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Temper Tantrums In The DSM


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http://thelastpsychiatrist.com/2012/11/temper_tantrums_in_the_dsm.html#more

 

From BoingBoing, only slightly more valid than any of the journals I read:
 

The American Psychiatric Association is set to add "disruptive mood dysregulation disorder" to the Diagnostic Statistical Manual (DSM), the bible of psychiatric disorders. A kid has "DMDD" if she or he has "severe recurrent temper outbursts that are grossly out of proportion in intensity or duration to the situation... at least three times a week." 

Easy, everybody, if you're enraged about the wussification of America you can assume you watch too much TV and like Blue Pills.

1.  Diagnosis is not the same as disease.  This just coordinates the language, "from now on we're going to call this this."  "Then why is it called a disorder?"  Ah, you must have no insurance or the best insurance.  Healthcare policy is set by Medicaid/Medicare, you Blue Cross suckers are merely collateral damage.

In Medicaid America, i.e. America, if you come through the door and I ask you all the questions and I determine there is absolutely nothing wrong with you, two things will happen at the exact same time: 1. You will punch me.  2. I won't get paid, can't get paid for no diagnosis, no matter how hard I work.

Can't order any tests without a diagnosis code, either.

Someone stupid will ask me this: "then why doesn't Medicaid just offer a billing code for "need three evaluations, but likely no diagnosis?"  Because if Fox News got wind that Obama was paying for black people to get "no diagnosis" they'd blow up an abortion clinic.  Paying for "temper tantrums" is just the right amount of enraging, TV and internet enraging, no violence will occur.  "Isn't this why we need universal healthcare?"  Well, lieutenant, pronounced like I'm a British naval commander, if we had a system of healthcare in which doctors were paid the exact same regardless of diagnosis or severity, then there'd be little attention paid to "correct" diagnosis, all of our epidemiological data would be totally invalid, and the number one drug in America would be Xanax.  "Wait, isn't that the situation now?"  Huh, nailed it.

2.  "Is this is an attempt at preventing the erroneous diagnosis of "pediatric bipolar disorder?"  No. Come on, stop it.  Not to go full Popper, but how can diagnoses be "wrong" while simultaneously "not exist?"  You guys have to decide whether you're materialists or idealists, then we can cross blades.

In other words, regardless of what you call it, assuming the MD thinks it is "a problem fit for a pill," will the pills offered be any different in either diagnosis?  I'm closing my eyes, don't tell me which diagnosis it is... I'm sensing  something, a presence.... is it Concerta?  Concerta, is that you?  And.... Depakote?  Are you here too? 

3.  "DMDD is "severe recurrent temper outbursts that are grossly out of proportion in intensity or duration to the situation."  I'd like someone to explain what behavior  is "grossly out of proportion" for a situation characterized by physical/sexual abuse, parental drug abuse, and visibly swarming roaches, every day, while you sleep, while you eat....

"But not all kids are raised in poverty."  True, many are raised by nannies who alive in poverty.  So what kind of temper tantrum is out of proportion for a situation characterized by marital infidelity/swinging, overparenting, spoiling them materially and depriving them emotionally?  "I love my kid, I got him a Wii."  You should get them some weed, they'll get it eventually.

"So then it's not really a disorder, it's just caused a response to the social environment?"  Isn't that what a psychiatric disorder is?  "No, a real disease."  Like diabetes?

4.  It's all very simple, you have it mostly right but the direction of the force vector is wrong.  In order to create a living wage, the system deploys its social services through the least offensive department, healthcare.  e.g. people are furious about Social Security, but not as furious about Medicare.  As long as it can pretend it's about "health" or "compassion" or "disability" it doesn't have to worry about politics or race or "need".

But in order for this to work, the doctor has to get paid.  Not much, but paid.  If he is to get paid, the patient must have insurance, i.e Medicaid.  In order to get Medicaid, the patient must be temporarily disabled, for which he needs to have a diagnosis, so he must see a doctor, who will need to get paid, so the patient needs to have Medicaid.  Ouroboros.  The system has won.

 

As usual I find the comments at least as interesting as the actual articles on this site.... 

 

part of a comment...

 

The Last Psychiatrist thesis goes like this: develop a diagnosis that hold the concept that an individual has a recognized disease entity; this allows you to bring the "problem" into the domain of individual-level medical model; this individual-based, psychaitrically based model allows the psychaitrist to be deemed as the approriate authority to call the shots; gerat portions of society want to get out of such things as responsibility, and this "psychiatry" route "legitimizes" pawning the problem off on the relatively powerless; the psychiatrist can make a good living as long as he or she plays along - but he or she must match a medical-seeming treatment to fit the medical-seeming "diagnosis."

That is where I get the diagnosis > treatment model."

Now, never mind that most of the time, the patient does not get "cured," or "healed," and does not get much better, and may ac tually get worse, once side effects and self-fulfilling prophecy effects are factored in. We have bought into this like cult-members, and we cannot question the prevaling oligarchy.

To question the status quo means that me, a parent, has to face the terrible truth that I have failed to do what I am tasked by God to do: raise an adult, including morals.

This drug has caused me to lose my sex drive, to lose the firmness of my you-know-what, has caused dry mouth and jitters, and super-realistic bad dreams; and when I tried to quit it, I felt like killing myself or someone else. Is tis really the treatment for "disgruntled?"

Things look really different when you have skin in the game.

You will eventually wish for your "disgruntled" to return if you buy the psychaitrist's cure.

Unless they convince you that you are the problem. Which is how many cullts work: hang on, pay the next payment and perform the next round of ritual, and may be just maybe that what seems like pee on your leg will be manna from heaven. But don't doubt us, we are the authorities, and as we predicted, you have lost your family and friends and that just shows how worthless you are - so hand over the dues, and your pubescent cildren."

 

Seems to make sense to me today. 

peace

WARNING THIS WILL BE LONG
Had a car accident in 85
Codeine was the pain med when I was release from hosp continuous use till 89
Given PROZAC by a specialist to help with nerve pain in my leg 89-90 not sure which year
Was not told a thing about it being a psych med thought it was a pain killer no info about psych side effects I went nuts had hallucinations. As I had a head injury and was diagnosed with a concussion in 85 I was sent to a head injury clinic in 1990 five years after the accident. I don't think they knew I had been on prozac I did not think it a big deal and never did finish the bottle of pills. I had tests of course lots of them. Was put into a pain clinic and given amitriptyline which stopped the withdrawal but had many side effects. But I could sleep something I had not done in a very long time the pain lessened. My mother got cancer in 94 they switched my meds to Zoloft to help deal with this pressure as I was her main care giver she died in 96. I stopped zoloft in 96 had withdrawal was put on paxil went nutty quit it ct put on resperidol quit it ct had withdrawal was put on Effexor... 2years later celexa was added 20mg then increased to 40mg huge personality change went wild. Did too fast taper off Celexa 05 as I felt unwell for a long time prior... quit Effexor 150mg ct 07 found ****** 8 months into withdrawal learned some things was banned from there in 08 have kept learning since. there is really not enough room here to put my history but I have a lot of opinions about a lot of things especially any of the drugs mentioned above.
One thing I would like to add here is this tidbit ALL OPIATES INCREASE SEROTONIN it is not a huge jump to being in chronic pain to being put on an ssri/snri and opiates will affect your antidepressants and your thinking.

As I do not update much I will put my quit date Nov. 17 2007 I quit Effexor cold turkey. 

http://survivingantidepressants.org/index.php?/topic/1096-introducing-myself-btdt/

There is a crack in everything ..That's how the light gets in :)

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