I have through conversation with a couple of other bloggers entered into the discussion about how psychiatry can be relative. I am using specific examples but it is not my intention to make light of or be dismissive of any disorders or the people who struggle with them.
Part of the discussion on my part surrounded a friend I have who deals with Obsessive Compulsive Disorder (OCD). He has no formal diagnosis (admitted to me at least) but is clearly so. He seems not to view himself or his “impairment” as psychiatric in nature. Does the fact that I view him as having OCD make him so? Does his denial make him not obsessive/compulsive? If he was in a room with a psychiatrist would he be considered as having OCD? If he was in the same room with a mechanic would he have OCD? I brought up the fact that in the past he may have simply been considered eccentric. Should we be alarmed that there are no more eccentric individuals? Eccentricity seems to have been diagnosed out of the vernacular. In our age of “there’s an app for that” have we arrived at “there’s a diagnosis for that” and subsequently “there’s a pill for that.” How have pharmaceutical companies influenced psychiatry and mental health? In pushing pills do we push diagnoses?
It appears to me that to a degree psychiatry can be specific to time and place. A behaviour exhibited on a psychiatric ward will certainly be checked off a list of symptoms in the Diagnostic and Statistical Manual of Mental Disorders, (DSM). At the shopping mall it may not even be noticed.
Part of what drew me into conversation was the fact that not long ago homosexuality could be found in the DSM. It would appear certain disorders can be cured by a shift in popular opinion. I’m not sure what I would think of myself or psychiatry if I was one day discharged from a psychiatric hospital because a new edition of the DSM came out. I guess it would depend on how many rounds of electro-shock I was exposed to.
I was also wondering about anorexia nervosa. My knowledge is limited but my understanding is that it was rare 60 years ago. Once society and psychiatry caught wind of this condition it became almost epidemic by comparison. Interestingly, it continued to be rare on other continents but seems to have spread with the adoption of western psychiatry and the DSM. Early cases of anorexia nervosa appeared without the typical aversion to becoming fat, confounding the argument of the changing societal ideal of beauty. The best example of what I am trying to arrive at is Lady Dianna’s disclosure of her struggle with bulimia. I don’t know the statistics but there was an increase in cases of bulimia which followed. It is often explained that others are more comfortable with self-disclosure when a celebrity comes forward. We might ask whether people find an avenue for their discontent paved by popularity. Where does one get the idea to take laxatives?
If a diagnosis is unheard of does it thus remain?
As the hysterics of the 1800’s disappeared other conditions took their place. Could it be that the pain is universal but the pandemic is always shifting? Will the disorders that plague society today become oddities in another 150 years? Is mental illness unaffected by popular thought and psychiatry itself ? Are we susceptible to taking something that disturbs us deeply and attaching the symptom of the day? If I was from another part of the world with a culture specific condition would I be disregarded by western psychiatry and the DSM-IV?
I’m glad psychiatry changes. In the past I may have been a good candidate for a lobotomy. It can send a strange feeling through your body to know how your symptoms were dealt with even 50 years ago. We look back and shake our heads but never consider that another generation will do exactly the same at what we consider to be science. I may not be around for it but I will not turn in my grave as disorders continue to wax and wane.