Diagnoses of mental disorders are on the way up. The DSM-IV task force, led by Allen Frances, sought to limit this inflation. The DSM-5 is expected by many (including Frances) to make it worse. If it does come to pass that nearly everyone can be diagnosed of a mental disorder of some sort, how should we think about what it means to have such a disorder?
Well, there are two attitudes that we shouldn’t have: we shouldn’t be afraid of apparent epidemics in mental health, nor should we take the other extreme and shrug off mental disorder entirely.
- For one, we can see the rise in diagnoses of certain disorders as a sign that all of the chemicals/”toxins”/technologies/radiation/whatever in our food/air/society or that the stresses and immoralities of our lives in the modern era are making us, well, crazy.
- We can, alternatively, reduce our thinking about mental health to “everybody’s got something”, meaning that we all fit on a spectrum of mental health somewhere and let’s not make a big deal about it.
The first position is a little big ignorant. I’m not saying that it can’t be that all the dangers of our world aren’t impacting our physical and mental health. They certainly are. But there are other social and psychological issues that are inflating our perception that things are going badly. One of them is the inflation caused by awareness of disorders and the diagnostic criteria of the DSM, in its various incarnations. If you become aware of these facts, you start to see that so-called epidemics are a product of our evolving classifications and not a change in the actual prevalence of certain conditions.
The second position is equally ignorant. Occasionally, people with severe mental health conditions are shrugged off by an individual because that individual knows someone else with a milder form of the same diagnosis. Mental disorders tend to exist on a variety of spectra, to be certain. But the fact that so many people can or are being diagnosed with mental disorders should not trivialize the experience of those who struggle through daily life because of them. To approach these people with a “so, what?” attitude isn’t helpful.
In general, I find our understanding of mental health lacking. We’re fearful that our children will have certain disorders, and in some cases we over-medicate them at the first sign of what might be perfectly normal distress. Yet, at the same time, we trivialize the plight of those who struggle with severe obstacles to mental health and have different mental abilities. There’s a middle ground between panic and apathy here.