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Simple games like Leapfrog once kept children too active to be labeled (libeled?) with diagnoses like “ADHD”.

Scientific American just published a fascinating excerpt from Andrew Scully’s new book on the social history of mental illness. Here are a few points to ponder.

New diagnostic criteria have labeled many more people as “mentally ill”:

  • Autism, a formerly rare diagnosis given to fewer than 1 in 500 children, affected 1 in 90 by 2004.
  • Hyperactivity, relabelled ADHD, now requires 1 in 10 American boys to take medication daily.
  • “Juvenile bipolar disorder” diagnoses increased 40 times between 1994 and 2004.

The DSM has made “mental illnesses” out of:

  • social anxiety disorder (shyness)
  • oppositional defiant disorder (resisting authority)
  • school phobia
  • narcissistic and borderline personality disorders (self-centered and attention-seeking behavior)
  • pathological gambling (losing money you can’t afford)
  • binge eating
  • hypersexuality (sex kittens and Don Juans)
  • temper dysregulation (flying off the handle)

For those of us whose primary lens on the world is the Bible, it is remarkable how many “disorders” for which medical treatment is advised are sins and how many others are simply character variations that don’t bother God at all. Those boys with ADHD? My grandmother, a rural schoolteacher, would have called them “boys” and organized a game of tag or Red Rover during recess. If “recess” is an unfamiliar word to you, that may explain why ADHD is something you know well. “Recess” is like a coffee break for children, but better. They go outdoors, run off some energy, and then come back to their classes refreshed and ready to refocus. But I digress …

Scully suggests that we have almost no understanding of what causes the major psychiatric disorders, forget these new diagnoses. But, he points out, that’s not stopping pharma firms from promoting new drugs to “treat” them.

The latest DSM, which came out nearly two years ago, was panned by two very influential psychiatrists: Steven E. Hyman, the former director of the National Institute of Mental Health and Thomas R. Insel, its current director.

Hyman called DSM 5 “an absolute scientific nightmare. Many people who get one diagnosis get five diagnoses, but they don’t have five diseases – they have one underlying condition.’

Insel said DSM 5 lacked scientific validity. “As long as the research community takes the DSM to be a bible, we’ll never make progress.” NIMH would be “reorienting its research away from DSM categories … patients with mental illness deserve better.”

To read the whole fascinating story, check out Madness in Civilization by Andrew Scully.