Posted by JohnL on April 13, 2000, at 4:30:01
In reply to DSM diagnosis...., posted by Isa on April 11, 2000, at 19:17:54
> I am a student trying to find an expert, all axis diagnosis for the actor/ Robert Downey Jr. Anyone have any ideas? Thank You.
Regardless of who the patient is, I find DSM diagnosis to be a very futile strategy. That's because regardless of the diagnosis, the underlying causes vary dramatically and are treated by at least ten different general approaches for the exact same diagnosis. And there is a lot of overlap as well. An anxiety medication may be the magic ingredient to cure someone's diagnosis of depression, where antidepressants didn't work. And vica versa. Just one of dozens of examples. Could go on and on with endless examples.
Let's assume for example we believe we have a concrete iron-clad diagnosis of bipolar depression. OK. But how useful is that? The cause could be low serotonin; low norepinephrine; low dopamine; elevated dopamine; elevated norepinephrine; GABA deficient; chemical instability; electrical instability; norepinephrine/dopamine failure; thyroid; hormones; blend of more than one. Which is it? Only through the trial and error process of different drugs can we gather clues as to what is going on. Knowing that a person has bipolar depression (just one example) is nearly useless, because it doesn't provide any clue as to the cause of the problem. I believe putting a label on the condition is rather futile. I mean sure, a diagnosis of bipolar depression would have a higher probability of responding to a serotonin medication and/or a mood stabilizing medication than other choices, but really not much more than a 50/50 chance. Flip a coin. Only trial and error will tell.
I believe the same reasoning applies to every other possible DSM diagnosis. What the person suffers from is almost irrelevent. All that matters is what treatment will get them well. DSM diagnosis provides little scientific guidance in that respect. We can put a label on the person's symptoms if we want to, but we are no closer to treating the person than we were without a label. It may be a medication outside of that DSM diagnosis that cures the person, not one we would normally expect. And ones we normally expect to work fail time and again. It all depends on the cause of the problem, not the name of the problem.
poster:JohnL
thread:29662
URL: http://www.dr-bob.org/babble/20000411/msgs/29812.html