to think DSM 5 will be shit because psychiatry is a pile of misogynistic wank anyway ?

[Mitchy1nge]

even they seem to think so DSM doesn't matter

plus it looked nicer with Roman numerals

'As for pharma companies doling out drugs left right and centre- does that really happen in the UK? '

I think it does, we are definitely subject to whatever treatment or treatments are in vogue at any given time whether their evidence base supports it or not. Can remember being in (psych) hospital and everybody was taking olanzapine - people with depression, schizo

oops stupid fat fingers, schizophrenia, the depressed bit of manic depression, the elated phase, a woman who was in shock after finding her husband dead in bed, people with borderline pd. It must be some kind of miracle drug? And poly-pharmacy definitely happens when it's not necessary, I have been on combinations of four or five drugs when lithium alone does the job about 90% of the time.

Mitchy I think that's a sentiment ruled over by your own experiences. Some people need a combination of four or five different drugs.

I don't think drugs should be handed out as the only treatment at all times, but I also don't think we should start thinking that they are a bad thing.

but they can be a bad thing, I don't think I would even have bipolar if antidepressants hadn't made me high and I wouldn't be so stressed about my weight if antipsychotics hadn't made me put on about five stone

am not say

grrrr not saying they don't have a role but drs could be much more ? judicious? in their prescribing with drugs and non-pharmaceutical treatments instead of let's give everyone quetiapine let's CBT them all to death etc

or DBT or MBT if you have borderline

I wish we didn't have categorical diagnoses at all and people were treated as people with all the wider influences on their mental state taken fully into account

I like having my diagnosis actually. It means I feel able to educate myself more fully, know the extent of my symptoms, work out why I act the way I do, and find the mos effective methods of treating it.

I'm Borderline, by the way. Have completed STEPPS and currently doing Stairways, which is hard but fantastic, and better than CBT by miles, which I completely agree is handed out too readily.

'Surely that can already happen? It happened to my dd in 2004. '

I think it happens a huge amount. But SSD scares me so much because that type of error risks becoming far more common, and normalised. And something people have no room to protest against formally to PALS, the GMC, etc. It won't be 'I was misdiagnosed, I seek an apology,' but 'I am in pain, I am deficient in some way that I keep asking for help and experiencing such pain in the first place' It will cease to be a type of mistake that a diagnosis isn't sought, and instead be another negative label someone has to feel guilty about. I find it profoundly misogynistic that women with severe menstrual cramps or severe pelvic pain risk being told they are defective at dealing with their body's signals rather than getting good pain relief and support.

I have no doubt some pains are psychosomatic. And I don't doubt that people in pain (myself included) don't benefit enormously from psychological support. It is a grey area.

loony mad loony

It is Obsessive Human Categorisation Disorder

oh look: there's another one.

I have to say that after nursing for many years ,i have only encountered one person who suffered from this disorder . I say suffered because to them the pain was real , regardless of whether the root cause was organic or not . It was a terrible diagnosis for the person as well , it comes across as a 'judgement' , especially in a non MH setting . I actually believe that the diagnosis did more harm than good to the person , they were trapped , either accept a MH diagnosis or continue to self harm in such a way as to become disabled .

glad to see interest in my article. everyone always go on about how the expansion of diagnoses is driven by the pharmaceutical industry and this just has very little grounding in reality. the drug companies don't want us making diagnoses, they would do much better if we didn't have a DSM or didn't follow the more stringent diagnostic criteria for mental disorders and instead just treated everyone.

as i mention in my article, most psychiatric diagnoses are made in primary care, so not by psychiatrists at all, but people who very little training in psychiatry and who more often than not are not familiar with the difference between a depressive illness and common unhappiness. the drug companies would rather we said sod diagnosis, if someone is sad they should get antidepressant etc! it may prevent a serious depressive illness developing!

re: somatic symptom disorder.

all chronic pain is psychosomatic. psychosomatic does not mean 'all in your head' it just means there is a psychological component to a physical illness. so asthma is a psychosomatic illness, rheumatoid arthritis is a psychosomatic illness, in fact all chronic diseases have an element of the psychological in that stress makes them worse, criticism or hostility in family triggers relapse. that is not the same as it being causal.

