Dr. David Rettew is a child and adolescent psychiatrist and is the current medical director of Lane County Behavioral Health in Eugene, Oregon. He was previously an associate professor at the University of Vermont Larner College of Medicine. He has been in practice for nearly 20 years, dividing his time between clinical, teaching, public policy, and research activities. Dr. Rettew has published over 100 journal articles, chapters, and scientific abstracts on a variety of child mental health topics, including the 2013 book Child Temperament: New Thinking About the Boundary Between Traits and Illness and Parenting Made Complicated: What Science Really Knows about the Greatest Debates of Early Childhood. He writes a blog for Psychology Today called "The ABCs of Child Psychiatry." You can also follow him on Twitter and Facebook @PediPsych.
In this episode, Dr. Rettew and I discuss the over- and under-diagnosing of psychiatric disorders, whether the mental health field is over-pathologizing regular human traits, and how biological research like genetic and brain imaging studies can help us distinguish between a trait and a psychiatric illness.
For more information on Dr. Rettew, follow him @pedipysch and make sure to check out some of his books and Psychology Today blog. Follow me @joshkorac on TikTok, Instagram, and YouTube for video clips, podcast previews, and more mental health content! If you are in a mental health crisis, please call 988 or go to your nearest emergency room. If you are from Colorado and are interested in scheduling a session, please reach out at sojourncounselingco.com/josh or josh@sojourncounselingco.com.
Takeaways
Mental health exists on a spectrum, and there is a dimensionality to impairment.
Personality profiles may capture psychiatric disorders more accurately than single dimensions.
Embracing dimensionality helps destigmatize mental health and encourages holistic approaches to well-being.
The field of psychiatry has moved beyond a solely medication-focused approach and recognizes the limitations and mistakes of the past.
Chapters
00:00 Introduction and Background
02:54 The Importance of Diagnosis in Mental Health
04:58 The Stigma of Diagnosis
07:20 The Continuum of Mental Health
08:48 The Arbitrary Nature of Diagnoses
11:00 The Threshold for Diagnoses
14:12 The Influence of Social Media on Diagnoses
18:28 The Role of Insurance in Overdiagnosing
20:48 The Holistic Approach to Mental Health
24:19 Differentiating Between Personality Traits and Psychiatric Symptoms
29:34 The Limitations of Medication in Mental Health Treatment
36:33 The Complexity of Mental Health Assessment
42:21 Dimensionality of Impairment
44:15 Personality Disorders
46:05 Five Major Personality Traits
47:34 Personality Disorders and Psychiatric Disorders
48:56 Embracing Dimensionality
51:13 Appreciating All Aspects of Ourselves
52:12 Moving Beyond Medication