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Nicole Feretich
The DSM: Diagnosing the Human Condition
Far too often, doctors diagnose patients with mental disorders that will have a detrimental
impact on their lives although there was nothing truly wrong with them to begin with. With use
of the DSM (the Diagnostic and Statistical Manual of Mental Disorders), patients can be
categorized and treated without much of a scientific basis. Not all diagnoses are wrong or based
on false findings, but there have many instances where normal human reactions coincide with
what the DSM has included as symptoms for mental illnesses, making it hard to differentiate
between the ill and the normal.
Categorizing humans is a part of our society today that both provides comfort and creates
division amongst people. American psychiatry has been using the DSM to give them more
credibility and make it easy to decipher what symptoms are connected to which illnesses. But
when doctors immediately label the minds of people, they are diagnosing the human condition
and it gives people the impression that they are not normal and need help fixing themselves. In
order to mend this diagnosing-epidemic we must revaluate the DSM and also correct flaws in
American psychiatry.

The DSM
The Diagnostic and Statistical Manual of Mental Disorders, commonly abbreviated as the
DSM, began due to the need to collect statistical information. The first official attempt in 1840
had a single category of idiocy/insanity. The first volume of the DSM was made in 1952 and
was used mostly for mental health in soldiers during WW2.
In the 1960s, psychologists began challenging the ideas of mental illness. Some said
mental illnesses were just cover-ups for moral challenges within people. Robert Spitzer, a
leading psychologist at the time, criticized this edition of the DSM and claimed it was unreliable
in diagnosing patients. With his lead in 1980 the DSM-III was created. The goal of this revision
was to improve the validity of psychiatric diagnoses and to make the general practice more
uniformed. This edition of the DSM included 188 diagnostic categories and was criticized by
Spitzer himself, saying it led to the medicalization of 20 to 30% of the population who may not
have actually had mental problems.
The fifth and most recent edition of the DSM was published on May 18, 2013 and was
the first major edition in 20 years. This edition, too, was criticized by many people for being
contradictory, not supported by major evidence, and was poorly written. This led to a petition
signed by 13,000 people and sponsored by many health organizations.
In 2007, on a television series, Spitzer again criticized the DSM saying it pays little
attention to the context in which symptoms occur and may have medicalized the normal human
experiences for people.


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Categorizing of Humans
The DSM is a categorical system. When a patient is close to a certain category that is
what they are diagnosed with. The DSM does not include treatments or causes for illnesses.
There is a lack of diagnostic reliability, even with the newest edition.
The book itself provides warnings to readers, explaining that if you lack clinical training
you can misdiagnose yourself. As previously mentioned, the DSM has turned human experiences
into diagnosable symptoms, which lead to the heavy need for people to diagnose themselves. By
categorizing themselves, they feel hopeful of their illness and life.

Infographic courtesy of Flying Chilli and Rachel Moeller Gorman
DSM-I had been a sixty-five-page booklet But, DSM-III was coming in at
494 pages Along with its revised edition, it sold more than a million copies.
Sales to civilians hugely outweighed sales to professionals. Many more copies
were sold than psychiatrists existed. All over the western world people began
using the checklists to diagnose themselves. For many of them it was a godsend.
Something was categorically wrong with them and finally their suffering had a
name. It was truly a revolution in psychiatry, and a gold rush for drug companies,
who suddenly had hundreds of new disorders they could invent medications for,
millions of patients they could treat. (Ronson, 240, 241)



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The problem with this categorizing of life lies with the intensive additions made to the
DSM manuals throughout the years. No stone has been left unturned. This is good for American
psychiatry and healthcare organizations; they make money and gain credibility in their respective
fields, but leave people (or patients) left constantly labeling themselves and others.

Over Diagnosing of Mental Illnesses
Psychiatrists have labeled everything as a mental illness from nose picking
(Rhinotillexomania) to altruism, lottery and playing with action dolls. They
market the spurious idea that DSM disorders such as spelling and mathematics
disorders and caffeine withdrawal are as legitimate as cancer and diabetes. Jan
Eastgate, President, Citizens Commission on Human Rights International, June
18, 2002
False epidemics in psychiatry have been started often with the over-categorizing of
illnesses and over diagnosing of patients.
What these two circle graphs are showing is the general increase in Autism diagnoses
within the past few years. Diagnoses for Autism have increased from 120% from 2000, and 30%
within the past few years. Instead of 1 in every 88 children, its now 1 in every 68. Once
Aspergers was considered to be a high-functioning form of autism, the rates of diagnosis of
autistic disorder in children drastically increased.
This led to the campaigns (ones that advocated Every 20 seconds a child is diagnosed
with autism.) that linked this outbreak of autism to the MMR vaccine. Because of this, parents
stopped giving their children vaccines. Some caught the measles and died (Ronson, 244).


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There is also an increasing trend in over diagnosing children with bi-polar disorder. The
illness itself emerges in late adolescence, but there is a prevalence of children under seven years
of age being diagnosed with it. Some children may very well be ill or troubled, but they are not
actually bipolar. Before the DSM-III was published, many of the eccentric and crazy
symptoms were considered just being a child.
The main issue with over diagnosing mental illnesses, apart from making them
mainstream, is that psychiatrists will be quicker to diagnose you with something due to simple
symptoms that may not mean anything. You can be medicated for something that does not exist
in the world or just within you.
Misdiagnosing Mental Illness
David Rosenhan, a psychologist, conducted an experiment where he and seven friends
went to different mental hospitals across America, having all adopted pseudonyms and fake
back-stories. They went into the hospitals acting completely normal but told the psychiatrists
they were hearing voices in their heads that would say the words empty, hollow, and thud.
All were diagnosed as insane. Seven were told they had schizophrenia and one was told he had
manic depression. The hospital did not let Rosenhan out for 2 months although he had thought
the experiment would only last a few days. The others stayed at the hospitals for an average of
19 days each. They all acted completely normal and when asked by psychiatrists how they were
feeling, they would say fine. Yet, they were all given antipsychotic drugs.
What this experiment shows us is that there is a danger of labeling in psychiatric
hospitals and dehumanization of patients. Also, its hard to know the sane from the insane in
psychiatric hospitals.
People went up in arms after Rosenhan reported his findings, and one mental hospital
implored him to send more fakes posing that they would be able to spot them. After a month, the
hospital announced they had discovered forty-one fakes. Rosenhan had not sent any.
This experiment was a disaster for American psychiatry, having shown the flawed
diagnosing-system; it was unreliable and now there was proof of it.

