Wednesday, 28 January 2009

This is why psychiatry is important.

I am infuriated by the "all in your head" school of denial of mental illness, or the "just get over it" approach. My very simple response to these sorts of crashingly ignorant attitudes is to point to a line which occurs, as far as I'm aware, in basically every definition in the DSM, and which says "Causes signifcant impairment in school, work or social functioning." For there, you see, is the rub.

A mental illness is not just behaviour we don't like or aren't used to, it's behaviour we aren't used to and which seriously fucks up the sufferer. We lump them together in diagnoses based upon shared patterns of symptomatology not because we have the definitive proof that they actually are related (physiologically, we don't), but because this allows us to talk about patterns of behaviour that respond in a similar fashion to certain treatments, and therefore guides us in which treatments we should be using.

Over at Science-Based Medicine, Harriet has written the best post I think I've ever seen which summarises these matters and explains
why psychiatry is important and needs our research dollars. If you want a more in-depth look, Steven Novella links to a five-part series he wrote on Neurologica about mental illness denial.

The problems discussed by Harriet are the usual problems which will always plague any school of medicine which can't show you before-and-after X-rays, and are ones which even I have made reference to over the years - flawed studies done using the inherently difficult-to-research subject matter of people; the inability to do a blood-test for mental illness (can't do one for migraine, either); the problems with the DSM, an inherently political and cumbersome document (which, incidentally, contains shifting diagnoses that have lead to a large part of the hysteria about the so-called and completely fallacious "autism epidemic") and so on.

Psychiatry remains like many other fields of medicine - the practitioner is important, the relationship between the practictioner and the patient is crucial, and just like your GP when they don't have access to blood tests and want to play on the safe side, medication is an inexact science.

But people who deny treatment because they deny the existence of psychiatric disorders, or are terrified about suidical ideation, are firmly in the same category as people refuse other forms of medical treatment - they are dying basic human rights, and perpetuating abuse through neglect.

Link to entry "Psychiatry Bashing" on Science-Based Medicine

Tuesday, 27 January 2009

Random headline wool-gathering and commentary

I was lying in bed last night, too tired to sleep or concentrate, and squinting at the screen of my phone as I scrolled through page after page of news, scanning the headlines for anything interesting or relevant and tagging it to read later.

Suddenly I realised that my brain had been digesting a headline it had read five items ago, and that it read "
NZ man finds US military files on MP3 player" (ABC News Online). Wait, what?

The Nasca lines in Peru are one of the more tiresome of Erik von Daaniken's bits of "evidence" that aliens visited Earth and fostered human civilisation. What he fails to acknowledge, of course, is the strength of commitment that common-or-garden religious belief can engender in all societies, primitive or (apparently) otherwise, and the lengths that a people who built the Sistine Chapel without powertools will go to when a powerful enough leader holds a whip over their heads.

Now it seems that the
Nasca/Nazca (wikipedia) lines (Skeptic's Dictionary) may have been the result of endlessly repeated ritual, as the "Peruvians walked walked their prayers into the earth" (New Scientist).

In order to belabour the obvious, the not-new and the tiresomly status-quo, ABC News Online tells us that a
Social Service provider says support programs struggling.

The Courier Mail, perhaps unwittingly, vastly strengthens the case for a Parenting Licence or mandatory Parenting Training, as it tells us
Parents panned as kids not toilet trained in time for school.

more stating-the-bloody-obvious from the Courier Mail, who trumpet that Mr Risky is aggressive on the roads, survey reveals. This was going to be a complete post by itself, but I really can't be bothered. I don't want to discuss potential procedural issues with the research, so I'll just point out that I don't ignore speed limits at all. I may choose to disobey them after checking the road conditions, my own mental and physical state and what other drivers are doing, but I always know exactly what they are.

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