Latest news with #SuzanneO'Sullivan
Irish Independent
29-05-2025
- Health
- Irish Independent
Real Health: Are we too quick to diagnose? With neurologist Dr Suzanne O'Sullivan
Dr Suzanne O'Sullivan, consultant neurologist, neurophysiologist, and author of the Age of Diagnosis, joins me on this week's episode of the Real Health podcast. I was interested in finding out what led the neurologist to write a book on overdiagnosis. She told me: 'I've been a doctor for nearly 35 years, and in that time, I have just seen a growth in the number of young people coming to me with like 10, 15 diagnoses. "In my traditional view of medicine diagnosis is supposed to lead to treatment, improvement and recovery and very often these young people who are gathering these long lists of diagnoses don't seem to be leading anywhere.' The rate of diagnosis in the past decade has gone up, not just for mental health conditions but also physical ones. The neurophysiologist said: 'I think the things that are growing at the fastest rate are things like ADHD and autism, mental health labels tend to be the most common, but there's also kind of a growth in diagnosis of physical conditions. So, we're constantly changing criteria for things like blood pressure and diabetes. In lots of areas of medicine, we are finding people at earlier stages of diseases with milder symptoms, through technology or changes in attitudes." You can listen to the full episode here or wherever you get your podcasts.
New Statesman
22-05-2025
- Health
- New Statesman
Symposium: Are we over-diagnosing mental health conditions?
Clockwise from top left: Lade Smith, Suzanne O'Sullivan, Minesh Patel, Joanna Moncrieff, Brian Dow Britain is in the grip of a mental health reckoning. Once taboo, the language of anxiety, depression, trauma and neurodivergence is now part of everyday conversation. Public campaigns have encouraged us to speak openly about mental well-being. But as awareness has surged, so too has a thornier question: are we diagnosing too much, too readily? In March, Health Secretary Wes Streeting argued that we are. 'Not every feeling of sadness is depression, not every feeling of worry is anxiety,' he said, warning that Britain is at risk of 'over-diagnosing' mental health conditions, especially in young people. His comments sparked fierce debate. Is the surge in diagnoses a long-overdue recognition of hidden suffering? Or are we at risk of medicalising life's ordinary struggles? The numbers are striking. Demand for NHS mental health services has more than doubled since 2017. Yet questions are growing over whether those services – already overwhelmed – are being diverted from those in greatest need. Are we mistaking everyday emotions for clinical disorders? Or does broader diagnosis simply reflect how far we've come in confronting mental illness? This is not just a clinical debate – it is a political one. The way we define and diagnose mental illness shapes the policies and resources that follow: whether that's school counselling budgets, workplace well-being schemes, GP referral pathways, or access to talking therapies. Over-diagnosis risks diluting resources and excessive medicalisation; under-diagnosing leaves silent suffering unaddressed. While one finds a range of views, even among our experts, there is one clear consensus: the system itself is in dire need of support. Dr Lade Smith CBE, President, Royal College of Psychiatrists It is no surprise that there has been an increase in mental illness diagnoses. Risk factors associated with mental ill-health – financial, housing and food insecurity, loneliness and isolation – have increased over the past decade. We have seen a 20 per cent increase in the number of people classified as disabled because of anxiety and depression – both eminently treatable conditions, both driven by social determinants. Subscribe to The New Statesman today from only £8.99 per month Subscribe With earlier intervention and assertive treatment, anxiety and depression can get better within months – long before a person's condition deteriorates into disability. However, the number of people waiting for mental healthcare has grown by 29 per cent in the last two years and now stands at 1.6 million. Moreover, severe mental illnesses, such as bipolar disorder and schizophrenia, are under-diagnosed or diagnosed far too late. This is particularly important for younger people, because 75 per cent of all mental health conditions arise before the age of 24. With illnesses like bipolar disorder or schizophrenia, it can take up to ten years before people receive a diagnosis and treatment, significantly impacting them achieving their potential. During this time of no diagnosis, their illness is likely to curtail their ability to complete education, function at work and form healthy relationships. They may even become homeless or come into contact with the criminal justice system. It is essential that people with mental illness have access to an evidence-based comprehensive assessment from a trained psychiatrist or qualified mental health professional, which formulates their problem, clarifies their diagnosis and provides a package of care and treatment to enable that person to recover and have the best quality of life they can. When misdiagnosis does occur, it is largely driven by people being left to diagnose themselves or being assessed by those with no or inadequate specialist skills and training. We must be careful not to encourage stigma and discrimination. People with mental illness are not 'fake sick'; the UK's productivity has not been undermined by over-diagnosis, but by poor access to timely and effective care. The Darzi investigation noted that mental illness is 20 per cent of the disease burden in the UK but receives 10 per cent of health funding. The treatment gap created by chronic under-resourcing