Why aren't brain scans used when diagnosing mental illnesses?

Example?

Drapetomania
Homosexuality
Female hysteria
Internet addiction disorder
Schizophrenia
Pretty much any mental illness you can be involuntarily committed for without actually breaking any laws

Weak af response.

Ignoring the first 4 since they aren't even recognized psychiatric disorders.

>Schizophrenia
Very bad example.

>Pretty much any mental illness you can be involuntarily committed for without actually breaking any laws
So, "being suicidal" is a form of social deviance with its own subculture aside from mainstream society? That's the only reason an adult can be involuntarily committed without breaking any laws.

You seriously believe schizophrenia should not be considered a medical condition?

It doesn't matter even if you had millenia of statistical analysis if the thing you're analyzing exists solely as checkbox selection opinions. That's the problem, there's nothing physical / real any of this is getting checked against. Studies on brain differences are attempted but no trends in brain differences have been consistent enough to define any psych condition by, and in fact if they ever did then they'd be ruled out as psych conditions and treated by a neurologist instead.

I think psychiatrists generally eschew brain scans because the overwhelming majority of people have subtle abnormalities in their brain structure. Also you don't even need to be trained as a psychiatrist to know when someone is off their rocker so psychiatry is kind of a meme field in that way.

Schizophrenia will fuck you up nigga

All diseases are diagnosed by checkboxes of signs and symptoms. Psychiatry isn't different from any other branch of medicine in that regard. At this point, the way symptoms cluster, we can be fairly certain that most of the diagnoses that exist are "real" in one way or another. Just because the pathophysiology of a disease isn't fully understood doesn't mean we shouldn't give the patient treatments if we have good ones, especially if treatment is the difference between life and death (e.g., suicidal depression) or being homeless and being able to provide for yourself (if that's what the patient desires).

Drapetomania had symptoms. Doesn't mean it actually existed as an organic disease.

Psychiatry is necessary. Would you be comfortable letting sociopaths/severe schizophrenics with aggressive tendencies run rampant around your community? Yeah sure whatever social deviance might be subjective, but having a medical specialty which aims to treat people like this reduces suffering for not only the mentally ill individuals, but for society as a whole

>mental illness is not innate

>mental illness is usually a myriad of processed stimuli/environment

Well... If our incarceration methods were centered around rehabilitation, instead of punishment, there would be no need to use psychiatry as an excuse to involuntarily commit individuals. Though you'd still need it as a mechanism to determine which prisoner received which sort of rehabilitation.

In the US legal system, at least, that's really the primary purpose psychiatry serves - it acts as a crime prevention mechanism, and as a secondary form of "prison light", which, in turn, has several degrees of prisons within it. The reason being is that our modern criminal prisons have almost no rehabilitative mechanisms, being primarily designed instead for containment and social vengence. (We talk about "Justice" a lot, but don't really understand it, so it's been a code word for institutionalized revenge.)

We have this odd cultural separation where we don't want to "punish" people who we feel aren't responsible for their crimes, even if they are dangerous, and wish to "treat" them instead. We somehow fail to realize that there is a narrow and often illusionary line separating that those choose to do harm and those who do it out of compulsory delusion.

DSM is often largely opinion-based because the board that is in charge of it doesn't have strict enough standards. A large portion of symptoms are social deviations at the end of the day because the definition for disorder that they use requires a negative effect that could be there due to social stigma or just difference. They supposedly try to mitigate that, but the entire approach is a mess. I don't know how to fix it, but the structure in place isn't useful.

Schizophrenia is a different case than many DSM disorders, because it's a genuine malfunction that's happening in the brain. Depression is similar to that, so the DSM works for them as the shortcut between hard science and human usability, but for disorders that aren't so feverishly researched, the effect amounts to very little.

because psychiatry is in the dark ages, prob.
If you can't measure it; you don;t understand it. Tats what I say!

Apparently you only need your face scanned to determine if you are homosexual

Because they don't show up.
Or (very simplified):
Mental illness is a problem in how the brain work rather than a problem in the brain structure itself.

Or (even more simplified):
It's a software problem, not a hardware one.

But that isn't diagnosing a mental illness, it is a way to rule out other potential causes for certain behaviors/thought patterns etc.

As has already been mentioned, brain MRI is usually done when diagnosing severe mental illnesses that can be caused by structural brain disease like trauma, tumors, strokes and infections.

This is usually done in psychotic disorders and late-onset mania.

Well, you can actually get a scan of a schizophrenic in an acute state. Depression as well, and chronic depression tends to have other physical cues outside of the brain.

Part of the problem is, there's a lot of other things that can cause a scan like that, and most folks enter semi-schizophrenic states from time to time. There's also a lot of high functioning folks with mental disorders - if it doesn't fuck with your life, it isn't really considered a disorder.

It might be possible, in the future, to diagnose chemical disorders associated with certain conditions, such as serotonin levels, but in addition to each brain being so widely varied in each individual, they also vary considerably over time.

For these reasons, among others, when it comes to such conditions, brain scans are usually only useful when comparing differences among a large group of subjects, and even then, only so much.

Would be nice to have good (and cheap) neurological tests for such things, but one could say the same of a lot of other things - like IQ. Meanwhile, all you can do is test for certain behavioral clues, which aren't all that more consistent, save in extreme situations (such as during acute attacks) or over large cross-sections of subjects.

Because psychology is pseudoscience based on subjective observation and has very few physiological connections.

so 100% of people diagnosed with schizophrenia have the same brain.

> based on subjective observation
Hey, still better than dermatology where most docs walk in with prescriptions already filled out.

Could you interpret things like depression and schizophrenia as "consciousness illness?" Since the brain itself doesn't change with the illness?

