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Yes, We Need Psychiatric Labels

Recently I stumbled upon a Huffington Post article by one Dr. Peter Breggin, who lists himself on HuffPo as a “reformed psychiatrist.”

This should’ve told me everything I needed to know, but I read on.

The article is titled “Our Psychiatric Civilization” and tries to make the tired point that in this day and age, we are defining ourselves by our psychiatric diagnoses and not by anything else. It’s difficult to fully dissemble this argument because Breggin unceremoniously shoves so many unrelated arguments into the same sad little article, but his main points seem to be:

  • Psychotropic medication is overprescribed.
  • Psychiatric diagnoses (i.e. major depression, bipolar disorder, ADHD, etc.) oversimplify the human condition.
  • Back in the good ol’ days, people apparently did a lot of spiritual soul-searching rather than resorting to all those damn pills.
  • The way people connect in our culture is through their psychiatric diagnoses.

I honestly don’t know which planet Breggin is living on, but it’s certainly not mine. I’ve addressed the overprescription crap elsewhere so I won’t talk about that now.

As for the second point, this is, to a certain extent, true. Psychiatric diagnoses DO oversimplify one’s psychological state, but that’s because you have to have a starting point. If you’re diagnosed with ADHD, you know that, some way–whether it’s through medication, therapy, or some combination of the two–you need to learn how to focus your attention better. If you’re diagnosed with major depression, you know that you need to somehow learn how to fix your cognitive distortions and become more active. If you’re diagnosed with seasonal affective disorder, you know that you need to do things that counteract the shortening of the days–use a full-spectrum lamp, take vitamin D supplements, etc.

Just as knowing that I have, say, asthma or the flu doesn’t describe the full state of my entire body, a psychiatric diagnosis isn’t meant to describe my entire psychological condition. Breggin seems to think that we live in a world where all we know about each other is what pills we’re popping, and nothing else. This is ludicrous. In fact, that’s something we don’t often know, given the stigma that still exists regarding mental illness.

Breggin goes on to claim in a condescending way that there’s no reason for people to connect with each other based on psychiatric diagnoses at all:

Patients ask me, “Should I join a bipolar support group?” If I were flippant, which I never am with patients, I could respond, “Only if you want support in believing you’re bipolar and need to take psychiatric drugs.”

My first thought upon reading this drivel was, Thank G-d he doesn’t say this to patients. My second was more like, What the fuck?

The idea that seeking support from others who face similar issues as you is somehow disempowering and promotes seeing oneself as a victim is quite possibly the most batshit stupid thing I’ve ever heard from someone whose profession is helping the mentally disordered. Shockingly enough, people like to feel like they’re not the only ones with problems. Perhaps this has truly never occurred to Dr. Breggin.

Quite the contrary, I have benefited immensely from connecting to other people who have depression and other mental disorders. Many of my friends have one, and together we’ve formed a sort of support network. All of us can always count on having someone to talk to, and those of us who aren’t as far along in the process of recovery as others can ask friends for advice. I don’t know where I’d be right now without that.

(Maybe in a perfect world, we could just have support groups called “Fucked-up People Support Group,” but somehow this seems counterintuitive.)

Anyway, psychiatric diagnoses can also be immensely helpful in explaining to healthy friends and family what the deal is. While Breggin seems to think that “depressed” is some sort of insulting, disempowering label I ought to reject, let me tell you some of the labels that my close friends and family described me with before they knew I had depression:

  • overdramatic
  • overemotional
  • bitchy
  • attention whore
  • immature
  • insensitive
  • selfish
  • crazy
  • weird
  • fucked up

Yeah um, I’d take “depressed” over that any day.

Not surprisingly, you don’t make a particularly strong case for yourself when you try to insist to people that, no, it’s not that you’re really overdramatic, it’s just that you have this problem with, well, being overdramatic, and you’re trying to work on it, you promise!

