What's the fucking point in a label?

Thanks Sharm and Stephen. Probably makes a bit more sense when I back it up with the big words.

It's been said by people smarter than me too. Richard Bentall's awarding-winning book Madness Explains takes a different tack. He shreds the validity and reliability of the diagnosis of schizophrenia at a theoretical level. That's before it's used in practice then labelling turns into total guesswork based on (according to one study) where the psychiatrist learned psychiatry. Bentall then spends the rest of the book talking about a complaints based model of mental health which, I think, is conceptually aligned with the dimensional model which is being proposed for DSM-V but based on subjective distress. It's desperately simplistic but appeals to the consensus idea of what mental healthcare should be about. My key concern is this idea of depression without low mood. It's the reason why low mood is one of the 8 o 9 possible symptoms of which 5 are needed for a reference-quality diagnsosis of depression. Subjective unwellness is rarely noted in the criteria of any diagnosis and when it is it is only one of a few symptoms. Research shows that men and women report roughly the same amount of subjective distress but as more symptoms are required to make a diagnosis of depression fewer and fewer are 'diagnosed' with the rate dropping faster in men than in women. This is know in psychiatric theory though I'll have to hunt down the study again which shows it to be true.

I've seen 6 psychiatrists since the age of 15. 2 judged me sane or at least chose not to give me a label. The choice by the first psychiatrist I saw to judge me sane meant I briefly ended up in a children's home then a foster home when I was a child. The other four gave me diagnoses of bipolar; schizoaffective: bipolar type; dual diagnosis; mixed affective disorder (in chronological order). Oh, and a diagnosis of depression but as a common mental disorder rather than a psychiatric illness. I was very lucky to end up in that children's home. My life continued without the label. I wasn't stuck in a psych ward and was able to take my school exams. About 2 years later I started a gap year job before university programming for a project for the European Space Agency.

These labels are meant to be enduring illnesses like diabetes or cancer. They're not. They just allow the psychiatrist to 'treat' (change) what they find different in their individual valuation of normal, a subjective quantity which allows them to effect whatever change in me they want. Clearly no psychiatrist could diagnose me with the same 'illness' either. Those 4 diagnoses were within three or four years.

The science of the label is bunk. The ability to use it reliably in practice, even with the operational cluster of symptoms approach, is about as useful as used toilet paper. Most of all, what it truly represents is, perhaps at best, a recognition that certain phenotypes exist which is about all that science can say. The rest is a psychiatrist or the hegemony of psychiatry choosing to make a pejorative of that phenotype by pathologising it (something non-scientific and non-medical).

Suffering still exists and suffering is complex. Again, to assume that it is something negative is to do what psychiatrists do and use subjective value judgements. Psychiatry was never invented to treat suffering (which is most evident in the example of when homosexuality was demedicalised in the US in the early 1970s. They were going to leave a diagnosis in for the suffering which came with the awakening of sexuality but chose not to leave it in, and thereby denied people treatment from the insurance-backed healthcare system, because the suffering is normal).

The labelling and the effect of psychiatric practice could be worse for more people than those they inflict these awful treatments upon. This quote makes a lot of sense to me. I've already rambled on long enough.

‎"…Jesus Christ might simply have returned to his carpentry following the use of modern psychiatric treatments." William Sargant, British psychiatrist, 1974