Actually the brain does change during the course of both of those illnesses. Schizophrenics will have a progressive increase in the size of their ventricles (the cavities in your brain which produce CSF). Depressive people could experience a whole host of changes like inflammation of brain tissue, or increases of serotonin levels.

Even though the physiologic changes aren't necessarily the same from individual to individual, we do have a strong reason to suspect there are physiologic changes because the vast majority of individuals with these illnesses respond very well to medication.

>most folks enter semi-schizophrenic states from time to time
>high functioning
I'm only picking on you because you used these conceptual allusions in the same paragraph.

"Most folks" never experience anything remotely similar to any Schizophrenic frame of mind, or they'd naturally develop enough context to treat people with Schizophrenia like actual people. I don't know how strong your empathy is, but the general rule of thumb with people is that they'll only have any method of healthily integrating with society when society treats them like actual people.

What you meant to say, was that most folks enter states of mind whose _corollary_ brain scan has some sort of arbitrary similarity to Schizophrenic symptomatic individuals under some unknown or possibly triggered mental state.

What this means, is that the entire concept of a "high functioning" individual is complete nonsense with no rational or epistemic basis whatsoever. The real answer is that we have no solid basis for understanding of what defines mental health, and only measure it by studying the variance of ways in which different personalities cope with the hypocrisy that is modern society. So when your psychiatrist tells you that it might be "high functioning" , what they ACTUALLY mean to say is, "I am an incompetent non-doctor with no expertise on studying human behavior in any non-anecdotal capacity."

Anything else is a (potentially high-functioning) delusion.

>the vast majority of individuals with these illnesses respond very well to medication.
What specifically is the figure behind "vast majority" and what exactly is "responding well" defined as here?

Okay I get it, I don't know anything about this I just saw an earlier post saying that the reason scans aren't super useful is because it'll look the same. Thanks for the info

Yeah, scans are difficult because what we might think of as one illness may actually be many illnesses that present similarly or identically. There are a ton of different theories of mental illness, covering differences in physical or chemical structures in the brain to high-level cognitive processes. As my grandfather, a psychiatrist who has been in practice for many decades says, the sum of all of the theories is closer to the truth than any individual one. Mental illnesses are complex syndromes that operate on a lot of different levels. Psychiatry is a field very much in its infancy, and I think that we should be looking at it with excitement instead of the hostile response and name calling that everyone here has.

It's exactly as you expect; that user is making a naive prediction based on the "trend" of a double blind controlled (in the scientific sense of the word) study. The data does not reflect the effects of those same drugs on the population because it would require each and every mental house in the country to take rigorous measurements informed by trained and competent psychologists.

The reality is that psychologists trust psychiatrists way too much and end up thinking they both know the DSM in the same ways, to the same level of epistemology, and to such a degree that psychiatrists can reliably report symptomology. So they just sign off on whatever drugs the psychiatrist wants to try on the subject. (Note that I don't use the term "patient" here.)

The reality is most people deal with more side effects than anyone should need or want. They work for some, and for those some, psychiatrists acquire first-hand anecdotal evidence that they "work" enough to have a meaningful impact on some recipients. But you do need the right drugs for that to happen, and our concept of how to deal with issues of mental health (or public health in general) are shit at best, so that ends up being much rarer than the FDA would hope.

>What you meant to say, was that most folks enter states of mind whose _corollary_ brain scan has some sort of arbitrary similarity to Schizophrenic symptomatic
Yes, temporarily... Though, at the same time, most folks have experienced waking dreams, and that state is actually very similar to schizophrenia, if again, temporary.

>So when your psychiatrist tells you that it might be "high functioning"
High functioning means the individual so afflicted is having few or no symptoms or has learned to mitigate or redirect them to the degree where it has not interfered with his life. In other words, generally, undiagnosed. Psychiatrists rarely get to diagnose high functioning individuals for obvious reasons. Nonetheless, though perhaps more often in day to day life, rather than on duty, psychiatrists will occasionally find perfectly functional individuals who nonetheless have tell-tale signs of all matter of disorders (as do neurologists and MDs), sometimes disorders much more cut and dry than schizophrenia, and occasionally they become voluntary case studies. More often, of course, a high functioning individual ceases to be so, and has a breakdown - though this is not always due to well self-managed pre-existing or even potential condition.

>psychologists trust psychiatrists way too much and end up thinking they both know the DSM in the same ways, to the same level of epistemology, and to such a degree that psychiatrists can reliably report symptomology
The psychiatrist is the authority figure in that situation - the psychologist has no say in what drugs his patient takes, sometimes much to their chagrin. At the same time, psychologists are more often the cognitive counsel work-horse end of the apparatus, while the psychiatrist is the medical end, and quite often, the psychiatrist will make his diagnosis based on the psychologist's observations, and never even see the patient - particularly common with in-patients.

Might be worth noting that, despite what the acronym stands for, the DSM is very rarely used for diagnosis. It's more of a categorization tool, often more about legality than the actual state of the patient. Basically, labels to slot numbers under and check off some boxes.

Not that it isn't useful, to prevent, for instance, accidentally prescribing a new patient exhibiting suicidal depression a tricyclic antidepressant, when he has a history of bipolar disorder, but for individual long term care, the DSM definitions are largely meaningless.

>Why aren't brain scans used when diagnosing mental illnesses?
Brain scans can diagnose Homosexuality.
Which is a mental illness so It's used.

If a Brain Scan shows Huge Brain Size under a Huge Forehead then That's a Genius Brain

The Huge Brain Phenotype

>that state is actually very similar to schizophrenia
No, it's not. You're conflating mental states and blood flow diagrams. We don't know how every facet of the metabolic activity of the brain works and there's zero reason to assume even a primitive semblance of exacerbative symptomology based on similarities in metabolic activity. It's like conflating telepathy with two people getting hunger pangs at the same time.

