped him with no ill effects for 13 years. The only problem was an occasional breakthrough into psychosis then swinging down into suicidal depression. It is my feeling that if anything would have gotten him it would have been while he was in one of those states. But he had made it for years; he very well might have been making it still. On the times he became psychotic he was given one of the old antipsychotics, which brought him down "quickly". My take on Phil's story was that was the way Zyprexa was originally to have been used.

You are lucky and must be proud that your daughter has such will.

The latest contestant for the DSM is computer/texting fixation. Imagine! Another was for the docs and Pharma to make money. I guess they will abstain from labelling people who are deaf, for whom texting is and can be a lifesaver.

None of you have any evidence that anyone would have been ok if they stayed on lithium, it is just rampant speculation. The key fact that never enters your minds is that the initial psychoses, are never allowed to resolve, and then in the months and years afterward, the brain is never allowed to live a single day unhindered by the psychodrugs... in its organic state. Therefore, it is entirely possible that the drugs make the brain more volatile than before, and every relapse psychosis, or every 'continuing' 'voice in head' is a combination of drug induced psychosis, and the original psychosis never being allowed to heal. You said it yourself, nothing but 'masking'.

The cruel truth, is that overseas unmedicated schizophrenics do much better, and your 'faith' in the 'maintenance' treatments, has no legs, no grounding in fact, because basically it's just a hollow faith based initiative you take, when you complain no end about the drugs not doing anything for you.

There is no organic extreme state of mind that lasts more than a few days when psychiatry is removed from the equation. There isn't. It's manufactured madness, the power of suggestion, and hypervigilance and the power of suggestion.

Psychiatry needs you more than you need it.

sorrowful, yes, i am extremely proud of her and she is my hero, she never gives up.

Jonathan,

I don't mean to minimize your distress or suffering in any way but I will say that if you are leading the kind of life you describe it doesn't sound like the medical disease model is really helping you.

Here's an analogy - It's interesting that you would mention bronchitis. I used to come down with a case of severe bronchitis every winter. Just because it was severe didn't mean it was abnormal for me to get it considering my habit at the time of smoking one and a half to three packs of cigarettes a day. When the bronchitis got so bad that I couldn't finish a cigarette because of extreme and debilitating coughing fits, I would go to the doctor. The doctor would prescribe antibiotics and that wonderful codeine cough syrup. I would eventually get better, but each year it took longer and longer. The doctor explained to me that if I didn't quit smoking soon I would get a more serious yet also under the circumstances normal condition, emphysema and was an excellent candidate for lung cancer, of course I already knew this. Cigarettes are legal but blessedly because of the courage of activists and the horrible death of lots of folks their manufacturers are legally forced to disclose the risks of abusing them. Did you see the movie The Insider?

Four years ago I finally quit smoking. Not because of my own health concerns but because I have a cat who has health problems and all of that second hand smoke literally had him coughing and gagging. Also, I was broke and 3 packs a day is expensive.

Now, while I have my share of problems, I no longer have bronchitis. I was able to quit by throwing out the cold turkey nonsense and cutting down. Occasionally I will smoke a cigarette and occasionally I still crave nicotine so much I wear a nicotine patch.

I sounds to me like a lot of your issues may be caused by the anti depressants you are taking as well the medical model of mental illness which tells you spend your every waking moment looking for symptoms of mental illness in yourself and fails to point out to you that most people who spend their lives in and out of therapists offices focusing on their problems and hopped up on psych drugs continue to get sicker and sicker just like most people who smoke three packs of cigarettes start to have trouble breathing.

Still, if what you are doing works for you keep doing it. I'm certainly not a doctor. Have you considering Reiki (I know it literally rhymes with flakey, but it's worked miracles for me in releiveing the free floating anxiety I used to suffer from).

Sally,

Why do you think the medical model isn't helping me? Not that it's perfect or anything, but it's because of drugs and therapy that I'm working again, that I'm finishing my degree this year, and that I'm no longer having suicidal thoughts. I don't spend all my time looking for signs of mental illness and I'm certainly not getting sicker and sicker. As bad as life still is for me, it's a far cry from where I was before I started anti-depressants.

I'd like to make my intentions clear, though. I'm not trying to defend any sort of model or form of treatment. I'm just defending the validity of the label "social anxiety disorder." I know that labels and diagnoses are complicated and messy and can have bad ramifications, but there is definitely something empowering in the label. It means that, yes, my problems are serious and that there's more to it than being shy and that, despite how it feels, I'm not alone in this.

Reiki? No thanks. I've had people try to "fluff my aura" before and I have to say that it didn't have any effect.

Bill,

While I've never been on lithium before to give a rebuttal there, I can say that I spent the first 19 years of my life in the "organic extreme state of mind" of depression and anxiety before any kind of treatment entered the picture.

The DSM..
Just the mere mention of it makes me laugh out loud..

Jonathan, I'm glad you're getting better. I think it's unfortunate that you defend the validity of the label social anxiety disorder, still I suppose it's your right.

Whereas I will say that mental illnesses do exist, I will also say that America has taken this psychiatric-rollercoaster way too far. Like some, I believe that some medications, do help, but I also believe that the pharmacological community has gone way too far in trying to make a profit. Medication is just part of the solution. Wellness coaches should be in every MH Clinic teaching ABOUT NUTRITION, about exersise, environment, socialization and they should encourage spirituality for consumers as well. Some medications DO make people sick, and hypoglycemia IS rampant, when one considers the mental condition affecting chemistries of the body as well as even the classic medications such as lithium to cause thryroid problems. Medications, in my opinion, should be used at the LOWEST DOSEAGE POSSIBLE and there should be a mandate for wellness training, support and cognitive therapy to be offered at the choosing of each patient. Were I president, it would be so.

As well, I think that society, not so much the people in it, but the people who run it and lead it, has caused its own mental health crisis, through strict behavioral codes in which people are not allowed to "cry" at work or to have time off to grieve the loss of a loved one. I am not saying that discipline and proper behavior is not important, but I am saying that issues such as community, mutual support and compassion seem to have "gone out the window." As well, personal accountability has gone as well. We aren't "responsible" per say inwardly, so we have more "outward" signs of discipline such as more security guards and cameras everywhere. We are given cheap pleasures like promiscous (misspelled?) movies or alcohol to replace what we used to do--sit on the front porch or have ice cream with the neighbor. We are all taught to be "to ourselves" and worry about our next door neighbor;this creates distrust and a sense of panic all around us. And then, pollution is everywhere plus over population. These factors all contribute.

There have always been folks who were or are different. We have seen that with a boost or help, many different folks can be helped. Until we see the larger picture, that our social problems contribute and that wellness isn't addressed, we will continue to over drug our fellow compatriots and allow biological determinism to bring discrimination. Medications are only PART OF THE SOLUTION. Just like pl 94-142 with a least restrictive environment, I believe that it is important as well for consumers to take safe medications that are only to the dosage that is theraputic enough to help them and are reduced as they age out. Only under this regimen would psychiatry work.

M Henley