"Mental illness" is a great source of income
If you thought your friends and family were normal, you may not be so sure after reading the DSM IV. For example, let's take your friend Suzy who, due to a series of failed relationships, thinks all men are brainless creeps. According to the DSM, Suzy is suffering from "Hypoactive Sexual Desire Disorder" (billing code 302.71). How about your buddy Allen who spends hours a day on the Internet. Allen definitely sounds like he has "Obsessive Compulsive Disorder" (billing code 300.3)not that he enjoys reading, researching or playing Internet games. Or how about Mom, who is depressed over the death of her brother? Mom is obviously "Bipolar I" (billing code 296.51), or if she has been depressed more than 2 months she could have "Bereavement Disorder" (billing code V62.82).
Aunt Dorothy hates to go to parties or any social gathering because she feels uncomfortable or shy. Aunt Dorothy must have "Social Phobia" (billing code 300.23). Even Dad has problems. With his sometimes volatile temper due lack of work and money problems, Dad must have "Intermittent Explosive Disorder" (billing code 312.34). If you look through the DSM IV you will discover that normal behavior or personality quirks are conveniently labelled as "mental illnesses". Why? Only in this way can the psychiatrist prescribe drugs to handle his patient's "condition". However, this simplistic system of labelling a person with a "mental disease" disregards and fails to get to the root of any real life situations that may be causing the person stress or difficulties. A drug is a nice, pat solution which only leaves a person numbed and less able to cope rationally with his or her life situations.
The psychiatricizing of everyday behavior
The psychiatricizing of normal everyday behavior by including personality quirks and traits is a lucrative business for the APA because by expanding the number of "mental illnesses" even ordinary people can become patients and added to the psychiatric marketing pool.
Does your 10-year-old dislike doing her homework? Better get her to the nearest couch because she’s got "Developmental Arithmetic Disorder" (billing code 315.4). Maybe you’re a teenager who argues with his parents. Uh-oh. Better get some medication pronto because you’ve got "Oppositional Defiant Disorder" (billing code 313.8). And if your wife won’t tell you that she snuck out to the outlet mall last Saturday, then she’s definitely got "Selective Mutism" (billing code 313.2).
Omigosh! My family is full of psychos!
Trust me, I am not making these things up. (That would be "Fictitious Disorder Syndrome"). The number of mental diseases identified in the manual has risen from 100 to 300 in the last 15 years. That translated to a virtual epidemic of madness sweeping the country. Only a decade ago, psychiatrists said one in 10 Americans had a mental illness. Now according to the manual, half the population is mentally ill.
How the other half stays sane remains a mystery.
The manual will have to be updated annually because mental health professionals and defense lawyers keep discovering new illnesses. Just since the beginning of the year the experts have unearth these new disorders:
Lottery Stress Disorder (or LSD): A London psychiatrist discovered the outbreak among lottery losers who experienced ‘definition of mood and feelings of hopelessness’ when their numbers didn’t come in.
Chronic Tax Anxiety Syndrome (CTAS): A Washington psychotherapist specializes in treating couples who suffer from excess worry, sleeplessness, and marital squabbling every April…
I know there are some cynics out there who will scoff at these new diagnoses. Maybe you think it’s all psychobabble, just a gimmick to make money for the therapists. You wouldn’t be caught dead on a psychiatrist’s couch.
You people are in serious denial. As a matter of fact, your unwillingness to seek professional help is itself a symptom of a serious mental problem. It’s right here in this book: 15.81 "Noncompliance with Treatment Disorder.”
–Mark Syverud, "Don't stop the insanity," the Daily Messenger
In case you think the above examples are the exception, the following are some more common behaviors all labeled, packaged and coded for billing:
* Bad writing and its symptom, poor handwriting-- Disorder of Written Expression (billing code 315.2)
* Coffee drinking -- Caffeine Addiction (billing code 305.90)
* Sleeplessness after too much Coffee-- Caffeine Induced Sleep Disorder (billing code 292.89)
* Jet Lag -- Circadian Rhythm Sleep Disorder (billing code 307.45)
* Smoking -- Nicotine Dependence (billing code 305.1)
* Quitting Smoking -- Nicotine Withdrawal (billing code 292.0)
* Any mood disturbance due to General Medical Condition (billing code 293.83)
* Snoring -- Breathing Related Sleep Disorder (billing code 780.59)
* Teenage staying out late at night and intimidating others -- Conduct Disorder (billing code 312.82)
* Teenage Rebellion -- Oppositional Defiant Disorder (billing code 313.81)
* Disruptive Behavior Disorder Not Otherwise Specified (billing code 312.9)
* Unable to sleep-- Insomnia (billing code 307.42)
An example of how this billing system works
To show how the plethora of psychiatric labels can work for the pocketbook of the psychiatrist, one only needs to reexamine Mom's reaction to the death of her brother. At the urging of relatives, Mom goes to see a psych to get over her sadness. The psychiatrist labels her as bipolar one episode, mild (billing code 296.51), bills the insurance company and Mom gets a mind altering drug sure to keep her in a bad condition, especially if she tries to withdraw from it.
The psychiatrist can make money off Mom once she comes into his office as he has no less than 31 separate diagnoses for bipolar disorder in the DSM IV to choose from. He then labels her Bipolar I, bills for his "labeling services" and picks up his check.
Bipolar is broken all the way down to single episodes -- one code for if it was mild, one for moderate or severe or severe without psychotic features (that means patient says it was bad but is now perfectly fine). For example:
* 296.51 Bipolar depressed, most recent episode mild
* 296.42 Bipolar I manic, most recent episode moderate
* 296.65 Bipolar I disorder, most recent episode mixed in partial remission
* 296.06 Bipolar I Disorder, Single Manic episode in full remission
* 296.70 bipolar I Disorder, Most recent episode unspecified
Well you get the idea. Then as if these were not enough ways to make a buck the psych has yet another catch all diagnosis with which to label the patient -- BIPOLAR DISORDER NOT OTHERWISE SPECIFIED (billing code 296.80).
|