12/2/2019
As the flu season comes around, many people go to their doctors for check-ups and vaccines. My friend, who suspected she had the flu a week ago, went into the ER and was prescribed the antibiotic Tamiflu for her illness. One week later, all her symptoms remain and she heads back to the doctors for another set of tests. Flu-like symptoms are debilitating. There is not much getting out of bed, food doesn’t stay down well, and people actively avoid you. She is getting a call later today about her true diagnosis and hopefully the next round of antibiotics will do the trick.
Why isn’t this the same process used for mental illness? When my friends have bouts of extreme sadness or debilitating anxiety, their response isn’t to rush to the ER. Either their parents tell them to tough it out themselves or to get some rest. In the Collected Schizophrenias by Esmé Weijun Wang, Wang describes her tumultuous journey to her ever-changing mental disorder diagnosis. She describes her mother shuffling Wang’s suicidal thoughts under the rug, her family and friends denying their own mental disorders and those of others around her, and the time she finally brought herself to the doctor where she was diagnosed with depression and anxiety. However, this diagnosis has taken many turns. Similar to my friend trying to find her diagnosis, Wang has had to approach hers with supreme patience. Unlike my friend, Wang cannot have a blood test or inner cheek swab to tell her whether she has depression with anxiety or schizoaffective disorder or schizophrenia.
A lack of objective diagnosis is due in part to the brain’s almost incomprehensible complexity and to a lack of research on the subject. Some blood tests are used to rule out some medical conditions that have depression-like symptoms like anemia or hypothyroidism but not exact mental disorders. As of 2019, genetic testing cannot accurately predict a mental health disorder. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is some psychiatrists holy grail for diagnosis of mental disorders. What is strange about the DSM-5 to Wang is that with new versions of the manual, her diagnosis changed. Some qualifications for certain diseases mean checking off four of the ten listed symptoms and with a new edition a patient now has to check off five of the ten symptoms which can completely rule them out for different treatments and attentions.
Mental disorders should be treated with the same attention and level of care that one treats a physical illness because it is a physical illness. Mental disorders can result in the same symptoms as my friend’s – staying in bed, not eating much, and people being less than thrilled to be around you. They should be treated with the same care on the patient and the scientist’s end. Hopefully sooner rather than later, there will also be objective and improved methods for diagnosing mental disorders.