Well the prosecution should have been all over this "expert" witness psychologist. They should have gotten a psychiatrist and asked him "In your medical opinion does affluenza represent a psychiatric disorder?" He probably would have chuckled.

Homosexuality used to be classified as a psychiatric disorder (listed amongst other 'paraphilias'). I think Santorum is still of that school of thought. Sadly, he will be on the losing side of history.

I'll just add some nuance to your assertion below. The issue is not so much that depression is "misdiagnosed." The issue is that depression doesn't have a known physiological cause. That is, there is no anatomical or physiological marker for depression. It's a behaviorally defined disorder. That means it is entirely possible (even likely) that multiple patients all suffering from "depression" (i.e. exhibiting the behavioral symptoms of depression, thus being properly diagnosed) could be suffering as a result of differing physiological problems.

Almost all psychiatric disorders (other than maybe Parkinson's and some other known neurological malfunctions) have this issue. The problem I have with this is our readiness to prescribe physiological interventions for conditions that can't be diagnosed physiologically. While many of these substances are relatively benign, some have the potential to cause extremely problematic side effects (e.g. acute suicidal urges). The real work is going to be in finding better mechanistic level diagnostics.

In the mean time, I think more conservative treatment protocols are warranted. If sugar pills show some efficacy, why not start with those? You could still ramp up to an SSRI or the like when the sugar pill is shown to be ineffective in that patient. Better still are behavioral therapies, e.g. exercise or sleeping schedule changes. At the very least, I think they should be prescribed along with and emphasized just as much as the pills and counseling.

Longterm, I think pharmacological interventions into the brain are somewhat misguided. Serotonin receptors, for instance, are expressed all over your brain. I think more promising are the newer treatments like deep brain stimulation. It has been shown to be extremely effective in disorders like Parkinson's, and trials are already underway in the treatment of depression. Not only do I think the treatment will ultimately be more effective, I also think research into that sort of treatment is more likely to bear fruit in understanding the mechanistic underpinnings of these disorders. Hopefully that will lead to better sub classifications of people exhibiting depressive behavior.

>> ^DuoJet:

I'm inclined to believe that, as is often suggested, depression is very commonly misdiagnosed. This would surely introduce "extraneous variables" into placebo studies as well.

This tears my heart out. I was no monster, but I did my share of ignorant bullying in high school. I'm in my 30's now and I have contacted every one of them via peer networks and apologized for my ignorance; however, I learned that one girl that me and some friends picked on has killed herself after she caught her husband cheating on her. In a strange twist of fate, the woman I've been married to for 17 years now is a good friend with this girl's sister and her parents. I was able to apologize to her parents. They assured me that I had nothing to do with her suicide, but I don't care. I certainly didn't help her situation. I live with guilt every day of my life, and I am so sorry for being so wrong back then. I became a psychiatric tech in the 90's and I work with people who suffer from depression and other psychiatric disorders everyday when I go to work. I hope to help heal as many people as possible after causing those few people so much hurt.

>> ^gtjwkq:
That's a good point: If 100% socialized healthcare were ever implemented in the US, it would be better (less worse) if it existed at the state level as opposed to federal. That would institute a faint glimmer of competition between the separate systems, and people would be able to "vote with their feet", which is terribly ineffective, but better than being completely helpless.

This is something I have discussed before in other places, and on other forums. Both with Americans and Canadians. If you look at Canada's federal health act, it comes down to a whopping 24 sections or so. That's it. When I started reading the American one, and hit section 100, I thought that the guys in Washington were insane.

The whole point of the Cdn. federal health act is to say: Hey, we don't know how the provinces operate, we don't know what the people need, and we sure don't know where you need the resources or where. You deal with it, and if there's budget shortfalls come let us know and we'll pick up the cost, by taking it out of the general revenue fund(or equalization payments). We'll make sure it's spent properly(oversight), and make sure that it's running smoothly, and if the system needs help, we'll do what needs to be done. But if people are dying because you can't provide care, you and I are going to have a big talk. Fed to province.

End of story.

Now, sounds pretty good. There's other issues in Canada on this. But the reality is, Canada and the US in forms of government aren't that different at a state/provincial level. Both are highly independent, and both want the federal government to piss the hell off. So if you want this to happen, that's what I'd suggest and people should be telling their congressmen the same as well. To make it work, it may require one of two things. Either nationwide tax(icky), or each state will be required to pay a 'health coverage' surcharge or levy(akin to a tax) excess funds are then dumped to a general health revenue fund for all states(offlimits to anything else), and states which come up short can with oversight get money from it to cover deficits. We have something similar up here for it as well. Again long drawn out thing that I don't want to yammer on about right now.

>> ^Winstonfield_Pennypacker:
There is no evidence that a socialized medical system improves health care. There is also no evidence that it supplies more people with more care than a private system. When you boil away the rhetoric and start actually drilling down into the facts, socialized systems accomplish very little in terms of medical care output.


Generally the more that people get healthcare, the longer they live. The longer they live, the longer and more productive members of society they are. Generally when someone goes to the hospital when they don't have healthcare, it's because it's do or die. That is, they're about to die. They're not ready, so better off to live. Unfortunately, that's a rather huge burden to place on the system, compared to say treating the underlying cause the first time a round.