results in a failure to quickly ascertain who is ill and who is not, and to assertively treat those who actually need it. Over-diagnosis is far less of an issue than lack of access to good-quality timely assessment and treatment by well-qualified mental health staff. Dr Suzanne O'Sullivan, Consultant neurologist, University College London Any discussion about over-diagnosis needs to start with a clarification of the meaning of the term. Over-diagnosis should never be read to imply a person is not struggling or in need of support. It simply asks if medicalising that suffering is the best way forward for them. Mental health conditions don't come with biological markers, so nobody can truly identify the point at which psychological distress moves from being part of the normal human experience into being a medical concern. Therefore, over-diagnosis can only be recognised by looking at how the growing number of people with a mental health diagnosis are benefitting in the long term. If the diagnoses are appropriate, they should lead somewhere positive and allow an easier progression through life. With that definition in mind, it feels impossible to say that mental health conditions are not over-diagnosed. Consider how the prevalence of autism has grown from affecting one in 2,500 children decades ago to more than one in 100 children today. More inclusive diagnosis promised to improve long-term mental health and well-being for young people. And yet, mental health diagnoses in adults, particularly young adults, are also steadily growing. This is the very definition of over-diagnosis — more early diagnosis, but no downstream improvement in well-being. Worse, these statistics suggest that the growing population of young people diagnosed as neurodivergent may actually be faring worse in adulthood than any population that has gone before. A medical label is not inert. It has a power all of its own to make people sick. When you tell a child that they have a neurodevelopmental condition, you risk encouraging that child to focus on what they cannot do. It could create the impression that the difficulties that child is experiencing cannot be overcome. You lower others' expectations for that child. The diagnosis can impact identity formation and become a self-fulfilling prophecy. Diagnostic labels make social and psychological struggles seem set in stone, which gets in the way of an examination of life that might have a more lasting positive impact on well-being. A thirst for finding mental health diagnoses in milder forms and the growing number of mental health awareness campaigns risk pathologising ordinary differences and encouraging people to worry unduly about the natural highs and lows of mood. We need to learn how to recognise and support struggling people, and children in particular, without medical labels because the current system is not working. Better lives for children, social change, is how you create healthier, happier adults. Suzanne O'Sullivan is the author of 'The Age of Diagnosis: Sickness, Health and Why Medicine Has Gone Too Far' Minesh Patel, Associate director, Mind It's hard to imagine that if the rates of cancer screening and diagnosis went up through public campaigns encouraging people to be aware of symptoms, to not suffer in silence and to seek support, it would not be a cause for celebration. But when it comes to mental health, that's where we are. And for many, it's treated as evidence that 'mental health culture has gone too far'. This is despite the fact that the threshold for a diagnosis hasn't changed. Several senior politicians from across the spectrum have made the argument about over-diagnosis or self-diagnosis, or a variation of it, in the last year. But I think, especially when it comes to the interventions of politicians, it's important to consider the context in which the debate is taking place. We are talking about a time of tight public finances, a rising welfare bill, and increasing numbers of people unable to work due to mental health problems. We are living in the shadow of a once-in-a-generation pandemic and cost-of-living crisis, both of which we know, from the people we speak to every day, have been substantial drivers of mental health problems. There are 1.6 million people on mental health waiting lists, with those on low incomes experiencing some of the worst health outcomes. While it has become convenient, or in some cases politically expedient, to deny that the scale of rising mental health problems is real, such denials inevitably lead to policymakers not pursuing a proper appreciation of what might be driving such rises. This increases the burden on both the healthcare system and patients, as the earlier the intervention, the more treatable these issues become. Our starting point has to be one of understanding the factors behind increasing levels of poor mental health and addressing the delays in people getting support. The solution certainly does not lie in making claims about over-diagnosis, which have little evidence to support them. This is especially the case when many of the people experiencing poor mental health are already facing the sharpest impacts of poverty and will be those hit hardest by proposed welfare cuts. It's clear we still have a long way to go when it comes to equal treatment of physical and mental health, a point made more real by the proportion of the NHS budget going to mental health falling next year. What's needed now is a conversation that is careful not to stigmatise people's real experiences and does not undermine the expertise of medical professionals. It must instead focus on how we can best create a mentally healthier society – one where fewer people experience poor mental health in the first place. Joanna Moncrieff, Professor of critical and social psychiatry, UCL, and NHS psychiatrist With the increasing