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Dissecting the DSM


The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the book therapists use to determine a diagnosis. Published by the American Psychiatric Association (APA), it lists the criteria for each disorder and gives a numeric code to signify each diagnosis (these are the codes used for billing your health insurance). As you may expect, level of understanding and knowledge changes over time in the mental health field and, therefore, the DSM has been published four times. The current version, the DSM-IV, was published in 1994 (though there was a minor text revision in 2000). The fifth version is due to be published in May 2013, after much anticipation. The very first DSM was published in 1952. Of course, there are many changes made in each revision, some of which are positive changes. For example, many years ago, homosexuality was listed in the DSM and was considered a mental disorder until the mental health field developed better understanding of sexuality and removed it. However, negative changes are being proposed for the upcoming DSM that many therapists, including myself, are concerned about. Part of the process of publishing a new DSM is making the proposed changes available to the public, and seeking feedback from mental health professionals before final decisions are made. Controversy has ensued! One of the changes proposed is removing the exception of grief from the criteria for diagnosing Major Depressive Disorder. This would mean that if you experienced the loss of a loved one and your completely normal symptoms of grief last more than two weeks, you could be diagnosed with Major Depressive Disorder. Two weeks?! As psychiatrist Allen Frances stated in the Psychiatric Times, "Grief deserves dignity not diagnosis". This and other proposed changes could cause millions of healthy people to be labeled with a mental health disorder unnecessarily. There is speculation that the APA has their own agenda with this, and that the pharmaceutical industry has lobbied for these changes. After all, they would profit (big time) off the medications prescribed to people if these changes become reality. The APA has denied being in cahoots with the drug companies, and I hope that's true. Nothing good comes of further commercializing and monetizing mental health. If these issues concern you, click HERE to read more about the APA's proposed changes. Also, you can sign an online petition HERE to make your voice heard (you are not required to be a mental health professional to sign it).

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