It was a challenge to get the label rip started Saturday.

So many "psychiatric survivors" were milling around outside the Convention Center that it was hard to get them to pick one of the big cards printed with names of mental illnesses.

"Who wants a psychotic one?" yelled Faith Rhyne, a North Carolina woman who belongs to MindFreedom International, an Oregon-based group that helped organize the protest outside the annual meeting of the American Psychiatric Association. "Who wants obsessive-compulsive?"

David Oaks, MindFreedom's executive director, chimed in, "I've got a depressive!"

"ADHD?" someone yelled. "Anybody have a hard time paying attention?"

Oaks then tried mightily to get the group to form a neat line that would rip the cards in a wave, with people adding pithy explanations of their displeasure as they tore. That broke down about midway through, but not before one young woman said, "You nearly cost me my life, my education, and the day I stop apologizing is right now."

The group, which numbered about 200 at its peak, planned to protest all afternoon as 10,000 psychiatrists inside discussed everything from sleep problems to addiction to narcissistic personality disorder. One focus of the five-day meeting is proposed changes to the Diagnostic and Statistical Manual of Mental Disorders, or DSM, the book that classifies mental illnesses and the labels the protesters loathe. A new edition, the DSM-5 is due out next year. Critics contend that the new book will expand definitions of mental illnesses to include more people, exposing more to potentially dangerous psychiatric medications.

Oaks said the doctors need to do a better job of listening to patients, who often prefer psychosocial support to medicines. "Nothing about us without us," he said.

Joseph Rogers, a longtime Philadelphia activist who is a veteran of several APA protests, said he would like to see more emphasis on individualized holistic treatment and less on finding names for what's wrong. "Those labels, all they do is stigmatize the person," said Rogers, chief advocacy officer for the National Mental Health Consumers' Self-Help Clearinghouse. "They lock them in. They begin to think of themselves as a mental patient with a label."

Rogers, who takes medication for bipolar disorder, said psychiatrists had let the pharmaceutical industry drive their profession.

As he spoke, workers were building ultramodern booths for drug companies at the back and sides of the meeting's main exhibit hall.

During a news conference earlier, the association's president, John Oldham, said one problem for psychiatry was that drug companies had largely stopped developing new drugs for mental illnesses. "That's a big concern we have," he said.

Oldham, vice chair of psychiatry and behavioral sciences at Baylor College of Medicine, said the protesters were wrong to think psychiatrists are turning away from talk therapy in favor of medications. A psychoanalyst himself, he specializes in borderline personality disorder, for which the top treatment is therapy. While medications for other disorders have troubling side effects, he said, they also save lives.

Contact Stacey Burling at 215-854 4944 or