diagnosis of mental health problems, we are medicalising a variety of human situations that are not medical problems. This has negative consequences for individuals and for society. Diagnosis is a medical activity. It implies that people have an underlying biological abnormality that is the cause of their symptoms. This is not the case with mental health problems. When someone is diagnosed with depression, anxiety or ADHD, this is simply a description of their problems. It is a label. It is not an explanation. It does not mean there is an underlying biological deficiency. The widespread belief that depression is due to a chemical imbalance has never been demonstrated, for example, and biological mechanisms have not been established for any other mental health condition. As a result, the process of making a mental health diagnosis is highly subjective. It depends on the beliefs and circumstances of the individual doctor and patient, and it is influenced by general social and economic conditions. Yet, giving people a mental health diagnosis creates the impression that there is an underlying biological problem. This is harmful because it results in people feeling pessimistic and powerless to change anything. It can lead people to limit themselves. It also results in unnecessary exposure to medical interventions, such as antidepressants. Despite being widely used, there is little evidence that antidepressants are helpful, and plenty of evidence that they can have serious adverse effects. Moreover, giving people a diagnosis risks overlooking the real problems. It focuses everyone's attention on the symptoms of the condition, rather than the problems that caused them originally. Overwhelmingly, these problems are social, such as poverty, unemployment, relationship problems, loneliness and lack of meaning. Diagnosing the understandable consequences of these features of our society as medical conditions inhibits social change. It enables politicians to ignore the inequality, insecurity and social fragmentation that have resulted from neoliberal political and economic policies, and which cause so much misery and stress. In the short term, medicalisation provides financial security for some through the benefits system, but this could be (and in some cases is) done differently, on the basis of need. In the long term, medicalisation perpetuates the system that is causing our mental health crisis in the first place. Joanna Moncrieff is the author of 'Chemically Imbalanced: The Making and Unmaking of the Serotonin Myth' Brian Dow, Deputy chief executive, Rethink Mental Illness There is lots of talk about the over-diagnosis of mental health conditions. But for most people living with mental illness, the reality is often a struggle for a timely diagnosis and access to the right treatment. Our charity's research found the majority don't receive support quickly enough, with four in five experiencing a deterioration in their mental health while they waited. The consequences are serious: crisis, suicide attempts and lost livelihoods. Of course, as in any area of medicine, misdiagnoses do occur. Some people in recovery may come to feel that a diagnosis no longer serves them. And yes, we should be doing much more to prevent people from falling out of education or work, rather than simply writing them off. On the other hand, a diagnosis is often the only way to access life-saving support. And we don't suggest that cancer awareness-raising campaigns are problematic because most people who get checked won't have cancer. Quite the opposite: we encourage people to seek help, knowing that early intervention saves lives. So why discourage the same approach for mental illness, when the effects can be just as devastating? This is a complex issue that requires nuance, not oversimplification. Right now, there's no compelling evidence of over-diagnosis, but there is ample evidence of a rising tide of mental distress and under-resourced services failing to meet demand. Recent research from the Institute for Fiscal Studies shows that mental health difficulties, particularly among young people, are increasing. Mental illness has never reached parity with physical health in either investment or priority. Our analysis of NHS data shows someone is eight times more likely to wait over 18 months for mental health treatment than for physical healthcare. The government's target for 92 per cent of patients to start treatment within 18 weeks does not currently include any commitment to tackling waits for mental health services. Against this backdrop, we must be extremely cautious we don't deter people from seeking help. We also need to do more to tackle the drivers of poor mental health, especially given that mental illness often begins young and becomes entrenched without support. That means investing in school-based support, housing, tackling poverty and reducing isolation. This is not soft policy; it's a pragmatic way to reduce pressure on an already overburdened system. While different conditions require different responses, all mental illness, from mild to severe, is distressing to the individual. What matters is delivering the right support, in the right place, at the right time. The question isn't whether we're over-diagnosing. It's whether we're doing enough to help. Related
The Guardian
30-04-2025
- Health
- The Guardian
The experts: neurologists on 17 simple ways to look after your brain
