It seems that the world is about to become a much more mentally unstable place! All that it will take is the publication of a revision of a very important book: The Diagnostic and Statistical Manual of Mental Disorders (DSM).
This publication is the ‘Bible of Psychiatry’ as it describes all the mental disorders known to man (and then some!). It is therefore the first thing that a psychiatrist will reach for when attempting to make a diagnosis.
The proposed new edition of the DSM is attracting widespread criticism as it is felt that the psychiatrists working on it must suffer from a disorder off their own namely “Over Definition Addictionâ€!
Many things that were previously just seen as being part of the scale of normal human behavior are described as disorders in the manual. Whatever you are struggling with, it seems that the new DSM will have a label for you:
•   Rudeness – Antisocial Behavior Disorder
•   Temper Tantrums – Temper Dysregulation with Dysphoria
•   Overeating – Binge Eating Disorder
•   Rebelliousness – Oppositional Defiant Disorder
•   Promiscuousness – Hypersexual Disorder
•   Attention Seeking – Histrionic Personality Disorder
•   Selfishness – Narcissistic Behavior Disorder
All of this labeling would actually have been extremely funny if it was not so very dangerous. Those of us who have been working in the field of ADD/ADHD for a long time are acutely aware of these dangers and I will therefore be at the forefront of warning people not to be sucked in by this ‘medicalization’ of everyday life.
Allow me to point out a few of the dangers:
Increased levels of psychiatric treatment: I do not think that it is overly cynical to point out that for every new ‘disorder’ that is described, new treatments will also be needed. It is therefore in the best interest of psychologists and psychiatrists to keep inventing new categories of disorders.
The more there are the busier they will be! In labeling everyday challenging behavior in this way mental health professionals make sure that they will be in business for a long time to come!
Blame shifting: It is a well-known fact that taking personal responsibility is a vital first step in achieving lasting behavior modification. This is why an important part of any ‘12 Step Program’ is to admit that you have a problem. If, however, you have a convenient label for your condition you will find it hard to step up to the plate and take personal responsibility for making things better.
People will now be able to say things like: “It’s not that I want to act like a total jerk, my problem is that I have oppositional defiant disorder!” If these revisions are accepted we should all expect a world where more and more people will shift the responsibility for their problems to other people.
This will be a world that will keep lawyers happy (e.g. lawsuits by obese people against fast food companies will have so much more chance of succeeding if they can point to the fact that they have a recognized mental disorder i.e. ’Binge Eating Disorder’!)
Is this really the kind of world we want to live in?
A world in which very few people take responsibility for their actions and in which we will continually be told that we cannot even hope to deal with daily life without some form of treatment.
Increased rates of medication: Perhaps the most serious implication of the proposed DSM revision is the fact that many psychiatrists will choose to treat these ‘conditions’ with drugs. The implications of this for the young generation are simply staggering.
Can we really afford to have an even bigger proportion of people drugged out of their minds simply because of the perception that they suffer from some kind of disorder.
We tinker with the workings of the human brain at our peril and this revision will certainly be interpreted by many in the mental health field as an invitation to tinker on a massive scale.
What are the implications of all of this for people with ADHD? I suspect that we can prepare ourselves for an onslaught of ‘combination diagnoses’. The growing public awareness of the dangers of medicating kids with ADHD (and of the fact that there are alternatives available) means that an increasing number of parents are asking some hard questions before resorting to medication.
This trend obviously makes the drug companies very nervous. My suspicion is that they will try to maintain sky-high prescription rates by encouraging medical professionals not to stop at simple ADHD diagnoses. Coupling the ADHD with something else (e.g. ADHD with ‘Oppositional Defiant Disorder’) make it sound much more serious and therefore beyond the scope of alternative methods to deal with ADHD.
I am quite sure that this is the reason for the increase in double-barrel diagnoses (ADD/ADHD and …). These will obviously only increase once all of the new disorders have been made official.
So what should we do when people want to take away our responsibilities as human beings and put us on medication to ‘make things better’?
I think our response should be the same whenever we are confronted with something dangerous: Just say no! The ‘3 Steps’ will help you to do exactly this.
UPDATE: New Videos on the DSM here
WHAT DO YOU THINK?
PLEASE COMMENT BELOW!
For more information about the DSM Revision Project see:
http://www.washingtonpost.com/wp-dyn/content/article/2010/02/10/AR2010021000009.html
