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Recent Challenges to Medical Diagnoses and Treatment

Over the last decade, two challenges to the current diagnostic and treatment sys- tems have emerged. First, the British Psychological Society (BPS) published two major position statements essentially calling for the abandonment of the very idea of psychiatric diagnosis—at least for bipolar disorder, depression, schizophrenia, and psychosis. The BPS argued that the feelings and experiences we label as symptoms of mental illness (such as sadness, elation, mood swings, paranoia, even hallucinations and hearing voices) are not uncommon. Instead, they occur widely and on a spectrum, with no clear dividing line between health and illness. Even among those we might label mentally ill, many experience only mild “symptoms” and are able to maintain a normal life. Moreover, these “symptoms” seem more clearly caused by deprivation and trauma than by any biological conditions. As a result, the BPS argued, individuals can best be aided by talking with therapists who help them make sense of their experiences without assigning diagnoses and who prescribe psychiatric drugs only briefly if at all. This philosophy underlies the work of the Hearing Voices Network, which offers both professional help and peer support to those who hear voices.

Second, in 2013 the director of the U.S. National Institute for Mental Health declared that years of scientific research had failed to find any specific biological markers for any psychiatric diagnoses. As a result, the institute would no longer fund research based on diagnostic categories and would instead focus on how genes, cells, and other biological elements may regulate emotions and behaviors in all people, not just those diagnosed with a mental illness. Three years later, how- ever, an article published in Nature—the top journal in the biological sciences— reported that a set of genes had been identified that significantly increased the risk of schizophrenia. These findings may reinvigorate interest in biological research into mental illness if they prove to be accurate—unlike previ- ous reports linking schizophrenia to genes.

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