An example: A man goes to his doctor, finds out that he's got an ulcer. Get medication. Ulcer goes away.
Flip it around: A man doesn't go to his doctor, ulcer keeps going, becomes peptic, nearly kills him. Spends 3-8 weeks in the hospital in recovery, may have lost their job that they couldn't afford to lose in the first place.

Now depending on the province, not all medications are covered. However, a lot of doctors do swing things on the by-and-by to get you what you need for next to nothing. They're generally pretty good folks, and walk in clinics will help you out the same with pharmacies. Now if you look at the NHS in the UK where it's more-fully socialized including medication. It's a non-issue unless you're dealing with idiots who believe that treatment will kill you(luckily for them stupidity isn't considered a psychiatric disorder, because you can get treatment for that too).

i am so sorry miss peggy /hugs
i deal with many who are considered "mentally ill" and do my best to help,i end up being a shoulder most of the time.
i did find that diet helped tremendously.
i cannot imagine the hell it must have been for you to watch your husband dis-intergrate in front of you.
tragic..very tragic.

In reply to this comment by peggedbea:
i've been bitching about this for years. my exhusband has a very real psychiatric disorder, but in the years we sought treatment he was over medicated over medicated over medicated, which only turned a sick man into a monster.

i've been bitching about this for years. my exhusband has a very real psychiatric disorder, but in the years we sought treatment he was over medicated over medicated over medicated, which only turned a sick man into a monster. we were spending over $1000/month on his meds, with health insurance. he had siezures, hallucinations, cried uncontrollably, lost his sex drive, lost the ability to feel love, lost his hair, gained or lost weight rapidly, had the shakes, and visual disturbances (very dangerous considering he was an electrician and a welder and built massive cranes for a living) etc. when i questioned the doc i literally got yelled at and called names. (we switched docs after that one of course) but its more of the same, none of them really know what to do and pharmacuetical kick backs are sweet! he was admitted to the psych hospital on several occasions, but on this one in particular, they admitted because he was so severely over medicated they needed to ween him off all that shit, then discharged him 3 weeks later with prescriptions for xanax, klonipin, wellbutrin, paxil, seroquel, and risperdal, WTF? its fucking sick. and in the end he chose to be unmedicated rather than go through that anymore.
now he lives under a bridge self medicates with meth and booze and gets beat up in homeless shelters.

my biggest fear for my kids is that they will inherit this shit, its coming at them from both gene pools. im even more terrified that i will either freak out at the first sign of mental instablity and rush to have them evaluated and medicated, or be so scared of diagnosing them of something they dont have, that i will ignore the warning signs until its too late.

its a scary balance.

FROM THE TOURETTES GUY SITE:
Although he has been diagnosed with Tourette Syndrome, his actions are influenced by other problems
(including alcohol) and are not consistent with most Tourettes syndrome sufferers. In exchange for a few laughs,
please educate yourself about the realities of Tourette Syndrome from a reputable site such as this one.
http://www.kidshealth.org/parent/medical/brain/tourette.html

-safe to say that "A combination of numerous psychiatric disorders and alcohol create entertainment. RIP, home skillet"
p.s. sorry for being a smartass.

In reply to this comment by artician:
It's really hard to tell if this is real, or just someone making fun of people with this disability. Is there more info? It would be interesting to know, I've never met anyone with Tourettes.

FROM THE TOURETTES GUY SITE:
Although he has been diagnosed with Tourette Syndrome, his actions are influenced by other problems
(including alcohol) and are not consistent with most Tourettes syndrome sufferers. In exchange for a few laughs,
please educate yourself about the realities of Tourette Syndrome from a reputable site such as this one.
http://www.kidshealth.org/parent/medical/brain/tourette.html

-safe to say that "A combination of numerous psychiatric disorders and alcohol create entertainment. RIP, home skillet"
p.s. sorry for being a smartass.

FROM THE TOURETTES GUY SITE:
Although he has been diagnosed with Tourette Syndrome, his actions are influenced by other problems
(including alcohol) and are not consistent with most Tourettes syndrome sufferers. In exchange for a few laughs,
please educate yourself about the realities of Tourette Syndrome from a reputable site such as this one.
http://www.kidshealth.org/parent/medical/brain/tourette.html

-safe to say that "A combination of numerous psychiatric disorders and alcohol create entertainment. RIP, home skillet"
p.s. sorry for being a smartass.

In reply to this comment by Jordass:
My brother has tourettes and its pretty safe to say this guy doesnt have it. The tick of uncontrollable cursing at times of stress is a trait sometimes though this guy shows anger and the want to curse so he is in complete control. Probably a parody.

I remember a german film called "dreiundzwanzig" (23) which told the true story of Karl Koch, a german hacker in the late seventies who after reading Robert Anton Wilson books on the iluminati started seeing the number 23 everywhere. He hacked into the west's sensitive computer systems and sold data he stole from, among others, the Pentagon, to the KGB.
He died in 1989 in an apparent suicide which has been said to be a murder.

In fact, 23dians are people who witness the number 23 in significant places and circumstances. It's a common sympton of people suffering from apophenia (a psychiatric disorder in which patients see patterns everywhere, think john nash in a beautiful mind).

Farhad's comment is probably spot on, but still it's intriguing that such a number should get more cultural significance than, for example, 24 or 22.

Check out the wikipedia articles on 23 and Karl Koch or Hagbard Celine. Interesting reading.