Thursday, February 2, 2012

A Mind is a Terrible Thing to Waste

Grief could be in and Asberger’s out, of the upcoming fifth edition of the DSM (the Diagnostic and Statistical Manual of Mental Disorders) that is--according to the Times (“Grief Could Join List of Disorders," "NYT,1/24/12). “Depression can and does occur in the wake of bereavement, it can be severe and debilitating and calling it by any other name is doing a disservice to people who may require more careful attention,” the Times quotes Dr. Sidney Zisook, a shrink at U. Cal San Diego as saying. A follow up Op Ed piece by a writer named Benjamin Nugent ("I Had Asberger's Sydrome. Briefly," NYT 1/31/12) who’d been the subject of a film called “Understanding Asberger’s, supports “narrowing” the definition of Asberger’s and goes on to conclude, “I don’t want a kid with mild autism to go untreated. But I don’t want a school psychologist to give a clumsy, lonely teenager a description of his mind that isn't true.” Nugent appears to have been one such teenager and the film in which he appeared “was a research project directed” by his mother. So how to vote? The issue does have serious implications in that diagnosis can affect medical coverage. Those suffering from depression following the death of a loved could be covered for treatment while some patients who were once considered to be suffering from Asberger’s might find themselves in the lurch when it comes to getting help. Nugent may have suffered from the stigma of misdiagnosis, but some other young man or woman, with far more debilitating symptoms, might suddenly find him or herself deprived of a needed support system. Still defining mental illness seems to be a sometimes arbitrary and even trendy affair. In the 50’s, people whispered the word “nervous breakdown” like the characters in a Neil Simon play who are constantly whispering about "cancer." Today bipolarity seems to have taken over as the mental illness du jour. Could so many people be bipolar? And then there are learning disorders like ADD. It’s nice to know that some slow learners are simply having trouble concentrating and that a dose Ritalin might be just the cure for their hyperactivity, but could whole populations of children require medication for their supposed attention deficit disorders? One would hope that matters like these would be addressed by the editors of the forthcoming edition of the DSM, but then one would have to ask who will be applying the criteria. “A Mind is a Terrible Things to Waste,” was a slogan coined by the United Negro College Fund back in l972. But it’s resonant in the context of the current controversies about diagnosis. Is there any such thing as true objectivity when a mind is evaluating another mind?


  1. It is an interesting phenomenon that smart and knowledgeable people become unsettled when a disorder becomes "too" common. For instance, "too many teenagers are committing suicide nowadays" (how many should?). Discomfort with the high prevalence of ADHD has been around for ages, but yes, whole populations can and do require Ritalin for their actual ADHD. We don't have prior knowledge of how many people should suffer from any particular disability. The thing is to provide help that works, child by child, to those who need it. And Ritalin treatment of ADHD children has been and is a spectacular success.
    To descend to trivia, if Dr. Asperger is watching us from a better place, he might be a little miffed.

  2. HI Marcel, don't you think there has been an epidemic of over and indiscriminate medicating. I'm only a layman, but one wonders about all the medicating and who is doing it. About a decade ago, chronic fatigue syndrome was in vogue and one couldn't help getting the feeling that the diagnosis was being applied rather promiscuously. Now bipolarity seems to be ubiquitous. Sure there are lots of suffering people. No one is denying that, but is the scattershot labeling and script writing always the most effective approach to what is basically a broad spectrum of complaints? Is there a logical positivist in the house?


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