Again:
>actually
No, not actually.
>very
No, not very.
>similar
And no, not similar: corollary. Correlation is not similarity.

>In other words, generally, undiagnosed.
That is *precisely* what we can't have if the promise of psychology is to come to fruition. People naming off disorders as if they mean anything diminished the value that those names hold. They stop being discrete categories of symptom correlations and start being slurs, insults, memes, culture. At that point all specificity is lost and nobody coming into the science knows which way is up.

Mental illness is NOT an easy problem, and dismissing things as symbols, thinking that a diagnosis is an *explanation*, or that artificially upskewing the numbers by saying, "Oh they're all sick, they're just *high functioning*," is *actually hurting people right now*. It's not just counterproductive, it's actively harmful.

>disorders much more cut and dry than schizophrenia,
It boggles my mind that you can actually say this, that you think even Schizophrenia is cut and dry. That attitude, that hard-categorizing behavior, is exactly what causes people act out in a desperate attempt to prove their sanity. Because despite how the media portrays it, people suffering from Schizophrenia are still fully capable of logical reasoning. It's not an all-or-nothing deal and it never has been.

>The psychiatrist is the authority figure in that situation
Then that's even more dangerous, irresponsible, and a recipe for a public health crisis.

It sound like you have the two confused though.

>despite what the acronym stands for
It's at least an attempt, to start moving anywhere, but it's nowhere near an explanation.

My humble advice is don't waste your time homes. Most of this person's posts consist of baseless platitudes common to the profession of psychiatry with no objective evidence to back them up. Just another fanboy.
>the psychiatrist is the authority figure in that situation

do you even fallacy bro

If this is about you it's spot on. Somehow you manage to talk about everything without actually saying anything.
Dear lord i just realized you might be an actual psychiatrist.....fuuuck

I'm not doing it for them, I'm doing it in spite of them. Those platitudes actually hurt and harm people, and I can't just sit by and pretend I don't know better or have experience with these things.

No, worse. His grandpa was a practicing psychiatrist. His entire perception of reality is warped two generations deep by inherently biased anecdotal evidence. He can't even help being a stereotype.

You are a good person.
>Those platitudes actually hurt and harm people
I've seen it for myself.

Who says that the two are seperate? What if mental illness is caused by brain structure/chemistry? Otherwise aren't we seperating the mind and the brain, and what evidence do we have for that?

I doubt this guy will reply so what does everyone else think?

Gotta say I'm curious how you know this, but it does explain a lot..

I'll bite. First of all, we don't have any evidecne that "mind" and "brain" are separate, but we do face the very real problem of correlating mental states with brain states.

I think that OP means that there are no obvious anatomical abnormalities than are correlated with the sorts of mental states people label as "mental illness". That is to say, an ordinary MRI scan will not show anything wrong with your brain.

>What if mental illness is caused by brain structure/chemistry?
The standard view in cognitive neuroscience and psychology (as the two branches of science that deal with how the mind and brain work on a fundamental level - psychiatry is irrelevant at this point) is that ALL mental activity is caused by brain structure/chemistry, including the type of mental activity some people classify as an illness. Again, the problem is that psych and neuroscience are still trying to figure out how the brain does incredibly basic things, like identifying a line drawing of a box as a box, or how you know that 2+7=9, never mind how the brain gives rise to complex thoughts like "fuck this world i want to kill myself".

He said it earlier. (I'm assuming it's all been one guy, I didn't read the earlier posts.)

Now take the example of depression. No one would say that the experience of depression is NOT caused by something going on in the brain, for the simple fact that all experience is caused by something going on in the brain. This is a trivial fact and not very useful. However, there ARE definitely happy pills you can take that alleviate the symptoms of depression by targeting chemical pathways in the brain known to modulate your mood. Note that these anti-depressants don't actually fix the underlying problems giving rise to depression, they simply literally fuck with your ability to feel things, so that you are no longer bothered by the things that used to bother you.

Truthful post, although don't some mental illnesses display signs in MRI scans, e.g abnormal blood flow/electrical activity? And is there not any documented correlation between an abnormality in brain structure/a mental illness?

The thing is, you might find such correlations (and I haven't kept up to date with this stuff so I'm sure there's lots by now), but what do they really mean?
First of all, fMRI BOLD response and EEG waveforms are always averaged across many participants. So although you may be able to say that some study found that people diagnosed with e.g. major depression showed a statistically significant difference compared to non-depression participants in BOLD response in some area of the brain while doing some task, this doesn't really give you much information re: the likelihood of a single person with depression showing that pattern of activation. In fact, it's pretty unlikely that any given individual will show the same response pattern as the group's average response, regardless of whether they do or don't experience depression.
Second of all, simply finding a difference in e.g. BOLD response on some task comparing normies and depressives doesn't by itself tell you anything about the underlying physiological causes of depression. The difference observed on the task could simply be due to a consequence of feeling like shit. It may in fact be the case that each of those people experiences depression for entirely different reasons, i.e, there is no actual single cause of depression, and therefor no unique pharmaceutical solution (other than getting hopped up on feel good pills)

You inspired me to read up a little, and I thought this article was pretty interesting.
theatlantic.com/health/archive/2013/05/the-real-problems-with-psychiatry/275371/

The dude Greenberg seems to be legit. Here's a review by a psychiatrist:
ncbi.nlm.nih.gov/pmc/articles/PMC3114681/

>when your psychiatrist tells you that it might be "high functioning" , what they ACTUALLY mean to say is, "I am an incompetent non-doctor with no expertise on studying human behavior in any non-anecdotal capacity."
No, what he's saying is, "I have no professional ethics, and I want to make a profit treating you for a condition you don't have."