As we live longer, our risk of cognitive impairment is increasing. How can we delay the onset of symptoms? Do we have to give up every indulgence or can small changes make a difference? We asked neurologists for tips on how to keep our brains healthy for life. 'All of the sensible things that apply to bodily health apply to brain health,' says Dr Suzanne O'Sullivan, a consultant in neurology at the National Hospital for Neurology and Neurosurgery in London, and the author of The Age of Diagnosis. 'When you're 20, you can get away with absolute murder. You can not sleep for nights at a time and stuff like that. But you get away with nothing when you hit middle age. With every year that I get older, my lifestyle gets healthier.' All of her consultations will focus to some degree on lifestyle choices, she says: 'I work with a lot of people with degenerative brain diseases, and they are not caused by lifestyle. But everything is made better by having a moderate degree of exercise, eating healthily and sleeping well, whether it be bodily disease, brain disease or mental health.' 'If you want to damage your brain, smoke a lot,' says Tom Solomon, professor of neurology at the University of Liverpool. Likewise, 'a lot of alcohol is not good for you. A bit of alcohol seems to be OK. There is some soft data suggesting one to two units might reduce risks of cardiac disease in the elderly, but the evidence overall is that alcohol is harmful, especially to the brain.' Dr Faye Begeti, a neurologist and neuroscientist at Oxford University hospitals, takes a hard line: 'I find that people who are not alcoholics, but drink a small amount of alcohol every day over many decades, can still run into problems. With alcohol I have two rules for my patients: not out of habit, so only when celebrating; and not drinking daily.' There is a well-established link between physical activity and brain health, says Dr Richard Davenport, a consultant neurologist in Edinburgh and the outgoing president of the Association of British Neurologists: 'It works on many levels: psychological, metabolic, physiological.' 'Things that are good for your blood vessels are good for your brain,' Solomon says. 'A lot of dementia is because of damaged blood vessels. Physical activity is good for blood vessels as it keeps blood pressure down.' Solomon got a Guinness world record for running the fastest marathon dressed as a doctor in 2010, raising money for Encephalitis International, a brain inflammation charity. But you don't need to run marathons to keep your brain healthy, he says. Although, 'there is not much hard data telling you exactly how much exercise to do – in our headache clinics we say do 20-30 minutes of something that gets you at least a little bit short of breath two or three times a week, so running, swimming, cycling. They are very good for de-stressing, too,' he adds – another bonus for the brain. 'There are studies that show being active in every decade really helps with brain longevity,' says Begeti. 'I advise people to include single-leg exercises in their routine, because walking relies heavily on single-leg balance, and maintaining this becomes crucial as we get older. Aerobic exercise releases a brain-nourishing chemical called brain-derived neurotrophic factor that supports our neurons. A combination of that with resistance exercises that build up muscle is very important, as numerous studies have found greater muscle mass reduces cognitive decline, even in those who have already been diagnosed with dementia.' Opt for 'antioxidants and unsaturated fats, and not too much red meat', says Solomon. 'The biggest evidence is for the Mediterranean diet,' says Begeti, adding: 'I was born in Greece, so maybe I am biased.' She says the advice she often gives on this is simple: 'When you cook, your primary source of fat should be olive oil rather than butter. This is what I do and it is a really easy transition to make. You can have cakes with olive oil in; everything you fry should be in olive oil, rather than butter. I'm not saying you would never eat butter again, but that the primary source of fat is olive oil. And having some omega-3 with oily fish has really good evidence for brain health as well.' She says it is important for vegans and vegetarians to take vitamin B12 supplements. 'We see people who have simple or chronic headaches,' says Solomon. 'The things that reduce the risk of headaches are all very much the same. Regular exercise. Staying hydrated by drinking at least two litres of water a day. Stopping all caffeine. Not skipping meals. Getting to bed at a sensible time. We usually say to people: if you do this religiously for three months, headaches will reduce or come under control. And most of those things are also good for your general brain health, as far as we know.' 'Good sleep starts at the beginning of the day,' says Begeti, 'rather than at night when you are stressing about not getting good sleep. Anchor your morning by getting up at roughly the same time each day. If you need more sleep at the weekends, then catch up with 60 to 90 minutes, or one sleep cycle extra. Don't make it too erratic, because then your brain doesn't know when to produce the right hormones.' 'We still don't exactly know what sleep is all about,' says Davenport, 'but increasingly, there is good evidence that sleep is allowing the brain some downtime to do a bit of tidying up, and in particular, tidying some of these dodgy proteins that ultimately may do bad things in terms of degenerative disease. In other words, getting decent sleep matters.' 'With insomnia, there can be a lot of worry when we hear that reduced sleep can give rise to disease,' says Begeti. 'I think it is about being able to do good things for your brain, but not being really stressed if you're not doing everything perfectly, because stress has really negative effects as well.' But, she concedes: 'It's easier said than done to say to somebody, 'Don't be stressed!'' 'There is evidence that people with perceived long-term stress are at increased risk of cognitive decline and dementia,' Solomon agrees. We are in the midst of a panic about what technology is doing to our brains, but as Begeti explains in her book The Phone Fix, the science does not confirm that we are addicted to our phones. That said, she limits checking her Instagram account to twice a day and mutes all WhatsApp groups. 