There's an amusing story in today's Wall Street Journal about medical students using fictional television and movie characters to learn how to diagnose psychiatric disorders. Hundred-Acre Wood Ashdown Forest (where Winnie the Pooh lives) might as well have been a psychiatrist's waiting room:
Piglet clearly suffers from generalized anxiety disorder, the authors noted. Eeyore has chronic dysthymia (mild depression) and could benefit greatly from an antidepressant. Tigger is hyperactive, impulsive and a risk-taker.
The piece is lighthearted, but it brings to mind a more serious concern: If you can diagnose cartoons with depression, how much more rigorous is the process for humans? And at what point does being Oscar the Grouch become a disorder? The unsatisfying answer is that it's difficult to tell; the tools we use for mapping out human emotion -- observation, patients' self-reports -- are still quite crude.
But this shouldn't become fodder for those who argue psychiatric disorders aren't real or that the FDA should take psycho-pharmaceuticals off the market. Doctors may pathologize and pull out their prescription pads for, what may just be "unruly teenager syndrome." No doubt profit-hungry pharmaceutical companies also contribute to antidepressants and other medications being overprescribed. But the fact of the matter is that psycho-pharmaceuticals as well as behavioral and cognitive therapy have helped millions live more productive, happy lives. For the time being, we may be using a sledgehammer on a nail, but that should compel us to proceed with caution and work to develop more refined tools -- not drop the hammer.
-- Gabriel Arana
