I think it's kind of categorical to say that there are no psychiatric disorders. But, I'm also skeptical about how and why quite a few are diagnosed. For example, huge numbers of people in recent years have been diagnosed with bipolar disorder (manic depression) as a lifelong, chronic illness, and have been prescribed various drugs for it. Given that the diagnosis process is a checklist rather than a blood sample or an MRI, and it then effectively sentences someone to a lifetime of taking the drugs, I am a bit skeptical and suspect that the disorder is being overdiagnosed.
Diagnoses of temporary, situational depression, I'm a much less skeptical about. Medication can help smooth things over while while the person works to improve the areas of their life that are depressing them.
The diagnosis of bipolar depressive disorder is very difficult and the problem as I see it is the number of general physicians who make the diagnosis. The checklist should always be viewed as what it is, a diagnostic and statistical tool that a physician uses to determine an appropriate label that then leads to succesful treatment.
There are a number of issues in the over diagnosis of bipolar disorder:
a. Hospitals do not recieve reimbursment for treating those with substance induced disorders, so while the correct diagnosis would be 'some condition induced by a substance', you would loose meoney for treating individuals who are at substantial risk of harming themselves or others.
(And as a side bar, it is very hard to get into the hospital in the first place.)
b. The prevalence of individuals who use alcohol, methamphetamine and cocaine. All substances can aggravtae people's lives and give them secondary features of a mental illness. A lack of co-occurrent substance abuse treatment is very detrimental, and the place where GP's often fail.
c. Lack of in depth assessment, most psyciatrists take a short time to do an assesment, 45 mins. to an hour. Something that GP's rarely have time for. There are a lot of people who have post traumatic stress, but you won't find that in a fiveteen minute interview. It usualy takes a lot of time, at least an hour , to get people to trust you enough to discuss trauma. So many people wh9o are diagnosed with bipolar disorder are actualy living with PTSD.
d. The eleventh hour syndrome, people, especialy those looking for help with thier children, almost never get help when the horse is just sticking thier head out the barn door, they usualy get help only after the horse has run away and the barn has burned down. this makea accurate assessment very difficult.
e. Denial: it is such a strong mechanism that iot intereferes in all human interactions, A just interview involves asking the person many clarifing issues, take the last flavor of the month, attention deficit hyperactive disorder', you have to ask the person alot of specific behavioral questions to get a good assessment.A child in school may be harrassed, have a parent beating the crap out of them or a learning disability and they are reffered for 'find out if they have ADHD', it helps to know how the child behaves in all enviroments before making the diagnosis.
f. The 'identified client' syndrome, very often the person seeking treatment is not the one with the actual problem.
Now, there are many bad psychiatrists who just perscribe the crap out of thier favorite meds, and if thier favorite med is a bipolar medication, then off they go.