Trust me, that doesn’t work. What does work is saying, “I have a disorder called depression that distorts my thinking and sometimes makes me act in a way that seems overdramatic. With therapy and medication, it’ll improve.”

Apparently, though, Dr. Breggin is much too intent on destroying his own profession to allow those with mental illnesses even that small comfort. After all, he makes it pretty obvious that the reason he hates psychiatric labels so much is because they make it possible to prescribe medication, and that, of course, is a big no-no.

If I got a dollar every time some well-meaning fool tried to inform me that the medication that saved my life is unnecessary, I would have enough money to actually afford a therapist.

Comments

  1. Chenrezi says

    I’m going to have to disagree with you on this one, Miriam. In fact, I say I don’t think that Dr. Breggin’s column goes far enough. Why stop at just the mind? Our society should shake off the labels of EVERY illness! You’re not “asthmatic,” you’re just a person who gets severely winded every time you partake in intense physical activity! And why should I let a doctor tell me what I can and can’t eat, just because I happen to be “diabetic.” And “chronic bronchitis?” No! I won’t let you pigeonhole my lungs like that! Down with labels! Down with treatments! And up with trying really, really hard to get better!

    • says

      BAHAHAHA. What do you mean I have the “flu”? I have physical symptoms that include body aches, a runny nose, a cough, and a fever! How dare you oversimplify my condition like that!

  2. Chenrezi says

    Don’t give me that nonsense about a “heart attack;” my heart has ceased to beat, therefore causing my blood to stop circulating, which means that nutrients and oxygen cannot be transported to my cells, which will eventually lead to my–*thud*

  3. says

    I challenge the good Doc to look at the autistic community (NOT the autism community, that’s different!) and still say that psychiatric diagnoses limit you or that support groups damn you to your diagnosis. We’re some of the most vibrant, interesting, and impassioned folk out there, and it’s because we have each other that we can do the things we od.

  4. says

    I think that he some cases he may be right. Not all diagnoses are right. In fact, many times children dont have ADD but its so much easier than looking for the actual problem. Working in health care I understand the need for many people to put a name to something even when there is not a complete understanding of what is going on in the body, can you say fibromyalgia?

    • says

      Some children are indeed diagnosed with ADHD when they don’t actually have it. But that doesn’t make this guy right, because he’s essentially saying that because some diagnoses are incorrect, nobody should ever be diagnosed with ANYTHING.

      • says

        I agree that a blanket statement like that is wrong. I do wish though that more health professionals didnt rush for a quick dianosis because it will placate the patient. Here is a joke for you.
        “What do you call a doctor that finishes last in his or her class? You call them doctor.” ;)

        The good with the bad.

  5. says

    “Just as knowing that I have, say, asthma or the flu doesn’t describe the full state of my entire body, a psychiatric diagnosis isn’t meant to describe my entire psychological condition.”

    Reminds me of the claim that overweight people make about doctors ONLY treating them for their weight.

    But a very interesting article. Especially for people (like me) with high-functioning, educated parents a label helped them to come to terms with my problems.

  6. says

    Awesome comments! Honestly, one of my first thoughts upon reading Breggin’s quote was “what if one of his patients is reading this?” Seriously, if I read an article that my therapist was quoted in and she said something like that I would be completely devestated.

    • says

      Wow, I didn’t even think about that, but that’s totally true. In fact, I wonder how many patients he HASN’T gotten because of this–many people, myself included, google potential doctors/therapists/what have you. I certainly wouldn’t go to a therapist who seems intent on shoving his own views about psychiatry down the throats of his patients.

  7. says

    Hey, I found your post through a friend reblogging it. Honestly, I had a therapist who was like this guy, tried to imply I was lying about my mental health because I wanted to be diagnosed, because it’s “trendy”. Since then, I never saw him again. He judged me in the first 10-15 minutes of our appointment. My GP was appalled by this idiot’s behaviour, and the psychiatrist I saw most recently agreed with me on my mental health issues, taking them seriously instead of assuming they’re an attention ploy, or me trying to be trendy.