'I suggest people try to develop a routine or a schedule of connection and disconnection that works for them. Distraction is a big thing when it comes to technology. I prefer people to use technology intentionally because they want to, rather than to avoid doing some difficult work or dealing with something, and instead using technology to fill that gap. When people use it as an avoidance tactic, I think that is when it can make them feel bad.' Does having so much information readily available online mean we are losing memory capacity? 'You may not be able to remember a phone number, but the brain is very adaptable,' says Begeti. 'It remembers things that you use and sidelines things that you don't. If you don't remember phone numbers daily, then your brain might not be accustomed to remembering them. It doesn't mean this ability has disappeared. It is more the brain is prioritising certain things that you do.' Maintaining social connections is crucial in helping to avoid dementia. 'Of course, there are problems associated with technology,' says O'Sullivan. 'There is some awful content on there. But I think we often forget the positive things it brings to our lives. For older people, who may not have great mobility, it is creating incredible connectedness.' Begeti adds: 'There are early studies with preliminary findings that show if middle-aged adults engage in social media, they have reduced incidence of dementia.' 'Brain and mind health is all about having ambitions and interests outside of yourself,' says O'Sullivan. 'I have so much work to do that my mind is kept well occupied, but my plan going forward is to do all the things I wish I had time to do now: go back to university, do art appreciation courses, and challenge myself in settings where I'll be mixing with lots of different people.' Find a 'magnificent obsession', says Dr Richard Restak, a professor of neurology at George Washington University hospital in the US and author of How To Prevent Dementia: An Expert's Guide to Long-Term Brain Health. 'Take up an interest, the earlier in life the better, and do a lot of mental work trying to learn more stuff. You can link it to social interaction, which is very important.' 'You need to exercise the brain every day, particularly with memory,' says Restak. At 83, he is still writing books. What is his secret? 'I think, in my case, it is mostly training the brain. I walk and have a sensible diet, but I'm not cultish about it. If my wife brings back some pastries, I will certainly have one.' What's his training? 'Every day I try to learn a new word,' says Restak. 'The word today is turveydrop – based on a character in [Charles Dickens's] Bleak House – and is someone who is just interested in looking important. If somebody calls you that, it's not a compliment.' He keeps lists of all his daily words to refer back to, if his memory fails him. But don't narrow your training too much, he adds. 'Remembering particular things is only good for the area in which they are applied, so that you become a good crossword puzzler or a great Scrabble player. I lose at Scrabble all the time. I think I've got a pretty good vocabulary, but Scrabble is its own world.' 'Learning is harder when you are older,' says Solomon, 'but it helps as you mature.' He played piano as a child, then took it up again 10 years ago. 'People who play musical instruments are less likely to have cognitive impairment because it is all about using the brain.' The same goes for learning languages. With both, 'You're using very different parts of your brain. If you don't do any of those things, there are whole chunks of your brain that are not really being used.' 'Deafness is one of the characteristics that the Lancet Commission has identified as being an important risk factor for dementia,' says Davenport. 'It's the same for vision. Anything that leads you to less interaction with the outside world is likely to be detrimental.' There is less evidence on the effects of reduced vision, he says, 'but if your vision deteriorates, you're going to stop driving, you may stop going out so much, and all of those things start to lead to social isolation, like deafness. Keep on top of your senses; make sure you can hear and see.' Interestingly, Davenport adds, 'sense of smell is often an early symptom of some of the degenerative diseases. No one is suggesting losing your sense of smell leads to them. It is probably just an early symptom, particularly in Parkinson's disease.' Davenport is a keen cyclist. Does he wear a helmet? 'Absolutely. There is good evidence that helmets do protect you.' He refers to the debate around the effect of repeated head injuries in sports such as rugby and football, and their role in neurodegenerative disease: 'There is still quite a lot to be unravelled about that, but it makes sense to try to protect your head from unnecessary injury. Where you need to be careful, of course, is that we know that physical exercise is very good for people, and therefore you don't want to stop kids playing football. But maybe easing up on heading the ball, which is already happening.' O'Sullivan points out that memory decline starts in your 30s. 'We all are increasingly forgetful over time,' Solomon agrees. Don't worry, he says, if, for example: 'You go upstairs for a jumper, and then you get upstairs and you can't remember what you've gone up there for. That's not a reason to see the doctor.' He says that the difference is obvious between patients who have dementia and those who are experiencing normal forgetfulness: 'When I say to these patients, 'Why have you come to see me?', they turn their head to look at the relative who is with them, because they have no idea why they are there.'