Most schizophrenia is literally just white kids acting retarded so they can get NEET bucks. It's funny how these white kids always behave themselves when they're near black people. They only act out when they know they can get away with it.

Honestly, I've met enough borderline narcissistic psychiatrists to think that they don't even have the self-awareness to realize how full of shit they are. The guy who was posting earlier in this thread strikes me that way

>As my grandfather, a psychiatrist who has been in practice for many decades says, the sum of all of the theories is closer to the truth than any individual one.

>unironically referencing your own grampy in a thread on Veeky Forums
>diagnosing people on the basis of theories you literally admit you don't understand (if you combine a bunch of shitty theories you get closer to the truth?? that's not how science works user...)
>mfw

>The psychiatrist is the authority figure in that situation
>It sound like you have the two confused though.
>the psychiatrist is the authority figure in that situation
>do you even fallacy bro
Not that guy - but he's right. It's not an "appeal to authority" situation, it's literally that the guy with two to five years of schooling and a lot more licensing requirement (not to mention an MD, PhD or PsyD), over the other guy, has authority in that situation. A psychiatrist can overrule a psychologist, and, most of the time, a psychologist has no say in medicative procedures whatsoever. Most psychologists can't make prescriptions or even commit you under their own authority. It's analogous to a Judge vs. Lawyer situation, in that only one can hold you in contempt, while the other can only make your case - and only one of the two will talk to you about your case regularly. Generally speaking, psychiatrists are medical doctors, while psychologists are "shrinks".

t. Psychologist, MFTC spec in chemical dependency (dun know nuttin about no birth of no baby)

Some psychologists do have MDs, and can prescribe medicine, but generally, when they do so, they are independent practitioners. Most practices and institutions consist of several psychologists, who actually interact regularly with the patient, make observations, and generally "help them work through stuff", while there are one or two psychiatrists on staff who proscribe medications, and generally only occasionally briefly meet the patient in question, if at all.

I worked intake a mental hospital for a long time (horror stories abound). We had 4-5 orderlies, 5-8 nurses, 6-10 psychologists/therapists, 1-3 psychiatrists, for 60 to 150 patients, depending on the time of year. The psychiatrists almost never saw their patients (really, it wouldn't have been possible with our patient population and turnover rate). Wasn't all that different in the outpatient office.

You don't treat high functioning individuals, and you certainly don't medicate them. By definition, you generally never meet them in a professional capacity. Like the guy said, there are some rare case studies revolving around such volunteers that helped build and modify some of the cognitive therapy models we use today, but the majority of that research is instead derived from successful recoveries, not folks who were high functioning their entire lives, as such individuals are not picked up by the system. At best, you hope your patient may one day become high functioning, if medicated, but high functioning individuals have no reason to seek you out or end up in your care.

...and aside from some of the independent practitioners, which make up less than 1% of all psychologists and psychiatrists, we don't make profit off patients. We aren't paid piecemeal. The pharmaceutical industry is another story, but they haven't been quite as lavish in their bribery towards psychiatrists as they have been to medical doctors. I do know a psychiatrist or two, however, who have so many free samples laying around, that they'll often try out those samples they have at hand on new patients, before prescribing them something (as there's like thirty brands for each type of medication that are essentially all the same). That seems more of an effort to save the patient money, as they are working with low-income patients who may not have full coverage, and once they find something that works, they invariably put the partially insured on generics.

>I am a fag and have no idea what I'm saying

OP you're a retard, they do use them to determine diagnosis as was mentioned
mental health isn't very clear cut
but don't try to pretend like some things are fake

there seems to be a very vocal set of posters who try to pretend like mental illness isn't real
whatever their motivation the majority of real dr's disagree so tough shit

Well, some things are fake - but schizophrenia isn't among them. There's specific chemical disorders and even brain activity that one can correlate among large samples, and may one day be able to scan for reliably in individuals. It's still "fuzzy", but it's one of your more established disorders with unique characteristics. (Sometimes even a bit frightening in their consistency.) Even with bipolar disorder, you can get a predictable response from certain chemical input. Sadly the negative responses are easier to generate than the positive ones, such as imipramine invariably resulting in a perpetuated acute manic episode, where there's no such response in a patient with simple chronic depression (this is also, sadly, how one often discovers a patient is bipolar rather than simply suicidally depressed - so yes, it would be nice to be able to physically diagnose that beforehand).

There's other mental conditions that are more amorphous that we may never be able to physically diagnose. Borderline personality disorder, and other associative disorders, such as basic phobias, aren't the direct result of anomalous brain function, but merely socially dysfunctional associations the brain has made.. Albeit, sometimes they are made of a result of physical brain disorders, and you can measure the fear response readily enough.

We can chemically induce schizophrenia, or at least schizoaffective conditions, among others (such as dissociative disorder) so it's not as if they are entirely beyond our neuro-chemical science. It's, of course, unethical to study the conditions in that way, but for better or worse, there's plenty of people out there who imbibe certain substances that readily provide that study material for us.

Everything we do is a result of our brain activity including borderline personality disorder and phobias.

Yes, but they aren't the direct result of a chemical imbalance you'd ever be able to scan for. I mean, you could show an image of a spider to test them for arachnophobia, even the degree, but that's about it.

In the distant sci-fi future, I suppose we may have simulated brains where you could predict details like that, but in the foreseeable future, associated belief structures are kinda vague, and not apt to show up as anything unusual until triggered. At least with schizophrenia and some other conditions, there's some neurochemical imbalances one might expect to find.

>aside from some of the independent practitioners, which make up less than 1% of all psychologists and psychiatrists, we don't make profit off patients. We aren't paid piecemeal.
Even if you're salaried, if there isn't enough business, you lose your job or take a pay cut. I've seen how it works. You make work for each other and reward each other for making work for each other.

