Let’s explore the myth that psychiatric conditions aren’t as well defined as other medical diseases and psychiatric treatments aren’t supported by as much scientific evidence, and don’t work as well, as other medical treatments. Even my fellow psychiatrists believe this. I’ll take broken limbs and that sort of thing out of the equation and go on from there.
Are psychiatric conditions nothing more than labels for normal behaviors? Is a person with social anxiety disorder just a shy person? Is depression just an experience we all have to live with during hard times? What makes a super-punctilious person a case of obsessive-compulsive disorder? It’s true that some psychiatric conditions exist on a continuum with normal reactions, normal states of being. Differentiating them from normal is no different than deciding what level of blood pressure is ‘hypertension,’ how many pounds add up to ‘obesity,’ or how many hours of labor it should take before a baby is born. A condition rises to the level of disease when it handicaps a person, is associated with bad outcomes, and/or can be treated — in psychiatry just as in the rest of medicine.