Associated Press
07-04-2025
- Health
- Associated Press
CCHR Says Despite Record-High Spending, Mental Health Outcomes Decline-Experts Say Fault Lies with Flawed Diagnostic System
LOS ANGELES, Calif., April 7, 2025 (SEND2PRESS NEWSWIRE) — The Citizens Commission on Human Rights International (CCHR) is sounding the alarm on the unchecked expansion of psychiatric diagnoses—most notably through the Diagnostic and Statistical Manual of Mental Disorders (DSM). What began in 1952 with just 106 diagnoses exploded to over 300 by 2013, despite a lack of objective biological testing to support these labels. The United States is spending more than ever on mental health – yet outcomes continue to worsen. Suicide rates are rising, psychiatric hospitalizations are increasing, and more Americans than ever are on psychiatric drugs. A growing number of experts and watchdog organizations argue that the root of the problem lies not in a lack of access or funding, but in the very foundation of modern psychiatry: an unscientific diagnostic system that pathologizes normal life. According to neurologist Dr. Suzanne O'Sullivan, author of ' The Age of Diagnosis,' 'fad' diagnoses pathologize the human condition itself. 'We are not getting sicker,' she writes, 'we are attributing more to sickness.'[1] Despite massive investments in mental health care, U.S. outcomes are deteriorating: Mental health/behavioral spending reached $329 billion in 2022—a 94% increase since 2012 [2]—yet suicide rates have jumped 30% since 2000.[3] Time in a psychiatric hospital raises suicide likelihood by over 44 times; psychotropic drugs alone can raise it nearly six times.[4] One-third of admitted psychiatric patients are readmitted within a year, highlighting treatment failure.[5] Involuntary commitment accounts for over half of all psychiatric admissions.[6] Yet evidence shows that forced treatment is ineffective.[7] The diagnostic system's credibility is undermined by deep financial ties to the pharmaceutical industry. According to research: 69% of DSM-5 task force members had financial ties to drug companies. Lisa Cosgrove, Ph.D., of the University of Massachusetts Boston, warns that the 'disease model' of psychiatry secured legitimacy for the field but at the cost of objectivity. 'It opened the door to an improper dependence on the pharmaceutical industry,' she says. DSM-driven diagnostic inflation has led to an explosion in labels that often medicalize experiences. Examples now classified as disorders include: Caffeine Use Disorder (8%) Restless Leg Syndrome (13%) Adjustment Disorder (15%) Oppositional Defiant Disorder in children (6%) Some estimates suggest that, when added together, DSM-labeled 'illnesses' outnumber the U.S. population. While the DSM gives the appearance of a clinical guidebook, it remains—by the admission of psychiatrists—scientifically unsound. Dr. Thomas Insel, former director of the National Institute of Mental Health, declared: 'The weakness of DSM is its lack of validity…. DSM diagnoses are based on consensus about clusters of symptoms, not any objective laboratory measure.'[8] Psychiatrist Allen Frances, who led the DSM-IV task force, has since warned that DSM has led to the 'medicalization of childhood' and a 'massive, careless over-diagnosis' epidemic. He emphasized: 'Mental illness is terribly misleading because the disorders we diagnose are merely descriptions of behaviors, not well-established diseases.' In other words, there is no verifiable biological test for depression, ADHD, bipolar or other any other mental disorder. Yet millions are labeled and treated as if they were suffering from chronic medical diseases. Psychiatric diagnoses do not reveal chemical imbalances. In fact, psychiatrist Professor Joanna Moncrieff, of University College London, notes: 'The theory that depression is caused by low serotonin is not supported by reliable evidence.' Still, patients are routinely prescribed antidepressants under the presumption of such imbalances. The consequences of psychiatric diagnosing are not just financial—they're deeply personal and often devastating. Women and children are disproportionately affected. Two-thirds of electroshock recipients are women. Children as young as five are prescribed psychiatric drugs. The American Academy of Pediatrics reported a 66% rise in antidepressant use in ages 12–25 between 2016 and 2022.[9] TIME and Smithsonian have reported on the enduring trend of diagnosing women's physical and emotional struggles as mental illness, delaying real medical care and increasing vulnerability to psychiatric interventions.[10] Even as access to treatment expands, mental health is declining across all major metrics. TIME summed it up: 'Even as more people flock to therapy, U.S. mental health is getting worse.'