Originally a comment by karmacat on Psychiatry is an important skeptical and social justice issue.
My anger comes from working as a psychiatrist and watching my patients suffer and scared that maybe there is nothing I can do for some patients. SC does have valid criticisms because the brain is so complicated that we have a limited understanding of it.
Mental illnesses do exist but we still don’t really understand the pathophysiology of the brain. We can see how patients with schizophrenia have different brains from “normal.” but one patient with schizophrenia can be different from another patient with schizophrenia even though they have the same diagnosis.
The problem with the DSM is that it is just a description of symptoms but doesn’t describe the physiology of the brain. But, right now, it is the best way of standardizing the diagnoses of mental illnesses.
Another issue is that patients and doctors can expect too much from medications. Most antidepressants are prescribed by primary care physicians and they don’t have a lot of time to figure out what is really causing depression. The problem is most people don’t have access to therapists or even psychiatrists, so they only get treated for one aspect of the illness. they don’t get treatment for the psychological and social aspects of their illness.
Another question that is important is to ask how much depression, anxiety, hallucinations or mania interfere with a person’s life. If a patient is managing his or her moods, then the risks of medicines outweigh the benefits. If medicine is taking away all emotions then it is time to switch medicines and/or focus on therapy more.
I could go on and on, of course. the point is that there are people who are suffering a lot and we need to find ways that are effective and with minimization of risks and side effects. We have a long way to go. If you look at the history of psychiatry there are a lot of screw-ups but there are some breakthroughs, especially for schizophrenia and bipolar disorder. Through the years, there have been more legal safeguards for patients and in research. As SC has pointed out, there are still a lot of problems.
Psychiatry can be frustrating because there , the treatments are limited, the brain is complicated but the suffering continues. All I can do for my patients is to keep reading articles and keep trying. I hope I haven’t rambled too much.