This is a letter from the New Scientist,
downloaded from their web site:
www.newscientist.com
Peter Aldhous warns us about the new version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) as if it will be something of a nuclear bomb (12 December 2009, p 38). I disagree.
The DSM is not the only classification of mental and behavioural disorders. It is used mostly in the US. The rest of the world uses Section F of the World Health Organization's International Statistical Classification of Diseases and Related Health Problems. Some doctors don't even consult a manual to reach their diagnoses.
Aldhous reports on an editorial in the Psychiatric Times, where Allen Frances wrote that broadening categories within the DSM would result in the medicalisation of normality and "a deluge of unneeded medication". I would argue that the effects will be hardly noticeable - because this is already happening.
I have worked as a psychiatrist for 10 years, enough time to see an increasing number of people consulting psychiatrists for all sorts of life-related problems, and using diagnostic terms to tell us that they are depressed, bipolar or suicidal.
At first, I thought that it was all the fault of us doctors, that we medicalise these poor, unhappy, non-coping people. But the longer I work, the more clearly I see that people want "a diagnosis" because a diagnosis means there must be a treatment, and a treatment amounts to an easy way of getting their life or themselves fixed.
Then they ask for medication. They want tablets to stop them crying, although their mother died only two weeks ago, or something to calm them down when they become aggressive after they have a drink. They ask us to sort out their unruly children who have never known any boundaries. They want it sorted and they want it now. This problem is partly a result of the modern pressure to be happy and advert-perfect all the time; if you aren't, there must be something wrong with you. Another part of it is the lack of life skills and poor social support networks courtesy of the decline of traditional family structures and close friendships.
I am astounded by the number of people who come to ask me for a diagnosis, and who are then unhappy when I try to explain that this is called "life". If the DSM is a bomb that is going to explode, it will probably generate more smoke than fire.
By Joanna Jastrzebska, North Shields, Tyne and Wear, UK.