[11] Experts and advocates are calling not for more funding, but for systemic change. Dr. Frances advises: 'Ignore DSM-5. Its suggestions are reckless, unsupported by science, and will result in unnecessary, harmful, costly treatment.'[12] 'The DSM must be abolished,' says psychiatrist Samuel Timimi.[13] CCHR, established in 1969 by the Church of Scientology and professor of psychiatry Thomas Szasz, urges lawmakers, healthcare leaders, and the public to reconsider the current trajectory of mental health policy. 'Until psychiatry is held accountable for its unscientific diagnostic system and the harm it inflicts,' says Jan Eastgate, President, CCHR International, 'the crisis will only deepen.' Sources: [1] Hanna Barnes, 'Our overdiagnosis epidemic: How a marked rise in the treatment of certain conditions – physical and mental – is harming, not protecting, public health,' The New Statesman, 10 Mar. 2025, [5] 'Readmission of Patients to Acute Psychiatric Hospitals: Influential Factors and Interventions to Reduce Psychiatric Readmission Rates,' Healthcare (Basel). 2022 Sep 19;10(9):1808, [6] 'National Mental Health Services Survey (N-MHSS): 2018 Data on Mental Health Treatment Facilities – Data on Mental Health Treatment Facilities,' SAMSHA, 2019; Christopher Lane, Ph.D., 'When Psychiatric Treatment Isn't Voluntary,' Psychology Today, 31 Mar. 2023, [7] 'Forcing homeless people into mental health treatment isn't the way to solve homelessness,' Los Angeles Times, 28 Jan. 2020, [8] Thomas Insel, 'Transforming Diagnosis,' NIMH Website, 20 Apr. 2013, [11] 'America Has Reached Peak Therapy. Why Is Our Mental Health Getting Worse?' TIME, 28 Aug. 2024, [13] Samuel Timimi, 'No more psychiatric labels: Why formal psychiatric diagnostic systems should be abolished,' Int. Journ. of Clinical and Health Psychology, Sept.-Dec. 2014, MULTIMEDIA: Image caption: 'Until psychiatry is held accountable for its unscientific diagnostic system and the harm it inflicts, the crisis will only deepen.' – Jan Eastgate, President, CCHR International NEWS SOURCE: Citizens Commission on Human Rights Keywords: Religion and Churches, Citizens Commission on Human Rights, CCHR International, psychiatry, LOS ANGELES, Calif. Send2Press® Newswire. Information is believed accurate but not guaranteed. Story ID: S2P125332 APNF0325A
The Guardian
07-03-2025
- Health
- The Guardian
Mind over body: the trouble with treating chronic conditions
While I agree with viewing health holistically and treating the person, not the disease, I felt uncomfortable with some of the conclusions that Suzanne O'Sullivan draws from the cases presented (Are we less healthy than we used to be – or overdiagnosing illness?, 1 March). Implying that we are overdiagnosing certain conditions only reinforces the stigma associated with them, and will prevent people in need from being taken seriously and receiving appropriate support and treatment. The scepticism, however well-meaning, can be damaging for patient outcomes and public health in general. Treatments and support available for conditions such as ADHD and autism are already lacking and underresearched. The rise of diagnostic levels of most of these conditions comes from increased awareness, and also from the environmental changes in our society that place ever-increasing pressure on individuals to perform at a certain standard. Neurodiversity conditions have become a lot more debilitating for those experiencing them. Increased population density exposes individuals to more stimuli than their nervous system can handle. Technological progress, particularly the advent of smartphones, has led to an expectation of being always available and a pressure to react and respond in real time that did not exist 20 years ago. The solutions to the problematic rise of diagnoses, then, must also be societal. Individual adjustments, as seen in the case of Anna in the article, can only help to a degree, and for some it may not be enough to allow them to be fully functioning in society. There needs to be a recognition that some of the narratives shaping our society today are actively preventing a significant part of the population from being able to fully contribute. Placing the onus on the struggling individual is AnisimovaLondon Suzanne O'Sullivan's 2015 book, It's All in Your Head, made a huge impact. We psychotherapists felt this doctor was singing our song – the power of the mind over the body. Her powerful case studies demonstrated the psychological underpinnings of medically unexplained diagnoses. Nine years later, O'Sullivan writes of the startling rise in the diagnosis of mental health disorders: 'We are not getting sicker – we