These questions are complex and highly debated. After all, these illnesses are supposed to be for life. People with severe “mental” illnesses are never expected to “recover,” just to continually struggle with maintaining, or returning to, a state called “in recovery” while on psychotropic medication.
But as readers of my book or this website know, both my daughters have recovered from their severe psychiatric illnesses (schizoaffective and bipolar). (Here is the post about when my older daughter "recovered from bipolar disorder")
Although my book touches on the topic of "recovery" vs "recovered" vs "misdiagnosis," I felt I should expand on this topic here since it is so misunderstood and controversial.
We know that some women have temporary and/or partial "remission" of symptoms during pregnancy (that should tell the doctors something!). However, we are talking here about the long-term type of "remission" or "recovery" which no longer requires psychiatric intervention for the (formerly) diagnosed condition.
The DSM (“Diagnostic and Statistical Manual of Mental Disorders”) states that when a person is diagnosed with bipolar, schizophrenia, or schizoaffective, the symptoms should not be due to another medical condition.
However, when later found to be due to a medical condition -- such as a brain tumour, adrenal adenoma, Lupus, sleep disorder, or hypothyroidism -- or mostly ignored by many mainstream medical doctors -- such as a reaction to gluten or casein), it is still not a "misdiagnosis" according to many professionals!
Yep! The "psychiatric" diagnosis is never "wrong." because it is just a label for the psychiatrist to use for the emotional, cognitive, and other brain symptoms seen at that time! To the psychiatric perspective, diagnoses (labels for symptoms seen over time) can change, but they do not misdiagnose. It took me years of confusion to finally "get" this. But in "real" medicine, when an illness is diagnosed as one thing but found to be something else, we DO call that a MISdiagnosis. What gives?
The psychiatrists use DSM diagnostic codes to bill insurance. They MUST give some label - some diagnosis from the DSM for every person walking in through their door in order to bill insurance. They are not allowed to bill with medical codes.
The DSM has codes for mood and psychotic disorders due to medication reactions and medical illnesses. But “Bipolar,” “Schizoaffective,” “Schizophrenia,” “Mood Disorder-nos,” and “Psychotic Disorder-nos” are supposed to be reserved for the cases when the psychiatrist does not know the medical cause.
A medical doctor (as opposed to mental health practitioners) can avoid psychiatric labeling simply by using an ICD (medical) code for a medical illness. If unsure of the medical cause, “encephalopathy” (Any disease in which the functioning of the brain is affected by some agent or condition), can be used. Or, a diagnosis can be made (depending on symptoms) based on the area of the brain affected, such as “hypothalamic dysfunction.” (For more on this, see: ICD-10 vs DSM-V.)
In my younger daughter's case, the psychiatrist simply stated, after she had stopped having symptoms of schizophrenia while being treated for medical conditions, that if after 5 years she still no longer had symptoms she just "would no longer have schizoaffective."
Others beg to differ. We feel the psychiatric profession should acknowledge these were MISdiagnoses. To the people labeled as bipolar and schizophrenic on medications for years for a "psychiatric" diagnosis caused by treatable medical conditions, it sure feels like misdiagnoses!
Even more controversial, is when the biomedical treatment that eliminates the symptoms is treating a cause that is not documented by an ICD (medical) code (such as by eliminating gluten and dairy, raising thyroid levels, and/or taking nutritional supplements). Here are some differing views:
- If the treatment is not recognized as the true remedy of the symptoms, then the illness is merely considered to be “in remission” but oddly, without medications. However, there is the view that all people with a “mental illness” should be on medication (even if they no longer have symptoms because "once you have a mental illness", they say, "you always have a mental illness").
- If it is stipulated that a psychiatric illness is one which can ONLY be treated with psychiatric medications, but biomedical treatment works for the person, then it wasn’t really a psychiatric illness.
- If we accept that these “mental” illnesses CAN be treated with biomedical approaches, it would have to be accepted that autoimmune reactions, food sensitivites, hormonal imbalances, need for micronutrient supplementation, sleep disorders, etc. can be medical causes of major psychiatric illnesses. However, since the symptoms can still return if the treatment stops, the person really does have bipolar disorder, schizophrenia, or schizoaffective disorder. In this case, the person is considered to still be in treatment. (However, accepting a medical cause should negate the psychiatric diagnosis to begin with).
Comments, as always, are welcome.
Note, that there are people who seem to have healed from these disorders, and talk about it in terms of spiritual journeys to wellness. Some call it using a "life model" approach rather than a "medical model." That is best saved for other bloggers. Here is one such interesting location for such discussions: Recovery from "schizophrenia" and other "psychotic disorders"
Besides our book, please let me know about other books about people who had been diagnosed with bipolar, schizoaffective, or schizophrenia who are no longer symptomatic. I’ve included some below, along with books by physicians helping with recovery.
And for the non-medical, psycho-emotional theme: Here is one book (memoir) by Lia Govers, who recovered from emotionally-driven delusions, also labeled as schizophrenia.
All these different illnesses. . . all being called "bipolar" and "schizophrenia." No wonder we can't seem to come to any agreement on cause, let alone treatment.
- Recovered - No Longer on Psychiatric Medications
- Bipolar and Off Meds - Part1
- Bipolar and Off Meds - Part2
- Recovered from Childhood-onset Bipolar / Schizophrenia (Schizoaffective) - Doctor's Perspective
- The Doctor Went Dumpster-Diving
- Asking the Right Doctor the Right Question
- Psychiatrist vs Endocrinologist: Who is Responsible?
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Last Updated: 10 August 2012