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A Dose of Sanity: Mind, Medicine, and Misdiagnosis

A Dose of Sanity: Mind, Medicine, and Misdiagnosis
By Sydney Walker

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"Bravo to Dr. Sydney Walker. He has written a masterful book for current and prospective mental health consumers. Before filling a prescription for Prozac or Ritalin, make sure you get A Dose of Sanity."—Charles B. Inlander President, People's Medical Society

Has your child been labeled hyperactive?

Has your parent been diagnosed with senile dementia?

Did your doctor prescribe Prozac for your so-called depression?

If you answered "yes" to any of these questions, you need A Dose of Sanity.

Each year, hundreds of thousands of Americans who are actually suffering from common medical conditions such as hyperthyroidism, Lyme disease, and even poor nutrition are misdiagnosed with psychiatric disorders. Studies show that the rate of misdiagnosis is more than 4 in 10.

In this powerful book, practicing psychiatrist Dr. Sydney Walker explains why psychiatric misdiagnosis is so common. More importantly, he helps you and those you love avoid the misdiagnosis trap. Dr. Walker's unique 24-Hour-Day Profile lets you track physical and emotional changes over the course of a day to give your physician valuable clues to what your symptoms really mean.


Product Details

  • Amazon Sales Rank: #768086 in Books
  • Published on: 1997-10-16
  • Original language: English
  • Number of items: 1
  • Binding: Paperback
  • 272 pages

Editorial Reviews

From Library Journal
Walker, director of Southern California's Neuropsychiatric Institute, here argues that clinicians should not rely exclusively on standard psychiatric labels. He contends that labels such as depression, hyperactivity, etc., often hide medically treatable disorders. He notes a trend in psychiatry to lump individuals under broad categorical labels, e.g., mental retardation, which often obscures the specific problems. Drawing upon 30 years of clinical experience, he cites cases illustrating the fallibility of psychiatric labeling. Walker writes that the current diagnostic system survives because of its support from the American Psychiatric Association, drug companies, and managed care providers. This thought-provoking book is an effective complement to Peter Kramer's Listening to Prozac (LJ 5/1/93). Recommended for public and academic libraries.?Dennis Glenn Twiggs, Winston-Salem, N.C.
Copyright 1996 Reed Business Information, Inc.

From Booklist
Many psychiatrists use the Diagnostic and Statistical Manual (DSM) produced by the American Psychiatric Association as not only their bible but also their daily practice manual. Walker, a psychiatrist himself, points out that the DSM has encouraged practitioners to label patients quickly rather than pursue the more time-consuming, deductive work of differential diagnosis. Labeling leads to fitting patients willy-nilly into groups rather than treating them as the individuals they are by carefully taking medical histories and performing physical examinations. Walker presents many appalling examples of patients who were routinely assigned DSM labels that then became masks for such often dangerous physical diseases as bowel blockage, lupus, brain tumors, and Tourette's and Klinefelter's syndromes. One case that leaps out is that of a Holocaust survivor who, diagnosed with severe depression, in reality had recrudescent typhus. Furthering his indictment, Walker stresses that many of the masked diseases are treatable if caught early and that many of the drugs psychiatrists prescribe are dangerous or addictive. William Beatty

From Kirkus Reviews
An incisive attack on the American Psychiatric Association that cuts to the quick. Walker (Help for the Hyperactive Child, 1978), a neurologist as well as a psychiatrist, contends that few psychiatrists perform the medical detective work necessary to evaluate their patients, but instead assign them a label from the Diagnostic and Statistical Manual (DSM), a catalog of disorders and symptoms published by the American Psychiatric Association (APA). The DSM, which has undergone increasing scrutiny and controversy in recent years, is not the result of careful scientific research, Walker says, but a constantly changing political document reflecting its APA panel members' personal biases and beliefs. Most psychiatrists, he asserts, do not like the hands-on practice of medicine and are more comfortable assigning a DSM label to a patient's symptoms and then writing a prescription or recommending psychotherapy. They have, in his words, ``replaced the science of diagnosis with the pseudoscience of labeling.'' Psychiatrists who rely on DSM labeling overlook symptoms of actual brain dysfunction that may respond to proper medical treatment, Walker asserts, and he includes numerous examples of patients with brain tumors, Tourette's syndrome, lead poisoning, and other medical problems whose disorders were misdiagnosed and consequently mistreated before they came to him. Besides the harm they do to their patients, he contends, DSM-reliant psychiatrists fall behind the progress being made in other areas of medicine such as genetics, molecular biology, and immunology. Walker blames the APA, which sets the standards for psychiatric training, as well as insurers, psychiatric hospitals, and the pharmaceutical industry for fostering a situation in which psychiatrists are not truly acting as doctors, and patients are misdiagnosed and unnecessarily drugged. While urging his colleagues to rebel against the DSM, he offers advice to patients on how to demand proper care. A dose of strong medicine for the psychiatric profession. -- Copyright ©1996, Kirkus Associates, LP. All rights reserved.