are attributing more to sickness.' I wonder if we need to think in broader terms about what is needed now for our sickness. If our bodies are screaming in distress, what is not being heard? Psychotherapy offers an environment in which people can and do heal and change. Through understanding and care, our most basic human needs are met. This transformational process is very different from diagnosis. It offers an exploration that tries to understand why we are the way we are, and not rush to conclusions. I can understand why taking the diagnostic route is tempting. But I have always believed that psychotherapy is, in the words of Stephen M Johnson, 'the hard work miracle'. Hard work in the sense that facing pain is not for the faint-hearted: opening up our vulnerability, being honest about our inner conflicts and entrusting ourselves to someone else are acts of bravery. And a miracle in that, with patience and time, the good stuff starts to make an impact. When we feel understood and accepted, and start to apply this to ourselves with compassion, the painful parts of the self settle down in peace and coherence. We can relax and feel safe in the world. These are the qualities, so much in short supply, that could be a salve for our current SmethurstDuns Tew, Oxfordshire The extract from Suzanne O'Sullivan's new book, The Age of Diagnosis: Sickness, Health and Why Medicine Has Gone Too Far, that you published lays bare a patronising attitude that many healthcare professionals take towards neurodivergent people. She has spoken to scores of people diagnosed with autism or ADHD – all of whom have said their lives were better for it. Yet she wants to discourage diagnosis. Why? Because she worries about their future, noting that many left jobs, dropped out of education, or lost friends. It seemingly never occurs to her that these changes might be deliberate, even positive. As an autistic person, my diagnosis empowered me to leave a high‑stress career in London and start a fulfilling online business, where I can work alone, from home. It also helped me cut out unhealthy friendships and build a life that genuinely suits me. Others have done the same, not out of helplessness but choice. O'Sullivan and her colleagues should try listening to their patients. And when neurodivergent people say they're happier, they should believe and address supplied I feel Suzanne O'Sullivan overlooks the anxiety and distress people who are neurodivergent have in trying to function in a world that often makes little sense to them. This can lead to profound feelings of isolation, which in turn can lead to problematic behaviours for society. And for an individual struggling like this, even suicide. I feel this is being largely sidelined here. If there is no diagnosis, there is a missed opportunity for helpful therapy and a better understanding of their struggle, both for themselves and those around them. People need to feel seen and heard, and when this is absent there can be profound implications for us all. So 'pathologising', with its implication of overdiagnosing symptoms, would not be the goal but perhaps the way the health and education systems work – without a diagnosis, no help is available. From a neurodivergent person's point of view, a great deal of relief may come from a recognition that they are facing real difficulties. I agree that to see mental health problems as a person's response to a threat to themselves can be a useful and compassionate approach. But if their struggles are profound and enduring over a lifetime, it still needs to be recognised, and we have a duty to offer treatment where SanachanEdzell, Angus I was disappointed by this edited extract from Suzanne O'Sullivan's book. As a disabled specialist psychotherapist working with neurodivergent and chronically ill clients, I feel that her representations need challenging. While I agree with the importance of hope and dangers of pathologising common experiences, she ignores the role inequality and social context play in health. She minimises the disabling impact that chronic conditions can have in the absence of mainstream understanding of their complexity; the medical gaslighting she scorns is all too common, and her simplification of the potential for improvement shows a striking ignorance of average experiences. These misrepresentations can, ironically, contribute to the lack of hope and disabling impacts she mentions. With a failing NHS and lack of specialist support, the validation of a diagnosis can be all a person has, if they can get one at TurpLiverpool Have an opinion on anything you've read in the Guardian today? Please email us your letter and it will be considered for publication in our letters section.
