Not to mention nonconformity and quirkiness — the definition of mental illness changes
By Sharon Kirkey
April 27, 2010
Since 1950, man has landed on the moon, made computers commonplace and harnessed nuclear power.
We’re obviously using our minds to the fullest. Yet the number of ways we can go officially crazy has nearly tripled.
The hugely influential reference book used by psychiatrists and other mental health professionals the world over to diagnose mental illness — the Diagnostic and Statistical Manual of Mental Disorders — currently lists 357 types of psychiatric afflictions, up from 128 when the first volume was published in 1952.
The psychiatric establishment says it has learned to detect more mental illness in the population than was possible a half-century ago, and that science has advanced to the point that the broadly defined disorders of the past are now seen with much greater resolution, yielding many more specific conditions.
We’re not expanding the domain, they argue, as much as we’re refining it.
But skeptics say it is less about advances in brain science and more about psychiatry shuffling more and more behaviours and reactions to life’s letdowns into boxes of mental dysfunction and assigning them codes, and that we risk becoming so overdiagnosed and overmedicated, we’ll be like the patient in The New Yorker cartoon, who asks his psychiatrist: “Could we up the dosage? I still have feelings.”
“The unavoidable conclusion is that we’ve narrowed healthy behaviour so dramatically that our quirks and eccentricities — the normal emotional range of adolescence and adulthood — have become problems we fear and expect drugs to fix,” says Christopher Lane, author of Shyness: How Normal Behavior Became a Sickness.
It’s not enough that people sometimes want to be alone, Lane says. Solitude? According to the DSM, including its criteria for “avoidant” and “schizoid”personality disorders, that could be viewed as a sign of mild psychosis, he warns. Feeling restless, keyed up or on edge could be markers of generalized anxiety disorder, and trouble sleeping a symptom of a major depressive disorder.
The more diagnostic categories added to the DSM, the more broadly they’re defined, the bigger the market of potential new drug customers grows, says Stuart Kirk, professor of social welfare at the University of California Los Angeles School of Public Affairs. Within each revision of psychiatry’s bible, pharmaceutical companies see a “bonanza” of marketing possibilities, he says.
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