Saving Normal: An Insider's Revolt against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

research. But they have also had the very harmful unintended consequence of triggering and helping to maintain a runaway diagnostic inflation that threatens normal and results in massive overtreatment with psychiatric medication.

Disease mongering cannot occur in a vacuum—it requires that the drug companies engage the active collaboration of the doctors who write the prescriptions, the patients who ask for them, the researchers who invent the new mental disorders, the consumer groups that advocate for more treatment, and the media and Internet that spread the word.

For a significant percentage of people with mild or transient symptoms, SSRIs are nothing more than very expensive, potentially harmful placebos.

Evidence of diagnostic inflation is everywhere. There have been four explosive epidemics of mental disorder in the past fifteen years. Childhood bipolar disorder increased by a miraculous fortyfold50; autism by a whopping twentyfold51;

Millions of people take medicine they don’t need for a diagnosis of MDD that they don’t really have, on the false assumption of chemical imbalance.30,31,32

In the early 1980s, about a third of Americans qualified for a lifetime diagnosis of mental disorder.45 Now about half do.46 And Europe is catching up fast at well over 40 percent.47 Some people think these are underestimates—more carefully done prospective studies actually double the lifetime prevalence. If you believe the results, our population

Seven percent of Americans are now addicted to a legal psychotropic drug.23 Prescription drug abuse has become a bigger problem than illicit drug abuse. If there is a conceivable way to sell a new diagnosis so that people will incorrectly believe they have it, drug companies will have figured it out and will do it successfully—if sometimes illegall

But there is a catch. The boundaries demarcating the different disorders are ever so much fuzzier in real life than they appear to be on paper. There is really nothing magical or preordained about any of the DSM thresholds—shades of gray exist between their seemingly black and white cutoff points. Requiring five symptoms and two weeks for major dep

Mental disorders should be diagnosed only when the presentation is clear-cut, severe, and clearly not going away on its own. The best way to deal with the everyday problems of living is to solve them directly or to wait them out, not to medicalize them with a psychiatric diagnosis or treat them with a pill.