A psychiatrist who didn’t believe in mental illness (2013)

So the problem here is that our ability to observe physiological differences, particularly given the development of EEG/MRI/CT/etc, has radically outpaced our ability to have any clue what they mean. The point being that just because a "condition" has a physiological manifestation in no way whatsoever then directly implies that the condition is therefore physical or can even be realistically 'treated'. For instance, we're not going to develop a drug to make you a strong chess player anytime in the foreseeable future. And while perhaps you could create a drug to make a master a weak player again, it would almost certainly be little more than a glorified lobotomy.

Of course the problem is related to wider social issues about permissive violence. If one person murders another because of their delusions, it's a crime and a medical failure. If an entire country declares war on another for similar reasons we assume we're in the realm of politics and history, not mass mental illness.

We're far too harsh on individuals and far too lenient on mass systems of thought and belief that have horrific outcomes.

(sorry, tangent)

I don't have the book available at the moment, but in the introduction he says something to the effect of "I don't regret writing this book, but I regret calling it what I did, because people judge it without reading it."

The gut-reaction to such a title is to think the writer is saying "depression doesn't exist" or "schizophrenia doesn't exist" or "manic depressives are lying."

This isn't what he says in the book at all. Rather, his argument is more along the lines of:

1. The word "illness" should be used to represent a cause-- and resolving the cause should cure the illness. Cancer, the flu, hyperparathyroidism--all map to causes.

2. The conditions which we call mental illness don't have a knowable cause. They are symptoms which we pattern match against.

3. Corollary: Illnesses should be hypothetically curable. There may be a cure for cancer. But there cannot be a "cure" for most "mental illnesses" because there is no shared, physical cause that underlies say, all cases of "bipolar disorder".

3. So we shouldn't call them "illnesses". We should call them something else.

Unfortunately that's about as much as I remember of his argument, but it's very different than the common accusation... And it also strikes me as accurate.

The problem with naming things is that it makes them real. I think often the hacker news crowd forgets how ill-informed most of the world is, and the degree to which people crave certainty.

When a person is told by a psychiatrists "Your 8 year has depression so we'll put her on X pill" or "You have bipolar type 2, so I recommend Y medicine", it has a certain finality.

Most people don't think "The doctor is telling me that my behavior matches some patterns. That is it. She does not know why, and we may never know why, there may not even be a reason why. So we should think about what we can do to mitigate this."

No. The we think "I've been diagnosed with a disease. (Sorry I'm being an a-hole|I won't go to your party|didn't get out of bed), I suffer from bipolar and there's no cure".