And don't fucking lie to me that over 99% are on salary. Medicine is largely a pay-for-procedure business. Most psychiatry work isn't dealing with people who think a witch is following them for the CIA, but pushing amphetamines to healthy, normal boys and antidepressants to healthy, normal women.

>high functioning individuals have no reason to seek you out or end up in your care.
Your industry literally runs ads on TV and encourages word of mouth campaigns to make people think whenever they're feeling some ordinary unhappiness or aren't successful enough or aren't getting enough sympathy or special treament, it might be a matter for the shrinks. And fuck-ups happen all the time in emergency, where people are sent unnecessarily to psych wards.

Then you vicious animals pose as assuming that if anyone is talking to you, that's proof that they are mentally ill, because otherwise, how would they end up in front of you? Either they're troubled enough to seek mental help (like they couldn't be confused or deceived), or someone saw such alarming signs of insanity that they felt it was necessary to take emergency measures (like nobody makes mistakes or uses psychiatric holds maliciously).

>phrenology is ok if we look at the inside of the head as opposed to the outside

It just works.

>mental illnesses

because they don't exist

>some things are fake - but schizophrenia isn't among them. There's specific chemical disorders and even brain activity that one can correlate among large samples
If you can only correlate them among large samples, then you're not looking at the pathophysiology, you're just looking at a correlation. Three big things: people with schizophrenia tend to be heavily medicated in patterns no other group is, they tend to abuse recreational drugs, and they tend to have poor self-care. Any one of those, let alone all three in combination, should produce a correlation of observable physical differences from the general population.

Schizophrenia correlations are "dead fish in an MRI scanner" garbage science.

There's no credible evidence that schizophrenia is one disease, rather than a broad catch-all term for general madness from many different causes, from voluntary behavior to unnoticed drug abuse.

It's defined solely through symptoms. Two patients can get the same diagnosis despite sharing no symptoms. That's a fake diagnostic category.

>Even if you're salaried, if there isn't enough business, you lose your job or take a pay cut. I've seen how it works. You make work for each other and reward each other for making work for each other.
Find me one psychiatric institution that isn't horribly understaffed. No, this field has the most solid job security around. I've never once heard of anyone losing their job due to a lack of patients - quite the opposite, most of the folks in this field who are independent have quit various institutions due to the workload. It's nightmarish, and often the stuff of nightmares to boot.

>Your industry literally runs ads on TV
Have you ever seen an ad for a shrink? Maybe for rehab clinics, but that's about it.

>Then you vicious animals pose as assuming that if anyone is talking to you, that's proof that they are mentally ill, [...] (like nobody makes mistakes or uses psychiatric holds maliciously).
Actually, our workload is usually so heavy that when we get a repeat visitor, who isn't having any life problems to speak of, we push them out or offload them as fast as we can (in our case, usually to Straighttalk or some other intern-based facility).

Using mental hospitalization for fraud, ie. falsely committing patients, in addition to being difficult, is about the least effective way to do it. We can't keep you for more than three weeks, by law, unless you have insane amounts of money or can get you declared incompetent, which requires a court process and an appointed guardian. If no family member is willing to dedicate their lives to that guardianship, the waiting list for court appointed guardians is literally years long, and if the target is under sixty-five, they have to renew that status each year. Unless it's declared in childhood, due to severe autism or what not, it's near impossible. It's easier for medical conditions (which I suppose includes brain injury), but being declared non-competent for mental issues alone is a pain in the ass.

>There's no credible evidence that schizophrenia is one disease
It isn't, and it isn't treated as one. It is, however, a series of repeatedly demonstrated behavioral conditions, that may be, and most often is, accompanied by others. These particular disorders respond in various ways to specific chemical input - both good and bad (mostly bad), and do so in a way that does not occur in the majority of the population, and similarly, those suffering from this series of disorders have brain scans that distinctly vary from the majority of the population. At the same time, you can induce the same condition through chemical inputs.

And a lot of schizophrenia is the result of drug abuse (indeed, I suspect probably most - though I'm a bit biased by my specialty). As stated above, you can alter your brain chemistry to the point where you exhibit schizoaffective disorders, and a lot of people do. Once drugs are removed from the equation you can recover, but it often takes decades before you're functional again.

>Find me one psychiatric institution that isn't horribly understaffed.
Most psychiatrists don't work in inpatient facilities, and the "horrible understaffing" is mostly nurses and orderlies, who (unlike the psychiatrists) are practically locked in with the lunatics, and have to live not only with that, but with the evidence constantly surrounding them that they're participating in quackery that does more harm than good.

Don't confuse the necessity of separating the dangerously mad from society, with a need to label them with some pseudomedical condition and attempt to treat it despite not understanding it. Madhouses would be far more humane without psychiatry.

Like I said, most psychiatrists are pill-pushers, who mostly make a living manipulating gullible women to harm themselves or their children, or selling certified disabilities to people who don't want to work or want special treatment.

>We can't keep you for more than three weeks, by law, unless you have insane amounts of money or can get you declared incompetent, which requires a court process and an appointed guardian.
Three weeks is plenty of time to hang life-ruining diagnoses on people, develop drug dependencies with withdrawal symptoms indistinguishable from the supposed condition being treated, and inflict new psychological problems through mistreatment.

Anyway, these rules vary from jurisdiction to jurisdiction, courts for involuntary commitment tend to be of the kangaroo variety (with the target often drugged beyond the capacity to organize an effective defense), and the people abusing the process are typically family members whose plan included volunteering for guardianship.

>being declared non-competent for mental issues alone is a pain in the ass.
I'm so sorry to hear that destroying people in a manner more horrifying than killing them inconveniences you.

>a lot of schizophrenia is the result of drug abuse
The medical definition of schizophrenia requires that it not have an identifiable physical cause.

