Abnormal Is the New Normal (DSM-5)

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Hi found this article decided to share what do you all think!! !! !

http://www.slate.com/articles/health_an ... ation.html

Thanks for sharing.
That's just too much.

I'm not sure what to think about it.

Actually, I think it's pretty simple:

You have a disorder, as defined by the DSM-5, if you're impaired in your daily life activities. No impairment = no diagnosis. "Impairment" is the difference between what is "normal" and what is not.

This article seems to regard the DSM-5 as a checklist where, if you tick enough boxes, you're "disordered." That ain't how it works.

I wish people who know nothing about psychology/psychiatry would quit writing these fear mongering articles about the DSM and the doom it spells out for everyone.

People who don't have any clinically significant impairment aren't going to be classified as mentally ill and have to suffer the stigma that might come with it......they don't have to worry. Also if anything the more frequent occurrence of mental disorders is probably a reflection of society and the state of things rather than what was considered normal before being considered mentally ill now

The article's being a bit overdramatic. Mental illness has never been rare.

Currently--according to this article--the lifetime risk of having a mental disorder is 46.4%. That sounds about right to me.

So... a 4% increase is not actually that much. Especially considering that they are adding some things that aren't particularly severe--the "caffeine intoxication" thing the article mentions, for example. (Which, by the way, has actually sent people to emergency rooms, because too much caffeine really can cause what you'd call "caffeine intoxication"--it'll make you anxious, make your heart rate go up, may trigger a panic attack. Caffeine is a very safe drug, but that doesn't mean it's absolutely safe, especially if you're taking two caffeine pills with your third can of energy drink.)

Also remember that "mental disorder" includes things like stuttering or having a lisp, learning disabilities like dyslexia, ADHD, the after-effects of stroke or head injury, postpartum depression, complicated grief, tics, bed-wetting, separation anxiety, delirium (of the sort you might have with a high fever), substance abuse and addictions, nightmares, and sleepwalking.

So, yes, 50% sounds about right.

That this statistic sounds high to anyone is simply a result of the myth that mental illness is always severe, obvious, and rare.

As I mentioned in a recent blog about grief being diagnoseable as depression, these guys are missing the point. They seem to think the whole purpose of the DSM is to define what 'normal' is, and tell you if you're abnormal and therefore inferior in some way.

It's not that at all. The purpose of the DSM is to identify people who need psychiatric help.

Just because you're normal doesn't mean you don't need help. I don't see why we should be concerned about helping someone who is in distress or having difficulty functioning, even if what they're going through is normal. Normal does not mean perfect. Normal means average.

I think another reason that statistic is so high is that more and more people are getting diagnosed with "depression" or "anxiety", but a lot of these people aren't having RECURRING depressive episodes or full-blown anxiety disorders. Lots of people at one point in time may fit the bill for MDD or GAD or the like, but keep in mind that true mental illness prevalence rates still are around 1-3% for most disorders.

I'm not sure whether for everyday life it's all that important. It's a diagnostic and statistical manual, not God's guide to who is "normal."

One application of the DSM is for classification for research purposes. I'm not qualified to judge the merits of one definition vs. the other for that purpose, but I trust the people writing it are.

The other application is for legal consequences. Our society has this slightly odd habit that at least for working the school system, carrying an "approved" label can have big ramifications. Since the DSM influences who gets services and other special privileges depending upon a label, as well as stigmatization and reduced self-esteem from depending upon that label, it's not just as a scientific manual, but also a political one. This political decision is arguably not one for the experts but for the public to make, and legislators are probably not doing their job very well when they outsource the decisionmaking to people who are experts in mental disorders, but have no special claim to knowing who deserves what.

Western culture is getting more and more prejudiced and intolerant; therefore, a larger and larger number of people are being labeled as "disordered" who wouldn't have been considered so in previous years.

Mild autism is just one example. Quirky and nerdy? Maybe. Disordered? Honestly hard to say. In much of the U.S., the "strong and silent" type was socially acceptable and common. No longer. Therefore, everyone who matches that profile is diagnosed with autism and/or social anxiety.

I agree with this. I almost find it insulting and I get very annoyed (perhaps that's weird, I don't know) when people tell me what I'm going through is "normal" and that "everybody experiences it from time to time". Sure, a lot of people might "fit the bill" for depression/GAD/something else sometime during their lifetime but that's not really what it's like to experience full-blown anxiety disorders and chronic depression (etc).

