Wednesday, June 07, 2006

Stop 'medicalizing' bad behavior

It may be hard to recall, but once there was a time when people took responsibility for their behavior, without recourse to the psychiatric and psychological communities.

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The major fallacy in the article and many of the comments is the assumption that "medicalizing" an issue equates to relaxation of personal responsibilities in the diagnosed individual. Diabetes, HIV, benign essential hypertension, glaucoma, migraine headaches, epilepsy, claudication are all real diseases. Everyone reading this should know at least one person with each of these disorders. The key to treatment and alleviation of symptomatology in each of these diseases is personal responsibility which typically includes appropriate medical treatment. Proper treatment and education of all disease necessitates an INCREASE in personal responsibility.

Don't take your anti-hypertensive medication = die of stroke
Irritable bowel disease, eat chili = flatulence and diarrhea
Don't take your herpes meds = give girlfriend VD
Don't follow your diabetic diet = dialysis, blindness, amputation of lower limbs, death
Xeroderma Pigmentosa patients, don't stay out of sun = death
Got PKU and don't follow diet = mental retardation
ADHD; don't receive proper behavioral treatment and/or medication = 3x increase in emergency medical services, lower than expected grade level in math and English, lower likelihood of enrolling in college, lower expected lifetime earnings

The number one problem with treatment of common disease is that patients don't take their medication and/or follow their treatment regiments. THAT'S RIGHT!!! THE TRUTH IS PEOPLE DON'T TAKE PERSONAL RESPONSIBILITY OR TAKE THE PILLS. Study after study have shown that people are typically non-compliant with medications unless there is an uncomfortable adverse side effect to non-treatment (e.g. broken leg & pain pills). Do you think Americans are fat because doctors forgot to recommend diet and exercise? Do you think people with hypertension are given bad drugs?

IED is a slightly different issue. Nearly all people who drive have been a victim of road rage and IED raises a fear that the asshole who cut you off and forced you into an accident is going to get away with it with a letter from a shrink. That's probably the only good thing an IED diagnoses could be hypothesized to do; such a diagnosis would likely increase health insurance rates, make people hate you, increase auto insurance rates, cause workplace discrimination (it might not be legal, but do you think they'd hire someone with IED if they could avoid it), and is comorbid with most DSM-IV mood, anxiety, and substance disorders. Sounds crappy to me.

Ok, since all of you holier-than-thou Digg-nation fans are lucky to be perfectly healthy and unmedicalized, remember this (USA anyway) is a capitalist, keep what you kill society. Do you really want to encourage all these people to get out of traffic court, go to college, stay off the shrinks couch, diet, exercise, and get black belts? I didn't think so! On average the fat sloths with poor interpersonal skills, who won't stop sharing needles or wear a condom and with reckless driving habits won't be rising the corporate ladder and taking your job (and place in line for a Prius) anytime soon. So relax.

Unless you have IED and in that case don't get mad at me, it's not my fault either!