If you're knowingly diagnosing dementia resulting from drug abuse as schizophrenia, you're committing fraud.

Just because psychiatry performs a net social good (which is debatable) doesn't negate anything he said, he's 100% correct that psychiatric disciplines are pseudo-sciences that exist for the purpose of trnasforming subjective and socially defined problems into medical ones. Pscyhiatry also has a long history of being used as a political weapon.

Don't forget lefthandedness

Dermatology probably helps more people than it hurts though, which is more than you can say for psychology

ITT: a practising psychiatrist with a pathetic need for validation/borderline narcissm mistakes personal anecdotes (see: need for validation & narcissm) with empirical evidence.

No, there's schizoaffective disorder, and genetic schizophrenia. Even genetic schizophrenia can have be aggravated by a physical cause. That being one of the debates that center around it with conflicting studies - how often that's the case, vs. how often a schizoaffective condition is established from scratch. (Or, in my branch, high functioning heavy drug users, vs. those that are a wreck for life after their first dose.)

The distinction between schizoaffective disorder and schizophrenia is not that one has an environmental cause and the other is genetic, but that schizoaffective disorder combines schizophrenia-like psychotic symptoms with symptoms of a mood disorder.

Both include among their diagnostic criteria that there is no identifiable physical cause.

DSM-5, page 105
>Schizoaffective Disorder
>D. The disturbance is not attributable to the effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.

They go out of their way to specify that if it's caused by drug abuse, it's not schizoaffective disorder.

So are you like a "pre-med" posing as what you imagine you'll eventually become, or are you a horrifying quack?

>Most psychiatrists don't work in inpatient facilities
Actually, inpatient facilities employ the majority of them, and nearly all of them work at an inpatient facility at some time - it's a requirement in most states.

But even outpatient facilities are extremely understaffed, especially those that are part of large HMOs, which would be the next largest employer. The third largest would be state-run facilities, and those are the most understaffed of all.

Again, aside from a handful of independents, who only take on as many patients as they need to (as we offload to them too), no psychologist nor psychiatrist makes money on a per patient basis. Everyone has more patients than they know what to do with... Aside from those few working way out in the ultra-rural sticks, but there's so few of them, they are sitting pretty.

And no psychiatrist makes cash on a per-pill basis either (indeed, in some institutions, that hurts the psychiatrist more than helps). There is, in my opinion, nonetheless, a whole lotta over prescribing going on, which particularly bothers me in pediatrics, but the psychiatrists are not the ones benefiting from it - even if they are sometimes unwittingly helping to enable it.

>courts for involuntary commitment tend to be of the kangaroo variety
I've only ever once seen someone under the age of 60 declared non-competent for mental issues alone, and that's in twelve years (sixteen, including internship). It's much easier, and much more effective, to simply get someone put in prison. No guardian required.

>I'm so sorry to hear that destroying people in a manner more horrifying than killing them inconveniences you.
I-I've never tried to get someone falsely declared non-competent. The only patients that I've known who were declared non-competent, actively sought that status themselves, and for good reason, and of those, I'm not aware of any that succeeded. The only non-competents I've dealt with, at all, were escaped geriatrics.

That, in practice, only means to indicate that it isn't a result of a substance they are currently under the influence of, which is why you don't make that sort of diagnosis (beyond noting the exhibited behavior), until at least three days after intake (and, indeed, is the minimum delay before any medication can begin, save for sedatives, if required). Brain damage resulting from drug use, or indeed, any other cause, is still a valid source of schizoaffective disorder.

>That, in practice, only means to indicate that it isn't a result of a substance they are currently under the influence of
You mean that unethical fraudulent diagnosis is so widespread as to be considered typical behavior among psychiatrists.

>>>D. The disturbance is not attributable to the effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
>>or another medical condition.
>Brain damage resulting from drug use, or indeed, any other cause, is still a valid source of schizoaffective disorder.
pic related

Well spotted.
I think we're just feeding the troll at this point. I'm sure this guy literally gets off knowing that people are reading about his personal anecdotes and stories of his gramps' theories on mental illness.
kek

>no psychologist nor psychiatrist makes money on a per patient basis.
Another obvious lie. Besides which, as I've already pointed out, if there weren't patients, there wouldn't be jobs, so you act collectively and collude locally to maximize consumption.

>no psychiatrist makes cash on a per-pill basis either
First of all, many psychiatrists directly or indirectly get a share of profits from psychiatric drug sales. They get paid to participate in research, they invest in what they understand and can influence, etc.

Secondly, anyone with a prescription is going to need periodic appointments, and the more drugs and stronger doses someone is on the more they're going to find side-effects intolerable and come back for adjustments, so while "per pill" would some narrow technical validity, it's misleading and dishonest. The more patients you medicate and the more heavily you medicate them, the more appointments you're going to have.

>Everyone has more patients than they know what to do with...
Induced consumption meets engineered undersupply. Yes, we know your profession as a whole cares far more about their incomes than about human life.

Patient is nonetheless considered to be exhibiting schizoaffective behavior, and, barring another treatable condition, those are the symptoms treatment will be attempted for.

One gramps was an admiral and the other worked for Boeing during the war, so... While I'd be curious as to what their theories of mental illness might have been, they are both long gone, and I don't recall asking.

>so you act collectively and collude locally to maximize consumption.
On what planet? Point to me a psychologist who is colluding to get more patients. That's the last thing most of them want.

>They get paid to participate in research, they invest in what they understand and can influence, etc.
Well, I'll give you that - although the second part is literally what they are getting paid for.

>anyone with a prescription is going to need periodic appointments, and the more drugs and stronger doses someone is on the more they're going to find side-effects intolerable and come back for adjustments
A psychiatrist's performance is basically determined by how quickly they can get patients stable, on a stable regime. Failure to achieve this regularly is a good way to get knocked out of your office, in addition to making their job all around harder, and having patients demand or seek other psychiatrists. Further, psychiatrists invariably seek to reduce dosages at every opportunity (sometimes overzealously).