This

The practical application of the Diagnostic and Statistical Manual (DSM) is to provide an ascension of diagnostic classifications for mental or psychological disorders that may attribute to symptomatic aspects of patients who are deemed to require an abundance of mental health services in order to treat, or perhaps alleviate their functional impairments in daily life. You can only procure a diagnostic label for a defined mental disorder if your symptoms are construed as a "clinically significant impairment" in being able to uphold a normal life, or daily adaptive skills (social or occupational functioning). The American Psychiatric Association (APA) has a financial affiliation with the pharmaceutical industry, hence that more diagnostic labels: equates with incrementing revenue in order to aid whilst conducting their "evil" deeds. In the mental health professional field, only psychiatrists are authorized to prescribe medications (anti-psychotics, mood stabilizers, psycho-tropics, and anti-depressants) to patients who are warranted for necessary treatment for their condition, although clinical psychologists maybe liable in doing so if granted license privileges; however, these privileges require additional training and possibly a doctoral level degree (PhD/PsyD).

I'm not at all disconcerted of the ascending incidence/prevalence statistics of mental illness, particularly with regards to anxiety and depressive disorders. I'm aware that some psychological conditions such as Schizoid, Schizotypal, and Narcissistic personality disorders can not be directly treated with prescription medication, although it can treat the presence of co-existent disorders like Post-traumatic stress disorder (PTSD) and grandiose delusional disorders e.t.c.. The "nature versus nurture" debate (genotype-environmental correlation and interaction) may explicate for these statistics as it's considered a exorbitant denominator for the manifestation and development of psychological disorders. "Abnormality" is still excessively stigmatized, misconstrued, and prejudiced by the mainstream media and "normalcy" cultures. The common stereotypical labeling (positive/negative) for people with high-functioning forms of autism are "computer geeks," "nerds," "geniuses," "absent minded professors," and being "socially awkward"; whereas, for those with severe autism may consist of "wheelchair bound" or "developmentally disabled." Although autism is biological in nature, and not as the result of nurturing implications such as inadequate parenting or psychogenesis.
_________________
Diagnosed with "Classical" Asperger's syndrome in 1998 (Clinical psychologist).
AQ: 48/50

Last edited by TheRedPedant93 on 23 Apr 2013, 1:37 pm, edited 3 times in total.

This is a good example. Yet the fact is strong and silent types have it hard now and probably had it hard back then. Not to mention that many resorted to academic life style simply, because being weird would be easier on that ground. It needs to be pointed out that many people have problems and back in the old days they would just hide the problem they had. So today it is uncle with autism and in 1950s it was - Ya know your weird uncle who never talks and cuts grass with his pocket knife - that is not normal. It is just society pretending these problems do not exist. Not to mention that with little treatement or advice from doctor people can live better life. The problem is even greater that a lot of culture stuff is being mixed with mental health.

I have an uncle who is weird and even possibly autistic, but hes just considered weird.

Also, realize that having a disorder and being disabled aren't the same thing. That's something a lot of people on here struggle with it seems.

75% of people with mental disorders aren't disabled by them

Depends on your definition of disability, though, doesn't it? Disabled as in unable to work... or disabled as in needing outside help... disabled as in needing accommodations...

Legally, disability is a very broad category that includes things like asthma, or having lost your hearing in one ear, or having bad knees so you can't walk far. Here in the US, people with disabilities are protected in that we are required to be considered equally for jobs and housing, and "disability" covers so much ground that there had to be a legal case that clarified that wearing normal eyeglasses for nearsightedness didn't count as a disability.

On the other hand, if you're eligible for disability payments, you need to be not just disabled but unable to work because of your disability. And that has more to do with how your impairments interact with work requirements than any general idea of "how bad" your disability is...

Socially... boy, there's a can of worms. A person can be considered disabled just because they look disabled, and another person who has much more trouble in daily life can be considered non-disabled because of some arbitrary difference. Like, if you can't speak English because you're born deaf, you're considered disabled, but if you can't speak English because you were born in a non-English-speaking country, you're just as impaired but not considered disabled. Or if you can't walk because you're six months old, you're not disabled; if you can't walk and you're six years old, you are.

Just so complicated.

Disabled under the ADAAA, which is the one which handles things like accommodations being legally required.



No actually. It's not that broad. Disability is not the same as impairment. Disability requires significant impairment. Disability requires being limited drastically, rather than stuff just being somewhat harder because of it.

A relevant case recently that is actually one of your examples

http://www.law.com/corporatecounsel/Pub ... 0323160712

This person was without question impaired. But the impairment wasn't significant enough. It wasn't disabling.

Every person with a mental disorder is impaired. It always interferes with their life.

But not every person has it significantly limit major life activities which is what it requires under the ADAAA in order to be called a disability. ("major life activities include, but are not limited to, caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, and working")

Autism Spectrum Disorders are frequently disabilities, but something like depression, usually impairs, but doesn't usually disable someone. It does sometimes, and those people do get accommodations for it. Of course, its stigmatized both when someone isn't disabled and when they are.