What is the DSM and Who Cares Anyway?

By Dyanne C. Bresler, RN, LCPC

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the American Psychiatric Association (APA).  It contains descriptions of the diagnoses that may be given for “mental illness”.  The system of insurance reimbursement in our country requires that a diagnosis be submitted in order for payment to be made.  No diagnosis, no payment.

Periodically, committees formed by the APA come up with new diagnoses and they are added to the book in a new edition.  Some diagnoses become unpopular and are removed from later editions.  An example is the removal of a diagnosis for people who are attracted to members of their own sex.  It used to be a disease, and now it isn’t. 

You may have read about the newest edition of the DSM.  There’s been a great hue and cry all over the world about the added diagnoses, most of which now justify the writing of prescriptions for treatment of such things as grief so that patients can be stoned in addition to suffering from the loss of a loved one.

The American Psychiatric Association supports the medical model, which posits that “mental illness” is caused by messed-up neurotransmitters in the brain.  Medical model proponents believe that these messed-up neurotransmitters must be treated with drugs.  This is why one of every four Americans now is diagnosable with a “mental illness”, including over three million children whose exhuberance has  demonstrated to physicians all over the country that they need to sit still and be quiet with the aid of stimulant medication from the same category of drugs as cocaine. 

That no laboratory test, no blood test, no spinal fluid test, no scan of any kind has ever proved a patient has a “mental illness” has not stopped the APA from coming up with lots of new diagnoses.  There has never been any proof of just how many of any neurotransmitters our brain is supposed to have, but still, the APA has insisted that there is a shortage or an overage of them that must be medicated. 

You should consider having some grave concerns about the DSM medicalization of normal problems. The morphing of sadness/anxiety due to death, divorce, job loss, financial ruin, relationship problems or any of the other things that cause misery into a “disease” that requires drug administration is not much more than greed and very effective marketing by pharmaceutical companies.   You will not hear physicians citing the research that proves counseling is more effective than medication for mild to moderate depression.  You will not hear them remind you that exercise, sleep hygiene, good diet and good work have no side effects.

The long-term effects of psychiatric medications are grim, under-reported, cumulative and can be life threatening.  That’s why you should care about the DSM.