Recall Polonius’ diagnosis of Hamlet’s madness in Bill Shakespeare’s famous tragedy.
“Your noble son is mad,” said Claudius’s counselor, “for to define true madness, / What is’t but to be nothing else but mad?”
You don’t need “No Fear Shakespeare” to make sense of Polonius’ conclusion, because it doesn’t make sense. It’s unnecessary.
Currently, most American psychiatrists determine mental illness using the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association (APA), which provides standardized language and criteria for the classification of mental disorders.
Be that as it may, something is rotten in America, methinks.
It often seems that diagnoses of mental illness are made in the same manner as Polonius’ — there’s no method in the determination of madness, so to speak.
And while it would be absurd to reduce modern psychiatry to something akin to Polonius’ drivel, there are comparisons to be made.
For instance, the DSM — the American psychiatrist’s bible — is often criticized for its expansive classification system, allowing for such “disorders” as selective mutism, or not speaking in certain situations, and hypoactive sexual desire disorder, or sexual dysfunction.
I’m a candidate for both, I suppose. On the first count, when I’m in the library, and on the second, when I drink whiskey.
The DSM’s inclusion of such disorders contributes to the “medicalization” of human nature, the process by which human conditions and problems become defined and treated as medical conditions and problems, authoritatively empowering clinical professionals to diagnose and treat them as such.
Additionally, the DSM is superficially concerned with the signs and symptoms of mental disorder, not its underlying causes. Accordingly, psychiatrist Paul R. McHugh, likened it to a naturalist’s field guide to birds. In turn, psychiatrist William Glasser, has “never, never identified anyone as having a DSM disorder.”
Psychiatrists and pharmaceutical companies are often accused of “disease mongering” to increase the marketability and profitability of treatments. Along these lines, Glasser further asserted the “DSM was not written to help people; it was developed to help psychiatrists — to help them make money.”
As playwright Jerome Lawrence once quipped, “A neurotic is the man who builds a castle in the air. A psychotic is the man who lives in it. A psychiatrist is the man who collects the rent.”
And a pharmacist, then, is the mustachioed, plumber’s butted maintenance guy, who temporarily “fixes” the mind’s leaky pipes, as it were.
Either way, the landlord and superintendent of this castle in the sky are paid a king’s ransom.
Antidepressant use in the United States increased nearly 400 percent during the last 25 years, according to a recent report issued by the Centers for Disease Control and Prevention (CDC).
Depressingly, the CDC estimates that 1 in 10 Americans aged 12 and older takes antidepressant medication.
The prevalence of antidepressants isn’t just an American phenomenon, though. In the United Kingdom, a 2004 study by the British government’s Environment Agency reported that trace amounts of Prozac could be found in the nation’s drinking water.
Cheerio!
I propose a new DSM classification — the Polonius disorder. The sole criterion for its diagnosis is that the patient must be a mental health professional.
Don’t get me wrong, Hamlet did murder Polonius. But I’m not calling for psychiatry’s demise.
Rather, what is needed is caution in the diagnosis of mental illness — the sort that isn’t exhibited, for instance, in the prescribing of antidepressants to patients as a first-line treatment.
Now, Hamlet could have benefited from a moderate dosage of an antidepressant, to be sure — or not to be, as it were. But which one, though? Wellbutrin? Zoloft? Effexor?
That’s the question.
And that’s the problem.
Phil Sweeney is a 25-year-old English senior from New Orleans. Follow him on Twitter @TDR_PhilSweeney.
 
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Contact Phil Sweeney at [email protected].