Tag Archives: Diagnostic and Statistical Manual

Psychiatry’s Diagnosis Manual Under Fire – will feed culture of overdrugging/overdiagnosing

The “bible” of American psychiatry – a manual of mental health used around the world by doctors, consumers and insurance providers – has come under fire from a growing group of psychologists who worry that proposed revisions will feed into a culture of overdiagnosing, and overtreating, otherwise healthy people.

The Diagnostic and Statistical Manual of Mental Disorders, or the DSM, is undergoing its fifth major revision in the more than 60 years since it was first published by the American Psychiatric Association. The last update was in 1994, and the new manual is expected to be released in spring 2013.

How PTSD took over America

The suffering is very real. We’re not saying that people don’t have difficult emotional experiences and aren’t suffering. What we’re saying is this is not necessarily a disorder that people are experiencing, and if people think like that, it can be very disempowering to them. When we think of ourselves as suffering from a disorder in a medical sense, well we go to the doctor and we expect the doctor to prescribe whatever the medical treatment is. We’re not in the driver’s seat. We go along – we tell them [our] symptoms, they listen to us, they diagnose what the problem is, and then they work out what the appropriate treatment is. That’s the mind-set when we’re working within a medical framework and we think of ourselves as suffering from a disorder. We sit down in front of the therapist and we expect the therapist to be like a doctor – to be looking out for what the symptoms are so that they can make the correct diagnosis and prescribe us the right treatment. The language of PTSD invokes those ideas, and I think it’s those ideas that can be quite unhelpful at times. For what we’re talking about here, if it’s a normal, natural process, what’s really important is for the person to be in the driver’s seat for themselves – to make their own choices, their own decisions, because we’re dealing not with a disorder, but a battle within the person to find new meanings and new ways of understanding the world. That’s what they have to do. Nobody else can do that for them.

Mental illness redefined

The American Psychiatry Association is now in the middle of a historic and controversial revision of its bible. The fifth and highly anticipated edition, DSM-5, has sparked dissension among psychiatrists and generated more than 8,000 public comments on topics ranging from sexual- and gender-identity issues and anxiety disorders to mind-body problems.

Critics say some of the new entries broadly extend some definitions of mental illness and lower thresholds for some existing disorders, which will result in higher rates of diagnoses. That, they argue, “could result in massive overtreatment with medications that are unnecessary, expensive and often quite harmful,” Dr. Allen Frances, chairman of the DSM,-IV task force, wrote in the Psychiatric Times.

Are you shy? Then you have a mental disorder

Even in these overly medicalised times, where feeling well is increasingly confused with awaiting diagnosis, the idea that well over a third of Europe is suffering from a mental disorder just doesn’t tally with our actual lived experience. After all, does it not seem absurd to think that one in every three Europeans is mentally ill? As many have observed before, absurdity abounds in the psychiatric worldview. The most banal of everyday behaviours, emotional states that I’d wager almost everyone has encountered at some point in their lives, have been given technical, medical-sounding names. So shyness becomes ‘avoidant personality disorder’; anger becomes ‘intermittent explosive disorder’; and if the experts get their way, not throwing stuff away will become ‘hoarding disorder’. In an incredible bit of insightless prose, we are told by DSM’s recent consultation document that, ‘The symptoms [of hoarding disorder] result in the accumulation of a large number of possessions that fill up and clutter active living areas of the home or workplace to the extent that their intended use is no longer possible’.

Psychopharmaceutical industry seeks world of dispassionate sheeple

People who obediently follow the herd, never markedly sad, angry or excited; children who play quietly and never annoy or talk out of turn – this is the object of the psychiatric/pharmaceutical industries. And when anyone steps out of line, the answer is simple: stamp them “abnormal” and give them a pill.

Human sorrow could soon be more easily diagnosed and medicated as a mental disorder. Psychiatrists creating the next edition of the psychiatric bible – the Diagnostic Statistical Manual (DSM-5, due out in 2013) – are recommending to eliminate the time clause for major depressive disorder. So instead of grieving for two months to qualify, if you mourn the loss of a loved one for only two weeks doctors could label you mentally ill and prescribe a drug.