Ronald Pies, MD

While it is true that the intense grief of bereavement and major depressive disorder often share some features—for example, tearfulness, insomnia, low mood, and decreased appetite—there are many substantive differences.

The ethical aim of psychiatry is the relief of suffering and incapacity.

When critics of psychiatric diagnosis insist that terms like “schizophrenia” or “bipolar disorder” are inherently stigmatizing, they are unwittingly perpetuating the very prejudice they wish to end. It is time to shine a bright light on this self-fulfilling prophecy.

There are several reasons for taking the ketamine findings with a substantial grain of salt.

In part 1 of this essay, I argued that panic attacks are nearly always pathological and disordered states, even when they occur in an understandable context. The issue of context and its relationship to disorderness extends well beyond panic attacks: it arises in nearly all psychiatric diagnoses not explicitly defined contextually.

Because panic attacks per se appear predictive of subsequent psychopathology, one proposal for DSM-5 is to rate panic attacks as a separate dimension of pathology, across all mental disorders.

It is important for the public to understand why the DSM-5 will drop the bereavement exclusion—and equally, for clinicians to appreciate the complexities of diagnosing post-bereavement depression, under the new guidelines.

If we, as a people, continue to sacrifice genuine security for a false sense of freedom, we shall find ourselves in a nation neither secure nor free.

Is the expression “mental illness” merely a metaphor? If so, does that tell us something about the persons we identify as having a mental illness? To clinicians who deal with devastating psychiatric disorders every day—and to those afflicted with these conditions—these questions may seem like a lot of semantic nonsense.

Dr Thomas Szasz dies at 92.