Our current approach to mental health labelling and diagnosis has brought benefits. But as a practising doctor, I am concerned that it may be doing more harm than good
Someone is shot, and almost dies; the fragility of life is intimately revealed to him. He goes on to have flashbacks of the event, finds that he can no longer relax or enjoy himself. He is agitated and restless. His relationships suffer, then wither; he is progressively disturbed by intrusive memories of the event.
This could be read as a description of many patients I’ve seen in clinic and in the emergency room over the years in my work as a doctor: it’s recognisably someone suffering what has in recent decades been called PTSD, or post-traumatic stress disorder. But it isn’t one of my patients. It’s a description of a character in the 7,000-year-old Indian epic The Ramayana; Indian psychiatrist Hitesh Sheth uses it as an example of the timelessness of certain states of mind. Other ancient epics describe textbook cases of what we now call “generalised anxiety disorder”, which is characterised by excessive fear and rumination, loss of focus, and inability to sleep. Yet others describe what sounds like suicidal depression, or devastating substance addiction.
The great topmost sheet of the mass, that where hardly a light had twinkled or moved, becomes now a sparkling field of rhythmic flashing points with trains of travelling sparks hurrying hither and thither. The brain is waking and with it the mind is returning … Swiftly the head mass becomes an enchanted loom where millions of flashing shuttles weave a dissolving pattern, always a meaningful pattern though never an abiding one.
