- raymond vazquez
- Raleigh, NC
- United States
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Overthrow of DSM -V
Great talk and badly needed ideas to stem out-of-control cost of mental health diagnosis and treatment, made worse by reluctance of profession to incorporate latest neuroscience findings. My nonprofit "Neuroscience - Now" is focused on carrying out Dr. Patel's ideas..
Closing Statement from raymond vazquez
Yes, it is time for a revolution in the diagnosis and treatment of the major forms of Mental Disorders but the revolution must start both within the field of psychiatry and from the neurosciences pushing from the out side. Either way BIG PHARMA cannot dictate the direction of this revolution it should play a role as facilitator of innovative ideas from academia and professional psychiatric associations.
I do not want to "throw out the baby out with the bath water" therapist on the front lines dealing with mental disorders have acquired vast store houses of empirical evidence on what forms of treatment work for a given individual. On the other hand, major organizations like the "Society of Neuroscience" in contact with mental health professional, congress and nonprofits must play a role in any grass roots effort to upgrade the entire field of Mental Health treatment, the results will be reduction in cost, suffering and increased compassion for those in need based on the scientific method. Please take a look at my website "http://neurosciencenow.org/" it takes a practical approach in making my prior points real...thanks a lot for all the thoughtful comments...
elizabeth muncey 10+
Chris Cavalari
raymond vazquez
Chris Cavalari
Zared Schwartz
raymond vazquez
Zared Schwartz
Heidi Overturf
At its core the DSM is a guide. Doesn't it really rely on the practioner? I've been in and around the psychology world all my life. My mom & 2 aunts all psychologists. The hype is that their are fundamental changes in diagnosis this time around. I can't wait to see if is progress or more illnesses.
raymond vazquez
I want to add that the research on adult Neurogenesis has the potential to revolutionize how we treat almost all the major mental disorders.
Helen Hupe 30+
John Smith 30+
raymond vazquez
John Smith 30+
raymond vazquez
John Dunbar 10+
Im also interested in what findings you are referring to?
heres an interesting discussion that touches on DSM-V by Dr Allen Frances http://www.youtube.com/watch?v=c2tOp7OxyQ8
Mitch SMith 50+
What is DSM -V?
Can you expand on the latest neuroscience findings that are relevant?
I aplaud your non-profit initiative - it's great to see someone do more than just talk!
John Dunbar 10+
Mitch SMith 50+
Yes - it's somewhat contentious. I recall some problem with a phenomenon of over-diagnosis.
Robert Sapolski has a bit to say about the foggy line between individuality and psychological dissorder at a certain point of classification.
However, there certainly are a host of debilitating conditions that require no philosophical arguement to classify.
Having personal experience with family and friends suffering from this and that, I can see that we are far more advanced than was the case only 100 years ago - and this is comforting.
The discussion now should revolve around taking the snake-oil and sharlitanry out of the field. Certainly there is a case for constraining the drug companies who are in the business of sickness, not wellness - but this is a factor of the money game, not psychiatry, an dis another subject.
In this, Dr. Patel's initiative is a significant step in the right direction.
Judging from some of the wildly eroneous comments in the video discussion, I can see where such lay-education is a matter of priority.
I think people get off the track when they fail to understand that human behaviour is not a result of machinery in their heads - but is an emergent factor based on the machinery, genetics, environment and experience - in that emergent continuum there is no linear causality. And I defy anyone to properly understand that until they have been through, at least, the elementary principles of all these as a gestault. If such awareness is not propagated, then the witch-doctors and snake-oil merchants will abound - and therein lies the rub.
John Dunbar 10+
"Certainly there is a case for constraining the drug companies who are in the business of sickness, not wellness - but this is a factor of the money game, not psychiatry, an dis another subject."
I wish this were so, but even as much as i enjoy and plan devote my life to the field there seems to be some very serious questions that need answering.
http://www.cchrint.org/2010/05/21/dsm-panel-members-still-getting-pharma-funds/
Like Sapolsky speaks of, you cannot try to unravel and explain and individuals behavior from one categorial bucket. I completely agree that behavior is a finality of synchronized interactions between "the machinery, genetics, environment and experience". Trying to treat an individual without looking at these causes as a whole or purposely ignoring some for whatever reason is where you see deception in the field of psychiatry. It seems as though DSM-V wishes to throw talk therapy to the wind and instead just hand out medication. In my opinion they have attempted to help the patient solely by offering a change in brain chemistry. Now theres no doubt that there are many medications that work and have done and will continue to do wonders for people. Unfortunately they have side affects and I believe psychiatric medications should be reserved for those who have not responded to other forms of treatment first. continued..
