Damn You … DSM

Today, I would like to vent about the DSM. For those of you who don’t know, the DSM is the Diagnostic and Statistical Manual, which is currently in its fifth edition. It details the diagnostic criteria for all the recognized mental health conditions. And while it can be a helpful source, it also can have several notable flaws, which is what I want to vent about today.

The biggest problem, in my opinion, is that it takes something that has a lot of gray areas, mental illness, something that we are still learning so much about, and it makes it firm and rigid. For example, the entry for obsessive compulsive disorder details how much time each day must be disrupted by that intrusive thoughts or actions. The purpose of this is separate from the fact that all persons, regardless of their mental health status, experience intrusive or obsessive thoughts from time to time. Yet mental illness is different for everyone, and there needs to be more flexibility in the diagnostic criteria that are used, especially since these diagnostic entries are used for insurance purposes.

And so some might feel isolated if they experience mental health battles that don’t meet the criteria detailed in the DSM. This is particularly true given that some conditions that the mental health community might widely recognize have not been adopted by the current DSM edition.

On the other end of the spectrum, there is the fact that some of us, particularly those of us who work in the peer recovery setting and don’t necessarily have the clinical training of the therapist might find it helpful to review the DSM to help our guests, only to have our own battles, our own mental illness lie to us and try to convince us that we have lots of the conditions listed in the DSM. Just looking at a couple conditions yesterday my mental illness tried to convince me that I had five more mental illnesses than I thought! Seriously, damn you DSM.

And I say this partly because I do really want to vent. But also because I suspect that I am not alone with these frustrations, and wanted to let others know, particularly those who might be new to the mental health field, that while some call the DSM the bible of the mental health field, the truth is that it is far more fallible than that. It is a helpful tool for sure, but it is not the be all and end all. And that is important to realize.

Okay, venting over. Thanks for listening.

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