I
was pleased to see that in the June 2018 issue of one of the newspapers for
psychiatrists, Clinical Psychiatry News, a psychiatrist by the name of Carl T.
Bell wrote
about something I have been harping about in this blog and elsewhere for years:
the sloppy use of psychiatric terminology by both the public and by many
psychiatrists themselves.
Glad
to know I’m not the only one who has noticed this.
He
brings up three examples: the use of the words (two of which also have a common
meaning separate from the corresponding terms in psychiatry): traumatized, depressed, and bipolar.
Colleagues
of his had used the word traumatized as
something that happened to a person who was the subject of a statement by
another person that has come to be known as a “microaggression.” A microaggression
is defined as “a statement, action, or incident
regarded as an instance of indirect, subtle, or unintentional discrimination
against members of a marginalized group such as a racial or ethnic minority.”
As
far as I know, there has never been an example of a microaggression, or even a
direct verbal insult, in and by itself leading anyone to develop post traumatic
stress disorder (PTSD). According to Dr. Bell, being stressed by something like that, or by your boss chewing you out, is
a far cry from being traumatized. Being distressed by something like the death
of a parent is a little worse. It can come up from time to time, like on the
anniversary of the death. However, in both of these cases, unlike in PTSD, “the
mind is able to make peace with the reality…and life goes on.
“Traumatic
stress, on the other hand,” he adds, “is an event so painful and disruptive
that it runs the risk of breaking the mind’s ability to make peace with the
event…[and it] disrupts or destroys normal psychic life.”
I
would add that if everyone around you treats you like you are so fragile that
the slightest stress will do that, you start to believe it even though you
probably aren’t that fragile at all. And if you feel like that, you are
probably not going to take measures to actively oppose and undermine things
like racism, sexism, and homophobia. If enough people think like that, it is paradoxically
a great boon to racists, sexists, and homophobes everywhere.
I’ve
already covered the misuse of the term depression
in my post
of November 24, 2015, Depression is a
Symptom, not a Psychiatric Disorder. Major depression is a clinical
condition has many physical symptoms and is something that can be quite
disabling, while being unhappy, sad,
grieving or even demoralized is
not the same thing at all. The latter conditions do not respond to
antidepressants in the least, but researchers doing current studies on antidepressant
efficacy have become very sloppy and often do not exclude the latter people as
they should.
Bell
then addresses how the term “bipolar” is creeping into common usage to cover
things such as being moody and having difficulty regulating one's moods and
having a bad temper (especially in kids, I might add). For maybe thirty minutes
or an hour. And many psychiatrists just take patients at their word when they
misuse the term, and prescribe unnecessary and ineffective mood stabilizers.
In
that vein, another article
in the April issue of the same newspaper quoting a Gabrielle Carson M.S. talks
about the issue of tantrums in children. It advocates investigating the child’s symptomatology to rule out
bipolar and other mental disorders, as well as clearly behavioral problems like
so-called disruptive mood dysregulation disorder, ADHD, and oppositional
defiant disorder.
The only mention of environmental factors that might lead to
the tantrums is a quick and superficial reference to child abuse and school bullying. But the article says absolutely nothing about the far most common cause of frequent tantrums by
children (as discussed by child psychologist and columnist John Rosemond as
well as other people who actually look at what goes on in the child’s home):
problematic parenting practices such as acting like a friend to your kids instead
an authority figure, letting them make decisions that should be made by the
adults, compulsive yelling or lecturing, and inconsistency in administering discipline.
