DSM debates - Volume I: Psychology Today: Mood Swings, #4

By Nassir Ghaemi

Between 2009 and 2013, Nassir Ghaemi debated Allen Frances and other DSM supporters and critics in the Psychology Today blog website.  In these debates, it became clear to Ghaemi that the supporters of DSM, like Frances, and the critics of DSM all shared a similar perspective: an anti-scientific attitude steeped in postmodernist cultural assumptions.  They criticized DSM for being too medical and too biological whereas the problem with DSM, according to Ghaemi, is that it is not medical, biological, and scientific enough. 

In these three volumes of posts and links to other posts among his critics, Ghaemi lays bare what is wrong with DSM and what is wrong with the critics of DSM: the same thing - postmodernist anti-science attitudes. 

In this volume, the following chapters are presented:

1. Death by DSM
2. Science and politics: DSM-5 and bipolar illness
3. The secret of DSM-IV: The danger for DSM-5
4. First do no harm – Part I: An empty slogan
5. First do no harm – Part II: Taking disease seriously

• Language: English
• Publisher: Nassir Ghaemi
• Release date: Oct 27, 2019
• ISBN: 9781393141501

Nassir Ghaemi

S. Nassir Ghaemi MD MPH is a psychiatrist and author. He is Professor of Psychiatry at Tufts University and Lecturer on Psychiatry at Harvard Medical School. He has published multiple academic books, including Clinical Psychopharmacology (Oxford University Press, 2019), and is author of A First-Rate Madness: Exploring the LInks between Mental Illness and Leadership (Penguin, 2011), a New York Times bestseller. He has published over 200 scientific articles, over 50 book chapters, and is a peer reviewer for many scientific journals, as well as Associate Editor of Acta Psychiatrica Scandinavica Disclosure: Since 2017, Dr. Ghaemi also has been employed at Novartis Institutes for Biomedical Research in Cambridge, MA as a director of early drug discovery research in psychiatry. The views expressed here are his alone, and do not necessarily reflect those of any of his employers. 

Book preview

DSM DEBATES FROM PSYCHOLOGY TODAY

VOLUME 1

NASSIR GHAEMI MD

Table of Contents

Death by DSM

Science and politics: DSM-5 and bipolar illness

The secret of DSM-IV: The danger for DSM-5

First do no harm – Part I: An empty slogan

First do no harm – Part II: Taking disease seriously

Death by DSM

Afew years ago, a middle-aged man had been newly diagnosed with depression (major depressive disorder, MDD; in contrast to bipolar disorder). His doctor treated him for a few years with different antidepressants, mostly without success. Finally, the man wrote his wife a note; they had no children. It's not your fault, he wrote; the pain is just too much. He killed himself.

The husband consulted a lawyer who called me. There is a strange fact in the history, the lawyer noted, after sending me some records. I looked at the chart. There, about a year previously, after starting an antidepressant, the patient had become hyperactive, overtalkative, spent a lot of money, did not sleep and was not tired, and was giddy - all this lasted for 2 weeks. It had never happened before; it never happened again, at least not that way.

The doctor diagnosed a manic episode, and added a neuroleptic to the antidepressant. The patient calmed down, and felt better for a while. Then the patient wanted to come off all medications for a while to see how he was; the doctor concurred. A few months later, on nothing, the doctor's noted documented racing thoughts and poor concentration. Another antidepressant, a few months of increasing depression, and then the end.

The doctor's expert witnesses, senior