Below is a graph breaking down the misdiagnoses of Bipolar Disorder. Out of 180
people, 69% were misdiagnosed originally. Some people did get a correct diagnosis for a
maximum of 10 years after the original diagnosis. For some people, the drugs that they took for
the incorrect illness led to them developing Manic-Depression.


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In The Psychopath Test, Jon Ronson describes a situation where the misdiagnosing of
illnesses went too far for one family. On December 13, 2006, four-year-old Rebecca Riley went
to her mothers bedroom with a cold and, after her mother had given her cold medicine in
combination with her bipolar medication, died in the night. The autopsy revealed Rebeccas
parents had overdosed her on antipsychotic drugs that had been prescribed for her bipolar
disorder, but the medicine had not been approved to use for children. As put by Ronson, Theyd
got into the habit of feeding her the pills to shut her up when she was being annoying.
Rebeccas parents were both convicted of murdering her. Later, in an interview with Katie
Couric, Rebeccas mother said she (Rebecca) probably did not have bipolar disorder and rather
was just hyper for her age. (Ronson, 251, 252)

Lifelong Stigma Attached to Mental Illness
Once labeled schizophrenic the pseudopatient was stuck with that label. David Rosenhan,
On Being San in Insane Places, 1973


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As put by Jon Ronson, who included the Rosenhan Experiment in his novel The
Psychopath Test, There was only one way out. They had to agree with the psychiatrists that they
were insane and then pretend to get better (Ronson, 235). There is a lot of social and self-
stigma attached to mental illness and it can be with a person for all of their life.

As seen above, social stigma surrounds people when they have a mental illness. Along
with these numbers, many emotions and actions by society towards the adolescents were
recorded. Unwarranted assumptions come from family members, along with distrust, avoidance
and pity. People lose friendships and experience social rejection. In school, students experience
fear expressed by teachers along with under-estimation and avoidance.
Although there is some comfort in being labeled or categorized, there are also a lot of
negative aspects. Being labeled closes a lot of social doors. It also affects your own self-esteem.


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You may doubt your abilities and use your label as an excuse for any behavior some may deem
as a symptom. This may also be why people find solace in having groups of people labeled the
same as them to talk to.

What needs to be done?
The DSM itself must be analyzed again; Standardized methods are necessary in order to
reduce the rates of populations that are either misdiagnosed or diagnosed with a less or more
severe syndrome than is actually present. It must be evaluated for any symptoms that are too
generalized or not supported by a lot of scientific evidence. It should not be available for the
general public at all, either, unless special permission is given or if the person is learning
psychiatry.
By giving the DSM to regular folk, it allows the book to become a self-help guide or a
tool of categorization too powerful for an untrained professional to use. The actual professionals
themselves must also be taught to take the book with a grain of salt. To label someone with a
disease when there is not much evidence to support it is foolish and a stain upon the practice of
psychiatry as whole. Once someone is labeled as something, they should seek out several other
opinions from varying doctors before taking treatment. These are all mere suggestions as to how
the American psychiatry system should be mended, first and foremost with the DSM, being that
it is constantly an unreliable source of information that has powerful effects over society.

Conclusion
It is easy to see that the DSM is a flaw in the practice of psychiatry. It has been shown to
medicalize the human condition and also lead to misdiagnosing of patients, especially children.
These labels stick with people forever and if it is a misdiagnosis, it is an unholy act done by a
doctor to a patient. The American psychiatry system must be amended to avoid further instances
where over diagnosing epidemics break out or misdiagnosing creating a rift between people or
even death.










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Works Cited
"Diagnostic and Statistical Manual of Mental Disorders." Wikipedia. Wikimedia Foundation, n.d.
Web. 01 Apr. 2014.

Davey, Graham C.L. "Why We Worry." Mental Health & Stigma. Psychology Today, 20 Aug.
2013. Web. 07 Apr. 2014.

"Half Kids Labeled Bipolar May Be Misdiagnosed." Msnbc.com. Associated Press, 2007. Web.
05 Apr. 2014.

Horwitz, Allan V. "The Loss of Sadness: How Psychiatry Transformed Normal Sorrow Into
Depressive Disorder." PsycNET. Oxford University Press, 2007. Web. 01 Apr. 2014.

Karen Weintraub, Special for USA TODAY. "Autism Rates Soar, Now Affects 1 in 68
Children." USA Today. Gannett, 27 Mar. 2014. Web. 06 Apr. 2014.

Regier, Darrel A. "Limitations of Diagnostic Criteria and Assessment Instruments for Mental
Disorders: Implications for Research and Policy." JAMA Network. Arch Gen Psychiatry,
1998. Web. 01 Apr. 2014.

Ronson, Jon. The Psychopath Test: A Journey Through the Madness Industry. London: Picador,
2012. Print.

Singh, Tanvir, and Muhammad Rajput. "Misdiagnosis of Bipolar Disorder." National Center for
Biotechnology Information. U.S. National Library of Medicine, 2006. Web. 03 Apr.
2014.