Customer Reviews

Much more sensible than most books critical of the field.4
This is not the first book I've read that is critical of psychiatry. But compared to Caplan, Breggin, and Szasz, this is the most sensible critique I've seen. Usually, in the anti-psychiatry literature one finds inexcusible nonsequiturs. For example: "Psychiatrists often don't realize that the medication is causing the disorder (good point). Therefore, biological psychatry is unsound (bad point)." Or "Psychiatric illnesses are voted on by committee (good point), therefore there is no such thing as mental illness (bad point)." Walker avoids making such obvious nonsequiturs. Far from being against biological psychiatry, Walker argues that current psychiatry is not biological enough. It appeals to highly hypothetical conditions (such as neurotransmitter disorders) while ignoring known conditions (such as pin worms or hypothyroidism). Some might think that this is all that Walker is saying, but his general point seems to be that since psychiatrists are taught to run through symptoms lists instead of being medical detectives, there a lot of unknown conditions which they are failing to discover.

Fascinating and Terrifying4
Dr. Walker's book is a stern indictment of the contemporary medical profession and the mental health field in particular. He charges the majority of psychiatrists of ignoring the true needs of their patients and instead practicing and arbitrary pseudo-science of labeling. They seem to have given up on the idea (fundamental to the philosophy of science)that all events have a cause and that to understand something we must understand the process of cause and effect that brought it into being. Most modern psychiatrists are not interested in finding out what is wrong through careful methodology. They are divided into two camps. The psychoanalytic types deny a medical cause for abnormal feelings and behaviour altogether (however, they still want the prestige that comes with being a medical doctor!). They look everything from a bad childhood to alien abductions to explain such things as psychosis and manic depression, even though no scientific study has ever proven the theories on which their claims are based. The next group, the standard issue biopsychiatrists are a little more up to date. They would admit the obvious scientific truth that someone who hears voices or is immobilized by a deep depression is psysically ill. However, they drop the ball as well. Most biologically based psychiatrists give very vague answers about the causes of mental illness, and rely on a few biological treatments which are tried on the patient almost randomly until one seems to "work". For instance, a depressed person will be given one antidepressant drug after another without the doctor even stopping to consider that the deprssion may result from anemia, a thyroid imbalance, poor nutrition or a host of other causes. Many psyciatric patients today are not even given a blood test, an EEG or any other genuine medical test before traetment is prescribed. Walker points out that until people are given a battery of tests, we will never really know what is wrong with them. Prozac or tranquilizers may make the! m feel better temporatily, but they could be literally dying. He also attacks the concepts of hypochodndria and facetious disorder. For the most part, he argues, these are destructive labels used to protect doctors and stigmatized patients ("if I can't figure out what is wrong with you then it is all in you're head and/or you are just making it up") While I don't agree with all his points (for instance, his extreme anti-prozac position) I must say that this book is must reading for anyone in need of mental health care.

Informative, but left me wanting more4
I was very impressed with A Dose of Sanity because so many books critical of psychiatry remind me of Breggin which claim that there is something "spiritual" missing in the patient, and the author ignores the bioligical problems inherent in the behavioral or mood disorder.

However, I as I made my way through the book I was concerned that Dr. Walker was not going to address what to do if you have been diagnosed with a serious mood disorder, but were unable to find a physical cause (like a boy that was ADHD but had cardiac problems). I was right. He never said what to do if you have been diagnosed with manic depression (or any of the other hard to treat mood disorders). He did not address lithium or other non-antidepressant therapies for mood disorders. I agree that these treatments are probably only treating the symptoms of some underlying brain dysfunction that science has not yet named, but what does the patient do until science has figured this out? Remain psychotic? Lithium therapy may be some band-aid solution for a cellular dysfunction of our brain matter, but is a patient supposed to discontinue this medication because science can only offer this treatment to help the symptoms of the disorder? I wish Walker had offered an opinion and information on this issue.

Also, along the same line, he didn't say what patients should do once they had gone through exstensive medical testing to determine their problem and nothing physically wrong was found. (Nevermind the fact that he did't give specific tests to ask for - just blood and urinalysis in addition to what else?) If you know that you don't suffer from pin worms, syphillis, typhus, cardiac problems or whatever else, but your symptoms only seem to match typical manic symptoms that only lithium helps, should you throw in the towel and accept the psychotropic medication?

I do think that Dr. Walker is truly concerned about patients who have fallen victim to DSM "diagnosis", and this book could be very helpful for a patient who has received psychiatric care, but did not have a full medical work-up before taking psychotropic medications. I only wish this book had touched on the issues that I mentioned above.

Finally, the most important message of this book is never stop learning about what you have been told your disorder is, and never take the word of your doctor as law. As Walker says himself, there is no way that one doctor can know everthing about medicine.