Sunday, April 21, 2019

Comments by orbit

Showing 6 of 6 comments.

  • The author states: “At the risk of stating the obvious, what psychiatrists call “intermittent explosive disorder” is not an illness in any ordinary sense of the term. There are rare instances where brain damage can precipitate episodes of extreme anger, and these should indeed be considered illnesses. But in the vast majority of temper tantrums, there is no neural pathology, but rather the simple fact that the individual hasn’t acquired the habit of controlling his/her temper. To previous generations, the need to train/school children in this regard was considered a self-evident part of normal child-rearing.”

    Gross mischaracterizations! First of all, we don’t know that individuals with explosive rage and mood regulation issues do NOT have altered brain structure, which either causes or is a RESULT of trauma or other environmental influences. Second, it is outrageous to suggest such an individual simply “hasn’t acquired the habit of controlling his temper” as part of “normal child rearing.” Individuals with with markedly poor care during childhood (neglect, abuse) and other trauma during childhood often experience difficulties with mood regulation! I can’t believe you are equating this to failure of mom & dad to “teach” someone to control their temper–as if that is something that could even be “taught.”

    I don’t deny your allegations regarding links between the codification of these “conditions” and Big Pharma’s attempts to make money by treating them, but I urge you not to be dismissive of the significant pain these clients and families are experiencing, or to imply that lax childrearing practices are at fault.

  • I agree that a “condition” such as IED could potentially have multiple etiologies, and typically a differential diagnosis is performed to rule out other potential diagnoses. A psychologist uses desriptions that best explain the client’s current behaviors–it’s not a perfect system.

    We are as yet unable to determine etiology of most psychological conditions, and there is so much interplay between biology and environment that will be a difficult task. Nor do we yet reliably know appropriate treatments (not just medications) for these conditions if there are any, or if treatment would be different based upon the etiology of the condition. DSM is descriptive of regularly occurring patterns or collocations of maladaptive behaviors commonly noted in clinical practice.

    In my experience, conditions such as IED and DMDD, oe patterns of behavior that DSM categorizes in this way, are serious and cause significant distress and disability. I have never seen these diagnoses given a rebellious adolescent or teen. Rather, most are verbally and physically aggressive, often involved with the criminal justice system at a young age. Certainly these conditions are largely trauma-based, as you said. I do wish there was more focus on prevention of childhood trauma as we don’t have good therapeutic treatments for these; meds assist in tamping down distressing symptoms I guess until we have better alternatives. Sadly most research is in pharma rather than other therapeutic treatments.

  • Prozac and Paxil are not “uppers.”

    Ativan, not Atavan.

    Implying here is an risk of early death from using antipsychotics is misleading in the extreme, for what should be obvious reasons.

    I want to listen to what you’re saying, and these types of statements make it difficult to do so.

  • SSI amounts vary. In California the amt is closer to $1000. Individuals with disabling developmental disabilities (autism, intellectual disability, CP, epilepsy) also can receive services and supports (including housing) from the regional center system, and Medi-Cal. There is no comparable state system for those receiving SSI solely for a non-developmental mental disorder. Free MH services in CA are negligible.

    Also, I’m sure you all are aware that individuals with developmental disabilities frequently have mental health disorders as well. Many regional center clients in California are found SSI eligible under a mood, psychotic or other mental health disorder, rather than under their developmental disability,as well. I don’t think those stats are tremendously reliable for demographic info on who has what.