Is The New DSM V Going to Help or Hurt The Mental Health Community?

Kristi - posted on 04/13/2013 ( 4 moms have responded )

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As some of you may or may not know from my participation in other threads, I have suffered from some hardcore mental illness starting around age 15. I am going to be 42 next month. Some years were worse than others, just like with most chronic problems. I've always been ashamed and embarrassed by the stigma. People hear "mental illness" or "borderline personality disorder" and they cringe with all sorts of fear, pity, confusion, repulsion, concern...my credibility goes out the window. I'm literally crazy so my thoughts can't be logical or reasonable, right?



So, when I hear so many "powerful" people talking about the need for better mental health care and movie stars and famous people coming forward to help erase the stigma attached to mental illness, I get pretty stoked. I think, finally...we might not be treated like a black people were in the 40's, before and after.



I happened upon this article tonight about the new DSM...the bible for diagnosing mental health problems. "Abnormal is the New Normal" Hmmmm. Paragraph 1:



http://www.slate.com/articles/health_and...



"Beware the DSM-5, the soon-to-be-released fifth edition of the “psychiatric bible,” the Diagnostic and Statistical Manual. The odds will probably be greater than 50 percent, according to the new manual, that you’ll have a mental disorder in your lifetime."



Not quite the result I was hoping for. Why, now, is more than 50% of the American population going to be mentally ill? The answer seems to be three fold. The more I read, however, the answer, to me, appeared to be purely financial, under the guise of beating the insurance companies at their own game and labeling behaviors for what they really are.



1. "First, we’ve gotten better at detecting mental illness and doing so earlier in the course of the illness. But the increased awareness and detection translates into a higher rate of mental illness."



2. "Second, we really are getting “sicker.” More of us are mentally ill than in previous generations, and our mental illness is manifesting at earlier points in our lives."



3. "Here’s a third explanation for the increased prevalence of mental illness, one that implies something important about our culture: What was once considered psychological healthy (or at least not unhealthy) is now considered to be mental illness. Some of the behaviors, thoughts, and feelings that were within the then-normal range of human experience are now deemed to be in the pathological part of the continuum. Thus, the actual definition of mental illness has broadened, creating a bigger tent with more people under it. This explanation implies that we, as a culture, are more willing to see mental illness in ourselves and in others."



It's a vicious circle...can't get help without a definite diagnosis, can't give a diagnosis unless you meet certain criteria, can't get coverage for prescriptions without a diagnosis. So let's make it easier to get a diagnosis. Ok, great...now, caffeine addiction is a mental illness if you meet the criteria. "Our" reputation was bad enough as it was. Now, when someone says they have a mental health issue, it's going to be like, "Yah, so does my dog, get over it." Someone on disability because their mental illness has incapacitated them (like me), is now going to be treated like all the "leeches on welfare." (I don't mean that...there are some but that is not MY pov. But it is a common one in society) I can hardly wait until the first not guilty by reason of mental disease or defect due to caffeine addiction verdict comes back!



I'm really interested in hearing your opinions/arguments. Obviously, this is a little personal for me so my objectivity may be compromised. Thanks!

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Mommy - posted on 04/23/2013

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I am a mental health professional, and the new version of the DSM will only help mental health. There are diagnoses that are being removed, as they were found to be either irrelevant or lacking scientific evidence, and there will be new disorders added to reflect changes in the mental health field. Of course nothing is right all the time, which is why it is continuously revised. I don't believe the DSM will make it so more people are diagnosed with a disorder, because truthfully I don't go out and troll for clients. If someone is having and issue they come to my office, I assess them, and determine if they need treatment and for what. Good professionals will use this revised edition as a tool to help their clients, but unfortunately there will always be people who abuse the system.

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I think that the DSM is never going to be perfect and there will always be people who should be diagnosed but aren't and those who shouldn't be but are. It's a balancing act.

Kristi - posted on 04/14/2013

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Exactly, it's kind of a damned if you do/damned if you don't. It's just so frustrating. It reminds me of Affirmative Action. There was a time, a place and a need but then it got way out of control and it was like no young, educated, white male could get a job.

It just makes me cry. Because "we" did need the research and better guidelines, etc. It was so hard for me, for so long. Even after they finally got my diagnosis, finding treatment that was remotely successful was painstaking and often fruitless. I know my case is not unique and not by any means, the worst. I know, despite the new lax criteria, many people will still go undiagnosed or misdiagnosed only to suffer in silence.

As you pointed out, if anyone rises or falls above a certain level of emotion they get medicated...you're depressed, you're bipolar, you're ADD/ADHD...well, yes, some people truly are and they need and deserve the best care and treatment available for their situation and some people do suffer from bouts of depression that medication and talk therapy can help them get through but NOT everybody who cries is depressed. Not every kid that can run straight through recess and still be excited has ADHD.

So now what? (totally rhetorical) : (

Denikka - posted on 04/13/2013

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I have been saying for years that many of the supposedly *minor mental illnesses* have been severely overdiagnosed. Things like depression and ADD/ADHD are top of the list.

Many times I have heard of people getting diagnosed with depression and taking medication for it because they feel a bit down. Some of these people I've actually talked to about how they feel and many times it's very mild *I feel sad because my family member or pet died/things are kinda difficult in my life/ etc* I suffer from depression. It's so much more than just feeling a bit sad. Especially so much more than feeling sad about a situation that would make anyone sad.
Same with ADD/ADHD diagnosis. Any kid who fidgets or stares out the window in class is labeled at the least and medicated at the worst.

I completely agree with you that it's become a *whatever* thing when someone who truly suffers from those kinds of problems says anything about it, because it's so over used by people with such minor problems (if any problems at all).

I do think that science has advanced that it is getting easier to diagnose problems earlier. And that's a great thing. But I also think that people are almost desperate to have something wrong with them so they have an excuse. I can't count how many times a parent (or a teacher or the child themselves) has excused their child's bad behavior because they have ADD/ADHD and just *can't help it*. I don't mean being fidgety or whatever, I mean really bad behaviors.

I'm not so sure about more people actually being sick with mental illnesses. It just seems to me that the standards to be diagnosed are just becoming more slack in many ways (I'm sad cause my dog died, I now have depression and need medication--my kid fidgets in class, he has ADD/ADHD and needs to be medicated) and there are many more things to be diagnosed with (addictions specifically seem to have jumped drastically. Shopping addictions, online addictions, caffeine addictions, etc. That's along with all the other assorted mental illnesses out there).
I don't know where this whole thing is going, but it doesn't seem to be anywhere positive, for those with real mental illnesses that debilitate them, or for those who are on the most minor side of the mental illness spectrum (if on it at all) who now use their diagnosis as an excuse.

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