On the other hand, the pharmaceutical industry does have this nasty habit of putting out drugs with so many side effects that you literally have to prescribe another pill to deal with the side effects.

...and yes, as I often complain of psychiatrists I work under, when the only tool you have is a hammer, every problem begins to look like a nail.

>Yes, we know your profession as a whole cares far more about their incomes than about human life.
You have no idea what most psychologists make, do you? I've yet to meet the psychologist who didn't get his or her degree specifically to help people.

Though I've met a few psychiatrists who have become so jaded that they've been reduced to pill dispensing robots, and plenty of psychologists who have been just plain broken by the experience. It's a rough job - which is yet another reason for the shortage - turnover is hella high.

>>anyone with a prescription is going to need periodic appointments, and the more drugs and stronger doses someone is on the more they're going to find side-effects intolerable and come back for adjustments
>A psychiatrist's performance is basically determined by how quickly they can get patients stable, on a stable regime. Failure to achieve this regularly is a good way to get knocked out of your office, in addition to making their job all around harder, and having patients demand or seek other psychiatrists. Further, psychiatrists invariably seek to reduce dosages at every opportunity (sometimes overzealously).
Again: most of the business of psychiatrists is not caring for the genuinely mad, but pushing pills to whatever normal people they can manipulate or selling false certifications of disability.

And your stuff about "invariably seeking to reduce dosages" is blatantly false, as is the idea that psychiatric treatments are of such reliable effectiveness that psychiatrists who fail to consistently produce rapid improvement lose their jobs. Qualified psychiatrists tend to stay employed as long as they don't get caught doing something equivalently serious to raping a patient, because it's not about results at all.

>>Yes, we know your profession as a whole cares far more about their incomes than about human life.
>You have no idea what most psychologists make, do you? I've yet to meet the psychologist who didn't get his or her degree specifically to help people.
"Psychiatrist" and "psychologist" aren't interchangeable terms, you ridiculous poser.

>Again: most of the business of psychiatrists is not caring for the genuinely mad, but pushing pills to whatever normal people they can manipulate
Again, where do you see psychiatrists going out and trying to recruit "normal people" into their offices?

>or selling false certifications of disability.
Given how easy they are to get for free, and that the only people who would want them are dirt poor, and that you could literally not only end your career but go to prison for it, I somehow doubt this.

>And your stuff about "invariably seeking to reduce dosages" is blatantly false, as is the idea that psychiatric treatments are of such reliable effectiveness that psychiatrists who fail to consistently produce rapid improvement lose their jobs. Qualified psychiatrists tend to stay employed as long as they don't get caught doing something equivalently serious to raping a patient, because it's not about results at all.
I've yet to see nor hear of an institution where this is not the case. Not achieving maximum stability for the least amount of medication would also go against everything I was ever taught on the subject. Results are extremely important for everyone outside of a state-run institution where the patients have no alternatives, and even there, chronically returning inpatients tend to get swapped to other institutions, which does rather kill that maximizing patient count conspiracy you're going for.

>"Psychiatrist" and "psychologist" aren't interchangeable terms, you ridiculous poser.
Only insomuch as "doctor" and "nurse" are.

>>>Yes, we know your profession as a whole cares far more about their incomes than about human life.
>>You have no idea what most psychologists make, do you? I've yet to meet the psychologist who didn't get his or her degree specifically to help people.
>"Psychiatrist" and "psychologist" aren't interchangeable terms, you ridiculous poser.
Wait, I misread that as "are interchangeable", so I suppose the proper response would be:
>t. Psychologist, MFTC spec in chemical dependency (dun know nuttin about no birth of no baby)

>where do you see psychiatrists going out and trying to recruit "normal people" into their offices?
1) Through drug companies that put ads on TV and elsewhere. Don't act like, "Oh, what they're doing is totally separate and beyond influence." Psychiatrists could get together and publicly denounce the ads, or boycott the companies, but they don't. It definitely couldn't proceed without their complicity.
2) Through word-of-mouth, by telling healthy normal people who come in that they need psychiatric treatment, and manipulating them to report that they have greatly benefitted from the treatment.

>>or selling false certifications of disability.
>Given how easy they are to get for free, and that the only people who would want them are dirt poor, and that you could literally not only end your career but go to prison for it, I somehow doubt this.
Not with a bribe, you moron, with business. It's an induced consumption scam. The patient gets disability benefits, the doctor gets to bill for having patients, or inflate his stats with a "successful treatment" when the patient continues "being disabled" but becomes compliant and manageable, capable of self-care but not employment.

>Not achieving maximum stability for the least amount of medication would also go against everything I was ever taught on the subject.
>everything I was ever taught on the subject.
Psych 101?

>1) Through drug companies that put ads on TV and elsewhere. Don't act like, "Oh, what they're doing is totally separate and beyond influence." Psychiatrists could get together and publicly denounce the ads, or boycott the companies, but they don't. It definitely couldn't proceed without their complicity.
Psychiatrists denounce big pharma all the fucking time, and indeed, the largest anti big pharma political organizations are headed by psychiatrist. They have nothing to do with those ads. They can't even legally appear in them.

>Through word-of-mouth, by telling healthy normal people who come in that they need psychiatric treatment, and manipulating them to report that they have greatly benefitted from the treatment.
I've never heard of any psychiatrist telling any patient "tell all your friends about me". The only patients that are going to recommend psychiatrist are those that are *really* happy with their doctor, and recommending a psychiatrist to a "normal person" is pretty damned insulting. (I mean, unless you're after recreational drugs, but psychiatrists are the wrong kind of doctor for that.)

