If your wellness is affected by a mental health problem, such as schizophrenia or bipolar disorder, treating it in the same way as one would an illness is not helpful to your wellbeing. This is according to leading psychologists, who claim that even labelling the conditions is counterproductive, as there is no evidence that a ‘breakdown’ or ‘severe emotional distress’ is the same as an illness with genetic or biological causes.
This statement, released last week by the British Psychological Society’s division of clinical psychology, comes shortly before the release of the latest edition of American Psychiatry Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM classifies many emotional and behavioural problems – including temper tantrums and excess worrying about personal health – as illnesses. This indicates that they are treatable by doctors using drugs.
According to Dr Lucy Johnstone, a consultant clinical psychologist who helped draw up the statement, there is no scientific basis for treating ‘emotional distress’ as a physical sickness. She commented, ‘No one is denying that people suffer very extreme forms of distress. What we are saying, and in fact what some of the world’s most senior psychiatrists are saying, is that there is no evidence that this kind of breakdown is best understood as an illness, with genetic or biochemical causes.’
She continued, ‘On the other hand, we do have an overwhelming amount of evidence that even severe psychiatric breakdown is the end result of a complex mix of social and psychological circumstances – in other words, things that have happened to you.’ Dr Johnstone argued that the new approach must regard mental distress as ‘people with problems, not patients with illnesses’.
Dr Johnstone explained, ‘People break down for reasons in their lives, and unless we can understand those reasons we will not be able to offer them the right kind of help to recover.’ Obviously our brains and bodies are involved in mental distress. The question is; is there evidence that distress is mainly caused by changes in our bodies and brains? There is no evidence to support this – as senior psychiatrists themselves are admitting.’
However, Professor Sir Simon Wessely, a member of the Royal College of Psychiatrists and chair of psychological medicine at King’s College London, argued that a classification system for mental disorder was necessary, and the DCP’s views have proven controversial within the medical community. He noted, ‘A classification system is like a map. And just as any map is only provisional, ready to be changed as the landscape changes, so does classification.’
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