Quotes from Allen Frances

Time heals so well because many of our ills are short-term, situational, and self-limited - our bodies and our minds are programmed to be resilient without any active effort on our part.

ADHD is spreading like wildfire. It used to be confined to a small percentage of kids who had clear-cut problems that started at a very early age and caused them unmistakable difficulties in many situations. Then all manner of classroom disruption was medicalized and ADHD was applied so promiscuously that an amazing 10 percent of kids now qualify.

DSM definitions do not include personal and contextual factors such as whether the depressive symptoms are an understandable response to loss, a terrible life situation, psychological conflict or personality factors.

It is equally dangerous at either extreme - to have either an expanding concept of mental disorder that eliminates normal or to have an expanding concept of normal that eliminates mental disorder.

Patienthood can become a way of life and rationale for people who are struggling for other reasons.

The DSMs have a mixed record. They have served an extremely valuable function in improving the reliability of psychiatric diagnosis and in encouraging a revolution in psychiatric research. But they have also had the very harmful unintended consequence of triggering and helping to maintain a runaway diagnostic inflation that threatens normal and results in massive overtreatment with psychiatric medication.

we neglect what are the best forms of prevention—i.e., promoting exercise, proper diet, moderation in alcohol use, abstention from tobacco and drugs. These extremely useful and remarkably cheap prevention measures aren't profitable for the medical-industrial complex and therefore lack its powerful and well-financed sponsorship.

We should not have the ambition to label as mental disorder every inconvenient or distressing aspect of childhood.

A ranting psychotic is far enough away from mean to be recognized as mentally sick by your aunt Tilly, but how do you decide when everyday anxiety or sadness is severe enough to be considered mental disorder? One thing does seem perfectly clear. On the statistical face of it, it is ridiculous to stretch disorder so elastically that the near average person can qualify. Shouldn't most people be normal?

D]iagnosis needed to rest in order to let research catch up. It made no sense to keep rearranging the furniture of descriptive psychiatry, creating new diagnoses or altering the thresholds of existing ones, based only on the whims of the experts who happened to be in the room. [...] Changes in diagnoses should be few and far between until we gained much deeper understanding of what causes the mental disorders and how best to define and treat them.

T]he DSM alone does not establish standards. Physicians, other mental health workers, drug companies, advocacy groups, school systems, the courts, the Internet, and cable TV all get to vote on how the written word will actually be used and misused.

3. Paul Enright, "A Homeopathic Remedy for Early COPD," Respiratory Medicine 105 (2011): 1573–75.

Nature abhors homogeneity and simply adores eccentric diversity.

We don't have to fully perceive or understand the underlying nature of our world to negotiate it well. Our senses and reasoning powers evolved as they did because they work just fine in the everyday, nonphilosophical business of survival. Mental constructs of reality are imperfect, but indispensable, ways to organize the otherwise bewildering phenomena of the world.

Our classification of mental disorders is no more than a collection of fallible and limited constructs that seeks but never finds the truth - but this remains our best current way of communicating about, treating, and researching mental disorders. [...] It is good to know and use the DSM definitions, but not to reify or worship them.

There is no definition of a mental disorder. It's bullshit. I mean, you just can't define it.

Psychiatric disorder consists of symptoms and behaviors that are not self-correcting - a breakdown in the normal homeostatic healing process. Diagnostic inflation occurs when we confuse the typical perturbations that are part of everyone's life with true psychiatric disorder[.]

Labels can also create self-fulfilling prophecies. If you are told you are sick, you feel and act sick, and others treat you as if you are sick.