>Not with a bribe, you moron, with business. It's an induced consumption scam. The patient gets disability benefits, the doctor gets to bill for having patients, or inflate his stats with a "successful treatment" when the patient continues "being disabled" but becomes compliant and manageable, capable of self-care but not employment.
1.) Being incapable of employment is being incapable of being capable of self-care. It's literally a prime measurement of success.

2.) Patients on disability benefits go to state-run institutions (or, in some states, state-sponsored HMOs). Those doctors all get paid salary, and all have far more patients than they can handle.

>2.) Patients on disability benefits go to state-run institutions (or, in some states, state-sponsored HMOs). Those doctors all get paid salary, and all have far more patients than they can handle.
Well, that, and doctors who can give disability certificates work for social security agencies. They aren't the doctors who get the patients, nor do they work for the institution that does. They work for the state, and the state actually loses money, on more than one front, each time they give out such a disability certificate.

>I've never heard of any psychiatrist telling any patient "tell all your friends about me".
Don't pose like you don't understand what I'm saying. All the time in everyday life I hear women telling each other about how they got help from psychiatrists and their life is much better now. The numbers being treated are fucking ridiculous. There are obviously not that many people who are so severely mentally abnormal that they need drugs to get through life.

It's the same thing as you see in alternative medicine: someone has some kind of discomfort that gets better and worse, they seek help when it's particularly bad, the quack has them try different placebos until the discomfort happens to get better, then they say, "Yay! We found the right treatment!" and the sucker is taken in.

Psychiatric research is garbage tier. They find strong placebo effects, comparable to the strength of the real treatment effect, even when the placebo is a sugar pill, and the drug is something with perceptible effects in healthy people, so the patients can make reasonably good guesses of whether they got a placebo effect, and as long as the effect is modestly stronger with the pill with perceptible effects than with the sugar pill, they conclude that the treatment works. These aren't real placebo-controlled trials, or blind trials. They don't even take obvious steps like asking the patients to guess whether they got the placebo, so they can make apple-to-apple comparisons of effectiveness based on patient perception. They don't want the truth about whether their drugs work.

And then working psychiatrists use the drugs in ways, doses, and combinations that have never been tested in organized studies.

And we see a more vicious version of the alt. medicine scam in inpatient treatment, where they use powerful drugs that hurt the patients. They hurt them, more and in different ways, until their behavior conforms to what the psychiatrist demands. Thumbscrew in a pill.

>real medicine
Like developing new strains of pot for you to smoke?
>conducting real research
They are overqualified.

>They work for the state, and the state actually loses money, on more than one front, each time they give out such a disability certificate.
Iron Law of Bureaucracy: they're hired by, and their programs are managed by bureaucrats who enjoy importance, advancement prospects, and salary based on the cost of their program and the number of their subordinates.

Actually agree with a lot of this, though you can't land most of it at the door of psychiatrists, and what little you can, only to a handful of them. It also, sadly, all applies to medicine in general. Similarly, doctors, both medical and psychiatric, rail against these trends more than anyone.

Part of that, in both cases, is people shifting what was once the responsibility of priests to the medical professions. And while you might describe it as "hurting them until their behavior conforms", in both cases, sans the hurting, that's the end goal. Most patients are voluntary, and want to work better within society. In the case of the doctor, psychiatrist, psychologist, and the priest, people just tend to have too much confidence in what they can do for them.

Though, personally, if the patient is religious, in a functional way, I actually know Baptist, Catholic, and Unitarian ministers I will refer them to (kinda wish I knew more, and of more religions, but alas). I also refer to religious 12-step programs. I'd kinda prefer they take that route, if they can, or at least augment whatever we're doing with said. I know I'm not the only psychologist that does this, but I couldn't speak to how common it is. The intake I used to work for did have a Presbyterian minister on call though, and he'd visit, from time to time.

Also, in regards to alt-medicine, the psychiatrist I currently work under sets people up in meditation groups, and has been known to recommend various alt-medicines to the few patients she has who probably shouldn't be medicated. My own GP also hosts a meditation group himself - though I've never gone, as it seems everyone in it is over 80, and that'd be, awkward.

Psychiatrists are M.D.s you retard

>you can't land most of it at the door of psychiatrists, and what little you can, only to a handful of them
Absolute nonsense. They're the ones doing these things to people.

>people shifting what was once the responsibility of priests to the medical professions
The people in question are members of the medical professions. If they didn't want it, all they'd have to do is refuse to take on that responsibility, which would be the only ethical thing to do.

>Most patients are voluntary
I've experience this "voluntary admission". When I sought emergency treatment for physical complaints, after confusion with a foreign trainee triage nurse who had very limited facility with the English language, I was taken by force to a psychiatric facility on a diagnosis of "manic episode", held for a week despite the attending psychiatrist immediately recognizing that I wasn't manic, denied all access to physical diagnostic attention for the entire duration, was diagnosed with "somatoform disorder" because I kept complaining of severe pain and begging to be allowed to see a real doctor, and not let out until I signed up for a community mental health program and disability benefits.

Later when I complained, I was told that it was a voluntary admission, though I had never been asked for consent, and they had no record of this claimed consent. When I raised the matter with police, they just got uncomfortable and refused to take a report or look at any of the evidence. Lawyers flatly told me it would go nowhere in court.

Consent for inpatient psychiatry is typically fabricated or coerced. It makes everyone feel better, and avoids paperwork, to pretend it's voluntary. They only go through the involuntary processes when it seems the patient will put up an effective legal resistance while being held, or what's being written in the record is inconsistent with the patient being capable of consent.

>Psychiatrists are M.D.s
That doesn't make what they do "real medicine".

Even psychiatrists call problems "medical" to distinguish them from psychological/psychiatric disorders.