Movement on Depression Diagnoses

[Skip Miller]

A NY Times article today indicated that the Psychiatric community is becoming aware of the fallacy of symptom-checklist diagnoses. Ultimately this is good news for us all.

“Larger and larger numbers of people are reporting symptoms on these checklists, and there’s no way to know whether we’re finding normal sadness responses or real depression,” said Jerome C. Wakefield, a professor of social work at New York University and the study’s lead author. "

-Skip

 

[KennyFlys]

The marketing blitz by pharmaceutical companies account for much of the self-diagnosing phenomena.

 

[skyflyer8]

My ground school students asked me what the number one reason for denial of a medical certificate is. I didn't know, so I asked my AME. He said depression. I don't know if that is just in his experience or nationwide.

Dr. Bruce, any insight?

 

[Skip Miller]

My ground school students asked me what the number one reason for denial of a medical certificate is. I didn't know, so I asked my AME. He said depression. I don't know if that is just in his experience or nationwide.

I'm willing to bet it is for taking depression-related drugs (SSRIs) not depression itself.

-Skip

 

[KennyFlys]

I'm willing to bet it is for taking depression-related drugs (SSRIs) not depression itself.

-Skip

The way Ritalin and similar drugs are doled out at the insistence of our great government schools, I have to wonder how many show up at the AME and list this as meds having been taken in recent years if not still current.

 

[bbchien]

My ground school students asked me what the number one reason for denial of a medical certificate is. I didn't know, so I asked my AME. He said depression. I don't know if that is just in his experience or nationwide.

Dr. Bruce, any insight?

The number one is the presence of SSRIs and the underlying illnesses that might or might not be there.

The ability of the doc community to actually subtype depressive symptoms into the sub-groups that will predict relapse or which don't, is poor, so the airmen end up on them because there was "depressive symptomatology". But which ones?

The SECOND most common cause is Ritalin and Strattera, also "diagnosed" with lousy precision by school personnel, aceeded to by the docs in a 6 minute visit, and agreed to by the parents who in the end obtain the pills.

The THIRD most common cause is Sleep Apnea,
The Fourth is Cardiovascular disease/diabetes. In my opinion (and just opinion) these can be lumped into a category "consequences of obesity".

This was taken from my 118 medicals last year (of all classes) of which only a handful were normal, healthy medicals.

I only had one deferral, because we would do our homework BEFORE the visit. Airmen do not take their denials lying down. At least not the ones that come to my place.....

 

[ScottM]

As you know my mother recently passed away. Needless to say I have been "depressed". I also am in the middle of renewing my FAA physical and the first step is a visit to my internist to make sure all is well before heading to the FAA. As we updating my history we talked about my mom's death. My doc, who I like and respect a lot, started asking several questions that made me realize she was leading me to a diagnosis of depression. I stopped her when she asked me if 'I wanted anything to help me through it'. Oh NO! I know what that does to my flight physical and I know that what I am going through is normal sadness. It just seems to me that most people are looking to avoid feeling anything but 'normal' and that is part of the problem too.

 

[bbchien]

As you know my mother recently passed away......I know that what I am going through is normal sadness. It just seems to me that most people are looking to avoid feeling anything but 'normal' and that is part of the problem too.

Boy is that spot on....

 

[ApacheBob]

It bums me out just to read this.

 

[jhempel]

It just seems to me that most people are looking to avoid feeling anything but 'normal' and that is part of the problem too.

You are exactly right. Of course, "normal" includes bad times too. How we deal with it defines the person.

 

[Chache]

Added to this, are the psychological screening questionaires that state:

"What would you say was the frequency you drank, when you last drank ?

a) three drinks/day
b) five drinks/day
c) ten or more drinks/day"

And...

When you last drank, you blacked out for:

a) a few minutes
b) an hour
c) a day or more

No opportunity to say I don't drink.
I've never blacked out!

The screening process for the Veterans Admin, has a psych student, administer these questionaires over the phone. They were instructed to accept only answers from the questionaire, and not to make subjective/objective decisions.

Therefore a glass of fine wine, with dinner, tags you as an alcoholic, if you try to answer their questions truthfully.

I refused to continue the screening! What crap! Questions like these shouldn't be in a screening process... when the first question is

"Have you had an alcoholic drink in the past year?"

Oh yes let me see now, There was the wedding in Jan., where I toasted the couple with a sip of Champagne,
The Beer I had at the BarBQue in July,
and the glass of "apple cider" I had in October.

So the question "When you last drank" is IMHO BS!