Daniel Tammet has memorized Pi to the 22,514th digit. He speaks ten different languages, including one of his own invention, and he can multiply enormous sums in his head within a matter of seconds. However, he is unable to hold down a standard 9-to-5 job, in part due to his obsessive adherence to ritual, down to the precise times he has his tea every day.
Toronto mayor Rob Ford has had a rough couple of months. He has recently confessed to using crack cocaine "in a drunken stupor", been caught on video making drunken death threats, and commented to reporters about his cunnilingus skills. He has also previously beencharged with drink-driving, and admitted on separate occasions tobuying illegal drugs and "smoking a lot of marijuana". Other allegationsfrom former staff members include physical assault, making racist and sexist remarks, and sexual harassment.
Needless to say, the man has made some questionable choices recently. While Mayor Ford has vehemently denied all accusations of drug or alcohol dependence, this pattern of poor decision-making is reflective of impairments in self-control and impulsivity that are often seen in problem drug and alcohol users.
When I was in elementary school, there were two kids in my class who always got “special medicine” at lunchtime. I didn’t understand this at the time, as they never looked sick to me, so I couldn’t comprehend why they would need to take a pill. One day I got up the courage (as only an impertinent seven year-old can) to ask my friend why she needed to take medicine every day, but her answer just confused me even more. She said that without the pill she would get too energetic and be unable to concentrate in class. But this didn’t make sense, as I knew that I often got quite excited and would sometimes talk out of turn, but I certainly didn’t need to take any medicine for this!
Flash forward twelve years, and in college nearly all of my friends were regularly taking Adderall to help them study for exams, whether they were prescribed it or not.
I watched a good ‘psychological thriller’ the other night - Side Effects by Steven Soderbergh – that centers on a woman’s debilitating depression and critiques the pharmaceutical industry’s untoward influence over clinicians (it turns into a plot-twisty crime thriller, but that’s beside the point). The film got me thinking about our reliance on psychotropic medications to treat psychological distress, and how helpless we are when these pills don’t work.
I’ve written before on the over-medicalization of psychiatric disorders and the pharmaceutical industry’s role in this controversy, but this time the topic got me thinking about possible alternative treatments for depression, other than cognitive-behavioral therapy or mood-altering medications.
Can we please not blame mass killings on people’s brains? Can we not say that Adam Lanza committed the Newton, Connecticut massacre because he might have beenautistic? Can we not say that Tamerlan Tsarnaev, the deceased Boston Marathon bombing suspect, might have committed the crime because he had boxing-related traumatic brain damage? Can we not say that his younger brother, Dzhokhar Tsarnaev, aided in the bombings because he was a teenager and his brain hadn’t fully developed yet, and thus he was easily influenced by his radical older brother?
ONE IN FOUR of us will struggle with a mental illness this year, the most common being depression and anxiety. The upcoming publication of the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM) will expand the list of psychiatric classifications, further increasing the number of people who meet criteria for disorder. But will this increase in diagnoses really mean more people are getting the help they need? And to what extent are we pathologising normal human behaviours, reactions and mood swings?
The revamping of the DSM – an essential tool for mental health practitioners and researchers alike, often referred to as the ‘psychiatry bible’ – is long overdue; the previous version was published in 1994. This revision provides an excellent opportunity to scrutinise what qualifies as psychiatric illness and the criteria used to make these diagnoses. But will the experts make the right calls?