John Dunbar 10+
Have you seen Elyn Saks Ted Talk, medication helped her greatly
.http://www.ted.com/talks/elyn_saks_seeing_mental_illness.html
There are also others in the field who claim that medication saved their life, like Kay Jamison, who could be considered the foremost authority on Bipolar Disorder and also suffers from the illness.
The point is this we need people in the field who are empathetic and care about their patients needs,quality of life, currently and in the future. This means understanding all facets of possible treatment and working with the patient to guide them through what would probably be most beneficial to THEM.(usually a combination of current treatments)
Dr. Patels initiative is inspiring and needs proliferation badly.
John Dunbar 10+
http://www.tufts.edu/~skrimsky/PDF/DSM%20COI.PDF
Mitch SMith 50+
We're pretty much on the same page.
I've gotten a lot of insight into the problem through experience in trying to get help for close family, plus some pre-experience in neural net dynamics.
In the instance of finding help for a bipolar sufferer, we followed the councellor trail through 4 or 5 practitioners (not including GP doctors) - all with degrees, sociologists, therapists and psychiatrists, and it wasn't till I shelled-out for the top psychiatrist in the country till we got the condition diagnosed and a suitable course of meds and talk-therapy. It took 5 years. ANd then the meds were progressed and followed up with blood tests.
Bipolar is a hideous condition. If it were not for my embarasingly high income, she would probably not be alive today, and I was intensely aware of those who were out-of-range for any kind of help - for reasons of income, ethnicity or just ambiant ignorance, they are doomed.
Autism was a bit easier to get diagnosed, no meds required there - just dedication and understanding.
MS was also a nightmare - there is still no recognised treatment.
All of these have a holistic source - genetics, enviro-chemical, in-utero conditions, early childhood experience, social stressors and genetic pre-disposition.
It is the emergent nature of human behaviour that must be studied to get any grasp on these things.
WE are now getting an idea of how neurons and synapses are involved in the process, things like neurotransmitters, re-uptake, degradation, receptors, ion dynamics, supressor neurons, glial cell, myelin etc etc. However, how do you detect a traumatic experience by looking at the machinery? This is nothing more than a certain complex configuration of synaptic potentials - that affect the synaptic potentials?
It's this emergent state that needs identification - and we are a long way from codifying it.
On top of that, there are not enough healers - and never will be in our current social model.
SOmething's gotta give.
raymond vazquez
raymond vazquez
Almost every psychiatrist in this country uses it as sought of a checklist to narrow down the possible mental health diagnosis from a questionnaire and your discussions with the doctor. It is very useful for a first cut and makes use of the large number of cases in the psychiatric literature. Here is the problem, it does not make any judgement on the cause of one's mental disorder, just a diagnosis. If you look at my website you will see the "light years" of advancement we have made in Neuroscience not even peripherally incorporated into DSM logic. Mental disorder and treatment MUST take into account the biological specifics of each individual. Email if you want specific mental disorder insights form the last 10 years of neuroscience research.
Mitch SMith 50+
Many thanks1
I'll send you an email.
Communities take aeons to turn around. Even though we think of ourselves as moden and versatile, the deep attitudes tend to persist even when they are demonstrably wrong.
I'll do ,my bit to help. I regularly write to my health minister and promote the great work being done by Damasio, Sapolski, Ramachandran et al.
Coming from a more AI angle, it's a bit easier to understand what neurons are actually doing -.dynamic topology is a hard concept to digest, but when it does it's a bit of an epiphany .. so much becomes clear.
Down on the practical trenches, you have to deal with the pathology, and that's way way beyond the root concept. One cannot expect the lay person to take on the task of understanding it - in many cases it wrecks their entire world-view - people get defensive when you do that to them - for good reason, it is damn hard to reconstruct an entire world view. It might help of it got quietly introduced into schools, but the teachers are all getting sick of teaching politics.
I'll do what I can.