    Some people should just GTFO of the mental health profession, seriously. They not only do more harm than good for patients, but they also contribute to the stigma with mental illnesses, acting like “They’ll get better if they get an injection of sunshine and puppies, and ignore psychiatric labels”. Why do people like this even BOTHER in the first place?

    • says

      I never understood the “trendy” argument. I know some people will go pretty far in order to be cool, but why the hell would someone bare their inner life to a stranger, take medication that may have crappy side effects, pay a ton of money for therapy and/or said medication, AND accept the burden of societal stigma against mental illness, just to be trendy? Makes no sense.

      • says

        It’d be easier to understand the “trendy” argument if I was in the appointment wearing a Charlie Sheen or Demi Lovato shirt. But really nothing about me is “trendy”. I’m almost 24 years old, I’m not looking to be part of a trend.

        In fact, I’ve been struggling with my various mood issues, emotions, self-injuring, suicidal thoughts, etc. starting at 12 years old. Safe to say, it’s not about being “trendy”. That therapist had the stupidest argument, and even judged me that way after only talking to me for 10-15 minutes, because the psychiatrist I saw previously wrote in my file that I was begging for a diagnosis, when I was really trying to explain my different mood episodes to her.

        But, the building I saw both of these “professionals” in has a bad reputation as is. My one friend had attempted suicide once, and they said she was perfectly fine. Years later, when her Depression became a bigger problem, she mentioned it to the family doctor she has, and he automatically knew what was wrong and prescribed her a medication, which worked for her. I have not been back to that building since.

        Since then, I had an appointment at a Mood Disorder Clinic, where I most recently saw a psychiatrist, and he agreed that my concerns about my various mood episodes were completely justified, and long story short, I need to find somebody to see on a regular basis. It’s unfortunate how, while searching for a psychiatrist for regular appointments, I find myself scared that I’m going to end up with another asshole. If these people don’t take their jobs seriously, why the hell do they bother? =/

  8. says

    I am appalled that such a person would even be in the practice of psychiatry. (Or does the term “reformed” mean that he has left? One can only hope.) My first thought was of the patients — some of whom may have used their very last ounce of energy to get themselves into therapy — that he may have harmed with his dismissiveness. If they left, did they have the strength and the courage to seek a more suitable therapist, or were they forever turned off the idea of therapy because of their experience? More than once, I have stuck with therapists who weren’t all that effective, simply because I didn’t want to start all over again with someone else. Although I may not have been helped all that much, at least I wasn’t harmed. I doubt that the same is true for some of this doctor’s (former?) patients.

    • says

      I can relate to that. Similarly, I had a therapist who wasn’t effective, but at least she didn’t tell me that I’d be perfectly fine as long as I just think happy thoughts or something.

  9. says

    If anybody has a spare $50.00 for a Westlaw search, I wonder if this Dr. Breggin has been sued, had his medical license suspended or revoked, or ever been stalked or assaulted by one of the patients he is so squeamish about “labeling.”

  10. says

    Hi,
    You’re probably not going to like this, but I think you’ve mis represented this guys article.
    I agree with most of what he is saying.
    Firstly, Dr Peter Breggin doesn’t refer to himself as a reformed psychiatrist.
    It says ‘reform psychiatrist.
    A small detail, but important I feel.

    Secondly, he certainly doesn’t suggest anywhere that ill people should ‘just get better.’
    What he suggests is that people stop self diagnosing, and medicating their emotions and instead seek out compassion and understanding for their situations, and problems. Good therapy in other words, be it from a priest, a therapist, a friend, wherever.

    I suffered from depression for many years, decades in fact. I saw a doctor once, who spent less than 10 mins with me before putting me on Seroxat, a drug that went on to be implicated in a number of deaths, and as one of the SSRI’s ultimately is shown now to be a futile path for depression, as new data has revealed as a myth, the belief that low serotonin causes depression. She didn’t give a damn about the abuses I had suffered as a child, she didn’t want to hear my story. She just gave me pills. But it was in these stories that could be found the source of my depression.

