Head Case: Can Psychiatry Be A Science?

DSM-IVLouis Menand writes in the New Yorker:

You arrive for work and someone informs you that you have until five o’clock to clean out your office. You have been laid off. At first, your family is brave and supportive, and although you’re in shock, you convince yourself that you were ready for something new.

Then you start waking up at 3 A.M., apparently in order to stare at the ceiling. You can’t stop picturing the face of the employee who was deputized to give you the bad news. He does not look like George Clooney. You have fantasies of terrible things happening to him, to your boss, to George Clooney.

You find — a novel recognition — not only that you have no sex drive but that you don’t care. You react irritably when friends advise you to let go and move on. After a week, you have a hard time getting out of bed in the morning. After two weeks, you have a hard time getting out of the house. You go see a doctor. The doctor hears your story and prescribes an antidepressant. Do you take it?

However you go about making this decision, do not read the psychiatric literature. Everything in it, from the science (do the meds really work?) to the metaphysics (is depression really a disease?), will confuse you. There is little agreement about what causes depression and no consensus about what cures it. Virtually no scientist subscribes to the man-in-the-waiting-room theory, which is that depression is caused by a lack of serotonin, but many people report that they feel better when they take drugs that affect serotonin and other brain chemicals.

Read More in the New Yorker

7 Comments on "Head Case: Can Psychiatry Be A Science?"

  1. NO! Psychiatry is NOT science in that there are WAY too many variables to control… psychiatry today only seems to treat the symptoms, rather than looking at the causes, and NOT just chemical… we KNOW that our environment and mental state can alter our body chemistry. I believe the psych. profession has it backwards….

  2. Word Eater | Feb 28, 2010 at 4:57 pm |

    I suffered deep depression before I could even speak and I was suicidal as a toddler.

    I finally got a diagnosis and some treatment in my early twenties and the meds I'm on have made my quality of life much better. I hate taking them and if I miss a few days, I start getting “withdrawal” symptoms (SSRI discontinuation syndrome).

    It is a hideous trade-off that I have to live with. I do live with it and I have decided it is worth it.

    But I was old enough to know what I was getting in to. I understood the risks (to some degree – this was before Zoloft was found to make teens suicidal) and understood the potential benefits.

    I also was lucky to get in before the FDA relaxed the rules for pharma advertising, so I didn't go in demanding some magic pill; I just wanted the psychologist to help me figure out what the hell was making me so perpetually miserable and angry.

  3. doubt it, how do you measure all the variables involved?
    just look at ptsd you take a bunch of soldiers and expose them to the same things, some crack
    some just shrug it off, some become alcoholics, unless there is some way to measure and define
    every part of a person that plays a roll it will never be a science.

  4. GoodDoktorBad | Mar 1, 2010 at 2:32 pm |

    Psychiatry, to be effective requires a belief in the practicioners God-like persona, which of course is an illusion.
    Metaphorically, at best, they can serve a thirsty man his own water. At worst, be a witchdoctor who gives you the equivelent of bat guano pellets and belly button lint tablets for your “depression”.

    Sorry, depression is a normal reaction to a depressing world. If your depressed, you probably are seeing things as they really are……generally fucked up. It means that you are still sensitive and not numb like the zombie hoards that roam the streets. It means that you are still human. There is nothing wrong with you.
    You are just awake…..

    • the world is beautiful,
      if you dwell on what you don't have or how you wish it was it will crush you,
      if you let go and experience what it has to offer free of expectation it is an amazing world,
      depression isn't the only awake state.

      • GoodDoktorBad | Mar 1, 2010 at 4:02 pm |

        Yes, an awake state would include the full range of emotion. I agree, there are also things to feel good about in this life. Good point.

  5. Anonymous | Mar 1, 2010 at 9:02 pm |

    Yes, an awake state would include the full range of emotion. I agree, there are also things to feel good about in this life. Good point.

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