Mental Illness & Diagnosis – Saving Normal

Statistics about mental illness abound and increase by the year, with more and more people being diagnosed with mental health disorders. On one hand, stigma surrounding mental illness is slowly lessoning. On the other hand…

…there is growing concern over the high numbers of individuals, particularly children, using psychotropic medications, many with side effects that can seriously impact health.

Most people I talk to, in counselling, identify one or more mental illness that they believe they have, that they’ve been treated for, or have been diagnosed with. Depression and anxiety being the most common. Many people come to counselling wondering if there is something wrong with them, asking if they are normal.

I recently finished reading a book called “Saving Normal”* written by Allen Francis, a retired psychiatrist who was in charge of the the fourth edition of the Diagnostic Statistical Manual (DSM). The DSM is the ‘bible’ of psychiatry and is also used by General Practitioners (GP’s), mental health clinicians, psychiatric nurses, social workers, and therapists to assess and diagnose mental illness. It lists all mental illnesses currently considered ‘valid’ illnesses and the criteria for diagnosis (symptoms needed to be considered to have the particular illness).

The author, Allen Francis, retired just prior to the publication of the fifth version of the DSM, in 2013, and wrote this book as a response to what he feels is psychiatry, out of control. He spoke about the increasing list of mental illnesses with ever-broadening lists of symptoms. Throughout the book, he repeatedly states that a good diagnosis can be very helpful, and he believes that medication can be life saving and life changing for many but…

…he argues that our society has become increasingly perfectionistic, with less and less tolerance for anything considered less than perfect or ‘outside of the narrowing range of normal.’

Francis blames the pharmaceutical companies for promoting the idea that we are not quite good enough, or happy enough, and need ‘something’ to fix us. He speaks of the need for diversity in society, for people to be allowed to be sad when there is something worth being sad over, such as a loss. (See “A Good Time to Panic”), for people to express intense emotions such as fear or anxiety when in physical or emotional or psychological danger, and have diverse ways of seeing the world. Francis points to nature as a guide, where diversity is generally better for everything.

In his book, the author notes various ‘historical diagnosis’ that have been debunked and warns against pathologizing historically ‘normal’ and adaptive behaviours. He speaks about the harm of utilizing psychotropic medications, which he claims have not improved in effectiveness since the 1960’s, and states the main changes have been in reducing the noticeable side effects.

Francis points to the limited science around brain activity and the inability to accurately pinpoint mental illness. He asks that we, as members of society, put psychiatry in its place, using diagnosis only when it comes with clear life improving benefits, and using medication rarely, and with caution. In this way, Francis argues that those who are sick, and desperately in need of diagnosis and medication, will better be able to access it, and the rest of us “worried-well” can refocus our energies on building the life we want and not obsessing about our imperfections.

My own feeling is that many of our current mental illnesses (with several notable exceptions) are often ‘normal’ responses to the situations within our lives, our families, our communities, and our societies…Lets start looking at ourselves, and our mental health, ‘in context.’

…I believe that the best medication is to build lives, families, communities, and societies that care for its members and promote healing and health.

See “It’s Not Just You.”

CAUTIONARY NOTE: Please consult with your doctor before discontinuing or reducing any medication you are currently on as there are potentially grave side effects from reducing or discontinuing some medications abruptly or without consultation. If you feel you are at risk of harming yourself or others, call a crisis line or talk to a counsellor. If you find yourself having difficulty, or being unable to carry out day to day responsibilities, don’t hesitate to talk to your doctor or make a counselling appointment.

Click link to purchase the book: Saving Normal: An Insider’s Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life by Allen Francis*

*Please note: I have signed on as an affiliate sales person for McNally Robinson which means that if you click on the above link, and decide to purchase the book I’ve recommended, I will receive an affiliate’s fee. I only recommend books I have read and believe to be worth recommending.

Check out Mental Illness – A Relationship Story

For more on anxiety and mental health see A Good Time to Panic

Also see Depression Vs Grief – When You’re Down