    Doctors literally don’t understand mental distress for one simple reason.
    They are scientists, and scientists only work with verifiable data.
    Personal anecdote, which is where we will find the roots of our depression, holds no interest to them. How can they measure it? How can they test it? Not to forget, how can they profit from it?
    They can’t. So they fill the minds or millions with lies, about ‘unbalanced brain chemicals’ and ‘genetic predisposition’, and give you a pill.
    At the same time, they also suggest therapy. But this doesn’t make sense.
    If you have a physiological disease, how can talking about it help?
    If however, depression is ‘problems with living’ (see Tomas S Szasz), then how could pills heal you?

    I don’t mean to belittle the help you claim medication has given you, and if it truly saved your life, then it is a blessing. However, many peoples lives are blighted by the psychiatric world, my brother is one, who was wrecked with incarceration, and anti psychotic drugs.

    I made multiple attempts on my life, I was a wreck through my 20’s and way into my 30’s, severely depressed, at times ‘bi-polar’, probably ‘borderline’ as well, but somewhere, I always knew that I wasn’t suffering from an illness, I knew that I was a victim of the way others had treated me, that my parents had failed me, and that my healing lay in confronting the deeply buried emotions that my depression was keeping at bay. When I found the right therapist, I was able to explore that. It was the most supremely painful experience of my life, but it set me free and I was able to heal myself. I guess I’m one of the lucky ones’ and I don’t ignore my privileged position in being able to afford my therapy but I worked hard to earn the money to pay for it. In the end, I got in debt to pay for it because It ranked just under food and shelter in the order of importance in my life.

    In my opinion, the only way to truly heal depression, and it is totally healable, is through facing your demons which is a long, slow, and painful process.
    No-one can ‘just get better’. Not for a second do I consider that.

    I personally find the term mental illness misleading. I think it allows people to disconnect from their depression, and to see it as something other, that happens to them, rather than something that is bound up in their own world view, and experiences, as a part of their defence mechanisms. BUT, I totally get why others choose to use this description. Your explanation above, and of the names people called you before, makes total sense to me. It is shocking that people didn’t care enough about you to consider what you might really need, and instead chose to label you so negatively. I also understand that using that label helped you explain yourself to others that perhaps lessened their judgement of you. Also makes total sense.

    To sum up, it is my belief that although medication can help us cope, when we have no other options, it is never going to heal the deep wounds that we carry with us.

    These are my beliefs only, based on my experiences, and what I have witnessed in those around me.
    Thanks for your wonderful blog.

    • says

      I’m going to read your entire comment, but first I have to say that “You’re probably not going to like this” really makes me cringe. Not because I don’t like reading things I don’t like, but because I can’t stand it when people make assumptions about what I do and do not like. It comes across as really condescending. Please do not talk to me that way in the future.

      • says

        Sorry about that. To be honest, I’ve wanted to comment on your blog for a long time but I’ve actually been quite nervous to do so, being sure I would get pulled up on some faux pas, or other. I see I’ve dived in with one straight away!
        You are right, it is an assumption.
        I promise not to talk to you like that again.

          • says

            :-)
            Well, it’s good to be clear, and to set clear boundaries. I’ve learnt to check in with myself if someone exerts a boundary and I end up feeling bad. Usually, it’s me with the problem.
            By the way, I found this the other day, and thought it was very interesting.
            It’s a piece about depression as a result of impossible to deal with societal pressure.
            http://theoccupiedtimes.org/?p=12841

            Thanks for being sweet. :-)

          • says

            Hi, umm, just out of interest, did nothing in my comment resonate with you?
            I get that your not responding is probably a ‘soft’ no, but I can take a hard no as well. :-)
            I’d be curious to know what you think, but no worries if you’re too busy, or just not that engaged with what I said.
            Hope you’re having a better one!
            :-)

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