Psychiatrically Diagnosing Societal Ills...

Work in progress, satire driven by adaptive humor…

Grant H Brenner

--

Grant H Brenner

As a Psychiatrist, I’m trained in the use of the DSM (Diagnostic and Statistical Manual) to classify mental illnesses.

War, poverty, lack of education, intergenerational trauma, high childhood adversity within certain subgroups, and related factors are largely social problems.

Labeling them exclusively as individual diseases misses the mark because the interventions required to treat and prevent them are not only on the individual level, but require intervention for prevention and treatment with smaller groups (like families and schools) and on broad levels, with changes in policy and resource allocation.

With the exception of Post Traumatic Stress Disorder (PTSD), Prolonged Grief Disorder (PGD) and stress-related reactions, by and large none of the diagnostic criteria include an external cause of the disorder. PTSD requires a traumatic event to have occurred, but Major Depressive Disorder and Generalized Anxiety Disorder do not mention life events as causal factors. Of course, clinicians understand that these conditions are precipitated by factors which include life events, and treat accordingly.

At the same time, there are strong biological factors which are individual, increasing the risk of depression (for example) showing up for any given person whereas for another person under similar circumstances they would not develop depression. Protective factors such as resilience play a role in mitigating who develops clinically-significant reactions and who does not. Some illnesses are considered completely innate, without any significant environmental contribution to the cause.

However, the role of external factors is so powerful that when large groups of people under similar conditions experience the same or similar problems, it stands out like a sore thumb. The way we think about these external factors is lumped under the term “Social Determinants of Health”, or the more fancy “Exposomal Factors” (anything which is not strictly biological).

Given the the fact that these conditions 1) have a strong social component and 2) affect large proportions of the populations — and in the face of chronic and escalating…

--

--

Grant H Brenner

Psychiatrist, Psychoanalyst, Entrepreneur, Writer, Speaker, Disaster Responder, Advocate, Photographer