DSM-5 : The Psychologist - Letter - February 2013

Further to the letter on the inaccurate use of the term
‘anti-dementia’ drugs (December 2012), I suggest
that exactly the same arguments apply to psychiatric
medications, and that our language should reflect
evidence and not mislead lay people – or indeed,
professionals. So called ‘antipsychotics’ have no
specific effect on psychosis, are not a cure, and do not
rectify identified biological abnormalities. The previous
term ‘major tranquilliser’ reflects their mode of action
much better. The same is true of ‘antidepressants’ and of the
most recent example of rebranding, ‘mood stabilisers’,
all of which are better described simply by their drug
class (SSRIs, etc.) Using these terms uncritically gives service
users false hopes about what medications can achieve, and
subtly increases the pressure to take them regardless of the
growing amount of evidence that in many cases they are
actively damaging (Whitaker, 2010.)
Psychiatric medication does have its uses, but only
if accompanied by clear messages about its limitations
– it cannot heal the trauma and abuse that, as a growing
amount of research indicates, plays a causal role across all
kinds of mental distress (Read & Bentall, 2012). Moncrieff
(2008) has argued for a drug-centred, not disease-centred,
model of medication use; in other words, one that
recognises that while general effects such as sedation may
sometimes be experienced as helpful, these medications do
not target disease symptoms or entities. While they may bring
temporary relief from overwhelming distress, theydo not actually ‘treat’ illnesses.
Careful use of language will help to ensure that their
benefits are maximised and the very real risk of harm is
avoided.

Dr Lucy Johnstone
Consultant Clinical Psychologist
Cwm Taf Health Board
Royal Glamorgan Hospital

References
Moncrieff, J.(2008).
The myth of the
chemical cure. Basingstoke:
Palgrave Macmillan.

Read, J. & Bentall, R.
(2012). Negative childhood experiences and mental health.
British Journal of Psychiatry,
200, 89–91.
Whitaker, R.(2010).
Anatomy of an epidemic
. New York: Crown