acute pain is a warning shot for tissue damage or the threat of tissue damage. chronic pain, is a failure of adaptation. all pain is perception, and ultimately modulated by emotional experience and meaning. sensations that become pain are modulated in the anterior cingulate cortex which has an important role in emotion in the brain.

somatic symptom disorder does sound rather silly. but it won't lead to people's illnesses being misdiagnosed. people with medically unexplained symptoms have the same misdiagnosis rate as other types of illness. the idea is rather than pretending that a physical symptom has a psychological cause (which is not really provable), recognizing some people do tend to catastrophize or ruminate about symptoms, excessively preoccupy or be disabled by their physical symptoms regardless of the cause and could benefit from a psychological approach.

oh I thought this thread was dead

that's interesting, I had a dream about someone injecting an unknown fluid into my anterior cingulate cortex* last night and it made my skin glow sort of grey but also my face melted and was hanging in great folds like when someone has lost about 30 stones

• might have been some other bit of my brain

For all its flaws I vastly prefer it to what was on the table when my mother in law was young and being regularly exorcised and internalising the concpet that she must be inherantly evil because evil resided within her.

Or blamed for her condition(s)

Hypersexuality combined with mania and psyhcosis in a female, in post war deeply Catholic Italy, was a tricky place to be.

The crude electroshock thearpy she went through back in the day was far from the worst thing that happened to her, becuase of a general lack of understanding about her condition(s).

There is no way she would have made it to her late seventies had it not been for psychiatriy and Big Bad Pharma.

There is no way we could have cared for her without the (too little) support we got from that particular medical field.

your poor mother in law :(

is she well now?

am assuming I will have completely grown out of it if I live to my seventies

is she well now?

She died at the end of December just gone.

If she had been born later, when things were better, imperfect, but better, she might have had a much better quality of end of life, and a good few years to boot cos she comes from a line that tends towards making it to a hundred.

But she was not only mentally and physically damaged from the Ye Olde Days style of mental health care, like tying her to the kitchen table or ceremonially exorcising her (which it seems may also have involved the use of purges) she was also phsycially and mentally worn out becuase it wasn't til she was in her fifties that she got a proper diagnosis and treament and many of her symtoms left her vulnerable to emotional and physical fall out due to high tension or frankly dangerous situations.

Becuase she was older she was less of a priority in terms of bed and intensive treatment during the shit hitting fan bits. And we couldn't cope. In part becuase the law tied our hands to what limitations we could place on her choices.

Too little, too late.

Her body and her spirit wore out.

Ah fuck

Sorry, I girded my loins and finally donated her hospitial bed, wheelchair, walking stick, shower chair etc yesterday. It's made me leaky.

I wish she had been born later. In an age of modern psychiatry. She didn't stand a chance and that lack of luck in terms of time and place stole her life decades before she died.

Carpe I'm so sorry for your loss. This sounds a lot like my own grandmother's life, although in her case a lot of the issues stemmed from my evil witch GGM lying about her. Treatment sounds horrendously similar though. If my GM had been born today she would have lived a very different life, but thanks to the 'treatment' she had at GGM's behest she ended up spending most of her adult life in an institution

canard I'm a bit puzzled about part of your post.

Tissue damage can be long lasting or permanent. Therefore pain from tissue damage (what you're calling "acute pain") can be long lasting. This would normally be described as "chronic pain", wouldn't it?

:( am sorry too

hopefully she is at peace now

Carpe and Wilson, I'm so sorry.

hopefully she is at peace now

Oh she isn't She wouldn't like peace. We think she is chasing FIL around heaven while he hides behind his newspapers going "Already ? Just four years of quiet before she gets wings too ?"

DH and I were in stiches between tears the day she died, immaginning St. Peter quailing before the force of nature that was MIL as she arrived at the gates and took issue with some minor detail that wasn't quite how she prefered it.

She had pitbull style determination when she wanted her own way and no jumped up saint would stand a chance.

It demonstrates what a crap atheisit I am, but it has been nice to think of her utterly liberated from the illness, but with her spirit still intact, causing absolute havoc and making all the male heavenly enetities wonder who is the weaker sex after all.

I'm so sorry love.

haha good for her! Ok I retract my wish for peace