A very interesting Newsweek article this week on how American children are being misdiagnosed as suffering from bi-polar disorder and the dire consequences highlights the relationship between language and our health.
In his article, Stuart Kaplan, a child psychiatrist with nearly 50 years experience, talks about the fad diagnosis that launched bi-polar disorder as a juvenile disease and the subsequent 40-fold increase of outpatient office visits for children and adolescents with bipolar disorder from 20,000 in 1994–95 to 800,000 in 2002–03. “Before 1995, bipolar disorder, once known as manic-depressive illness, was rarely diagnosed in children; today nearly one third of all children and adolescents discharged from child psychiatric hospitals are diagnosed with the disorder and medicated accordingly“.
What he tags as ‘trendy thinking’ started in the 1990s, is founded on shaky scientific grounds he says (notably that the symptoms for children bi-polar disorder include behaviours that are natural in children, and that several of the studies done by some leading scholars on the disease are based entirely on reports by parents).
Children (mis)diagnosed with bi-polar disorder “will likely be given dangerous adult medications with no known effectiveness for children and plenty of known dangers. One of these is the powerful drug valproate, a medication for seizure disorders, which has proved useful as a “mood stabilizer” in the treatment of bipolar adults but has yielded anything but clear results in children. The side effects can include fatal damage to the liver, pancreas, and brain, as well as the masculinization of female patients“. The issue is serious.
It is well worth reading the whole article which is an eye-opener on how a certain type of medicine is practiced and the consequences on our health.
NLP is a study of how language not only describes but literally determines the world we live in. And this article is a good illustration of this.
Take ‘nominalisation‘ for example. A nominalisation is the process of turning a verb (i.e. a process which has movement) into a noun (thereby freezing it in time). For example: blood pressure is a noun that refers to the how the blood flows (a process) in our body. Virtually all diseases are nominalisations (i.e. a name that describes a process that is happening inside the body).
A process has movement, and can therefore easily be changed, but nouns refer to something that IS. The issue with nominalisations is that it becomes very difficult to see a way out of it.
Then, there is the issue of the psychology behind influence. When someone in a position of authority/celebrity (a fortune teller, a doctor, your parents, a friend, a celebrity etc…) tells us something, we tend to believe it (read “Influence, the Psychology of Persuasion“, by Robert Cialdini for a very good study of those mechanisms at work). So when ‘a Harvard child-psychiatry group led by Dr. Joseph Biederman, a prominent supporter of the diagnosis, recently insisted, “Juvenile bipolar disorder is a serious illness that is estimated to affect approximately 1 percent to 4 percent of children‘ most people, even psychiatrists, will deem it to be true.
Another dimension of influence is that, as propagandist and advertisers know, the more we see and hear a message, the more familiar it becomes and the more we tend to believe it is true.
Finally, the more we invest (time, money, efforts) in something, the more attached we become to it because our focus becomes solely concentrated on the subject we study. Someone who specialises in studying bi-polar disorder in small children will more likely indeed find that the disease exists because the mind is programmed this way.
Have you ever wondered how psychiatrists know that someone suffers from a mental disorder? All mental disorders are compiled in a ‘bible’, a book called the DSM (Diagnostic & Statistical Manual of Mental Disorders). The book is published by the American Psychiatric Association, but is used outside the US as well. There have been several editions of the DSM since its first edition in 1952, the DSM in use nowadays is the DSM 4 published in 1994, and a major review is to be published in 2013 (DSM 5).
Of course, we need objective references and scientific criteria in medicine, hence the necessity for a reference book such as the DSM. And it is also true that putting a noun in print and making it a ‘condition’ has a huge influence on how we see the condition, which is why the revision of the DSM attracts so much criticism. In the first edition of the DSM published in 1952, homosexuality was listed as a mental disorder. What would we do with this nowadays? Societies evolve with time and societal beliefs change.
Kaplan laments that ‘in the U.S., popular culture has had an outsize influence on psychiatry, […] the popular debut of a medical disorder began with the publication of a book, The Bipolar Child, by Dr. Demitri Papolos and Janice Papolos, a husband-and-wife team. As part of the book’s promotion, the authors were featured on the show 20/20. Within 30 minutes of the segment’s airing, 20/20 received more than 6,000 emails. Shortly thereafter, the authors appeared on Oprah and eventually sold more than 200,000 copies of their book‘.
It is not possible for the human mind to be completely objective (see the post ‘the limits of reason‘ in The MasterMinds Blog), but it is worth keeping an open mind and getting a wide range of information on subjects that affect us as deeply as out health.
NB1: Kaplan is a child psychiatrist and a clinical professor of psychiatry at Penn State College of Medicine. This article is an adaptation from his book, Your Child Does Not Have Bipolar Disorder: How Bad Science and Good Public Relations Created the Diagnosis.
NB2: For more on the business model of the pharmaceutical industry and the business of defining mental illness, read this post on The MasterMinds blog.