Psychiatric Labels Plague Women’s Mental Health
May is mental-health awareness month, but sadly, much of the publicityand public “education” connected with it consists of trying to persuadepeople they are mentally ill and need medication and psychotherapy.
What is little known but frightening is the damage often done tomany women simply by giving them psychiatric diagnoses.Because theyreceived psychiatric diagnoses, women have lost health insurance or hadskyrocketing premiums, lost jobs, lost the right to make decisionsabout their medical and legal affairs and lost, or nearly lost, theirlives. Last month, a woman on the West Coast went to court after losingchild custody on the basis of having been psychiatrically labeled.Anenormous amount of research — including in the 2004 book I edited,”Bias in Psychiatric Diagnosis” — has shown that women are at evengreater risk than men of attracting many serious psychiatric labels.Even women who never enter a therapist’s office run the risk of beingbranded by family or friends with one type of demeaning non-psychiatriclabel or another, such as “cold, bitchy and rejecting” or”overemotional, overly sensitive and needy,” so that even an averagewoman’s emotions and behavior look pretty terrible compared to those ofan average man. It should not be surprising, then, that the psychiatricfield is riddled with diagnoses that are used to demean and pathologizewomen.
Like every therapist I know, I’ve had women come to see me, afterhaving seen another mental health professional, and introducethemselves by saying, “My name is Maude. I’m bipolar,” or “I’m Lula,and I’m a borderline personality.” They do not regard themselves aswomen who have some problems. Instead, their whole identity has come tobe connected with a mental illness. Then, having been told they aresick, many women–like second-class citizens everywhere–think in termsof how they can change themselves rather than thinking that anotherperson or, in many cases, a system (such as public assistance) or asetting (such as the workplace or the family) is the source of thetrouble.
Often feeling powerless to change the major systems that oppressthem or to escape from harassment or violence, they try to maintaincontrol over their lives. Masochist, Depressive, Inadequate Forinstance, women whose partners batter them often think–indeed,therapists or well-meaning but misguided loved ones may tell them–thatthey must be masochists and bring the violence on themselves. Women whoare harassed at work but cannot afford to lose their jobs–oftenbecause they are financially supporting others, as recently dramatizedin the movie “North Country”–may become seriously depressed orfrightened because there is no satisfactory way to escape theharassment. Mothers who go on welfare immediately learn that ourfederal government does not give them enough money to providesufficient healthful food and a halfway decent place to live. Manyinternalize the message that it is they who are inadequate, not thesystem. It may be natural but it is counterproductive and often harmfulfor people who feel unable to change external realities to seek somesense of control by aiming to alter themselves. The social andpolitical sources of much of women’s emotional pain are obscured by theapplication of psychiatric diagnoses, which locate the problem withinthe woman herself. Thus, diagnosis deflects energies that could be usedfor social and political change.
On our PsychDiagnosis Web site you can read, among many otherthings, more than 50 stories about the vast array of damage that haveresulted from receiving a psychiatric diagnosis. These include a womanwho nearly died and accrued a quarter-million dollar hospital billbecause doctors had labeled her mentally ill and thus failed torecognize that she had the serious physical condition called Wilson’sdisease, which causes copper to accumulate in body tissue and can causepsychosis as a side effect.
Harm Hidden from View
This harm is largely hidden from public view. The continuing lowstatus of women overall obscures much of their suffering. Manypsychiatrically labeled women become seriously isolated because theyhave been branded as pathological.
Especially in our highly psychiatrized society, lay people oftenthink that those who are “mentally ill” should confine talk about theirproblems to therapists’ offices or residential institutions.The mentalhealth establishment has been wildly successful in leading the publicto believe mistakenly that psychiatric diagnosis is a science, and thedrug companies have happily promoted that view because it helps themwith their multi-billion-dollar business of marketing drugs forspecific diagnoses. A bible of the psychiatric trade is a compendium of374 categories of alleged mental illnesses. Titled the “Diagnostic andStatistical Manual of Mental Disorders,” or the DSM, it was publishedin three new editions in one 14-year period, and the next one is now inpreparation. With each new edition, therapists, libraries, insurancecompanies and government employees have to buy the new one, whichbrings millions of dollars in profits to the publisher, theWashington-based American Psychiatric Association. Many therapists donot know how unscientific and highly political the DSM actually is.Shoddy research has been used to support the addition of increasingnumbers of diagnoses that expand the territory and increase the incomeof psychiatrists and other therapists.
Premenstrual ‘Mental Disorder’
A particularly dangerous label for women was theinvention–reportedly by two men on a fishing trip–of the notion of apremenstrual “mental disorder,” which entered the manual in 1985. Weare not talking about bloating and breast tenderness and someirritability, like what used to be meant by “premenstrual syndrome,”but rather a psychological disorder.Even though vast amounts ofresearch have failed to prove that there is such a mental illness, oreven that women are more likely to experience cyclical moods,Premenstrual Dysphoric Disorder is in the DSM anyway. As soon as PMDDappeared in the DSM, pharmaceutical company Eli Lilly worked with theDSM committee to make the case that the Food and Drug Administrationshould approve Prozac to treat this non-existent condition, and thusthey got an extension on the Prozac patent. Lilly rushed apink-and-purple Prozac renamed “Sarafem” to market and in the firstseven months, more than 200,000 prescriptions for it were written.Hordes of women who watched Lilly’s commercials that showed angry womenwho “had PMDD” and “needed” Sarafem rushed to their doctors, hopingthat this pill would help them get rid of their “unfeminine” anger. TheEuropean Union’s drug regulator–the Committee for ProprietaryMedicinal Products–found that PMDD was not a well-established entityand forced Lilly to tell health professionals to stop prescribingProzac for that “condition.” However, Lilly took no such steps in theUnited States.
Meanwhile, other companies have geared up to promote genericversions, and companies that market similar drugs–such as Zoloft andCelexa–have for some years been pushing those drugs to treat thisnonexistent entity of PMDD.Since the whole enterprise of psychiatricdiagnosis is entirely unregulated, in March 2005, I issued a pressrelease–supported by more than 40 organizations and 175individuals–calling for congressional hearings about this subject.Such hearings will only happen if a member of an appropriatecongressional committee makes them happen, but in the meantime, thevery act of calling for the hearings has given rise to a good deal ofpublic education.
Paula J. Caplan, Ph.D., is a clinical and research psychologist,author of 11 books–including “They Say You’re Crazy: How the World’sMost Powerful Psychiatrists Decide Who’s Normal,” her expose of theDSM. She is a former full professor of applied psychology at theUniversity of Toronto. At Harvard University, she recently finishedteaching a course she designed, called “Psychology of Sex and Gender.
with author’s permission, source: Women’s eNews