During nearly two decades in practice, I have seen diagnosis fads come and go, both in mainstream medicine and in alternative medicine. I first encountered the phenomenon early on, when my office was located in Kent. Periodically, without warning, I would have a series of patients come in telling me that they had been diagnosed with XYZ disorder.
Being a fairly competent diagnostician myself, I was having trouble understanding how they had been diagnosed with XYZ, particularly in the absence of any appropriate lab testing or radiological studies. But, being the new guy in town, I was a little reticent to just flat-out say “your other doctor is wrong,” so I would just dance around the issue of nomenclature and instead discuss the dysfunctional processes they were experiencing. Which was fine, as that’s how I like to explain things to my patients anyway.
It wasn’t until after a few years that I discovered that these new diagnoses would appear soon after one of the other local doctors was “detailed” by a visiting salesman (“detailing” is the term used by drug and supplement company representatives when they visit a doctor personally, encouraging them to use/prescribe a certain product). Whatever the product of the month was, that’s how the diagnoses tended to go.
“Sometimes,” one of my professors once said, “you have one of those days when everything looks like a gall bladder.” I guess that other doctor had a lot of those days.
The problem is, there is a lot of money to be made through overdiagnosis, particularly for the pharmaceutical companies. Medical doctors also get their piece of the pie from overdiagnosis as well; many MDs make thousands of dollars in “consulting fees” from drug companies, and not surprisingly, the big prescribers get the big bucks.
There are several allegedly common diseases which are overdiagnosed, and these wrong diagnoses hurt the patient in two ways; not only are they exposed to the dangers of the drug therapy itself, they are also denied the proper treatment for what is truly ailing them.
The most common mythical diseases are the following:
1. ADHD. I hate this diagnosis, because its potential for severe, long-term damage. It is also a gender-driven disease; just like women experiencing the symptoms of everything from heart attacks to asthma are told that “it’s your hormones,” boys and young men engaging in normal, gender-appropriate behavior are often told that they have ADHD — and then the life is drugged right out of them. It is a self-serving diagnosis made by teachers and parents frustrated by a child’s highly physical engagement with their world, and fulfilled by medical doctors too uncaring to investigate other possible causes — or even determine if their is any aberrant behavior in the first place.
My advice to anyone with an ADHD diagnosis or a child with one: Get a competent, thorough examination by a psychologist or social worker with expertise in pediatrics. Do not rely on diagnosis by education system or MD; they simply are not adequately trained to parse out the situation.
2. Depression. I wish I had a nickel for every person who walked into my office taking SSRI drugs for no good reason at all except that their PCP, after a 5-minute consult, determined that they had depression. There’s a reason why SSRIs are among the most prescribed drugs around, but it’s not because people are depressed (it’s also not because SSRIs are particularly effective medications for depression. Multiple large-scale studies have found that most SSRIs are only slightly more effective than placebo). It’s because SSRIs make a lot of money for drug companies and are an easy sell. They are the quintessential happy pills.
In my office, I have treated people with depression by normalizing their digestion, eliminating chronic GI infections, by eliminating long-term health problems which hobbled my patients’ activities, by teaching them and helping them to make wiser lifestyle choices. I often – gasp – send people with depression to see a social worker or other mental health specialist, as research continues to show that non-pharmaceutical approaches to depression remain the best.
And, I might add, sometimes depression is a normal response. The loss of a job, spouse, dog; abusive relationships and economic woes; someone experiencing any of these migh quite rightly experience depression. People in this situation don’t need a drug. They need a friendly face, a warm hand on their shoulder, companionship and good food. Therapy and assistance with changing their environment are far more useful here.
3. High Cholesterol. High cholesterol isn’t a disease. It represents absolutely no pathological process going on in the body. The only thing high cholesterol may be is a marker for increased risk of heart disease. Increasingly, the research is showing that the cholesterol model of heart disease is wrong, but since Lipitor and its cousins have been the biggest moneymakers in history, this paradigm won’t be overturned until about the same time the patent on the statin drugs run out. In the meantime, if you are looking to prevent heart disease, look everywhere except your cholesterol numbers, because they don’t mean a thing.
4. Fibromyalgia. This disorder has always been a wastebasket diagnosis, and today it is simply a means of selling bottles of re-purposed antidepressants (Cymbalta and Effexor are the most popular drugs for “treating” fibromyalgia). High-powered anticonvulsants, also sold under a consumer-friendly label (who wouldn’t want a dose of the poetically-named Lyrica?) is another popular drug for treating this problem.
The problem is that fibromyalgia is actually 4 different disorders, each of which presents with the same symptoms, but which have different causes and therefore should have different treatment strategies. Did you know that whiplash is one of the most common causes of fibromyalgia? Call me a silly ol’ chiropractor, but somehow I don’t think an antidepressant is the right treatment for whiplash injury, do you?
5. Otitis media. (aka ear infection). A lot of things can cause redness and tenderness in the ears of young children (including things like trying to stick forks in them), but show a pediatrician a red ear and they’ll be writing out a script for antibiotics before you can say MRSA. On top of which, even when the cause is infectious, it is most likely to be a virus, and viruses are utterly unscathed by antibiotics. Tell that to your pediatrician, and he will counter that the antibiotics will “prevent secondary bacterial infection.” You can tell him that it’s not true, because it isn’t. Research does not support the routine use of antibiotics for middle ear infections.
What your pediatrician will probably forget to tell you is that research does show that chiropractic manipulation is an effective treatment for otitis media. So, skip the MD, and go straight to the DC. Might as well get treatment that works, right?
So that’s five out of 10. The next five are the real doozies.