Tuesday, February 16, 2010

The endangered odd person?

The DSM is being revised.

That's the Diagnostic and Statistical Manual of Mental Disorders, the book that draws the line between individuality and pathology in the human personality. If you're interested, a history of the DSM can be found on-line in, no surprise, Wikipedia.

The DSM's last revision took place in 1994, at which time the diagnosis ADHD (Attention Deficit Hyperactivity Disorder) was included. Before that children who jumped around a lot and couldn't pay attention and disrupted class were problems, not pathological. The controversial results of this diagnosis' creation have been well-documented, but then such change is bound to create controversy. Psychiatry is still an infant science and, as such, is still groping toward understanding the relationship among a person's brain, environment, and behavior.

But the fact remains that the labeling of a behavior by the DSM as a disorder means it's now officially a pathology in search of a cure. This in turn signals the pharmaceutical industry to get cracking at producing a pharmaceutical treatment.

If someone's family has been riddled by serious depression for generations, I, personally, feel that the blessing of the gods reign should rain down on every research scientist who helped invent selective serotonin reuptake inhibitors and every therapist who helped organically, chronically depressed people realize it's okay to re-balance their serotonin by taking a pill.

However, I know many people who seem to prefer brandishing a diagnosis and taking pills for physical conditions that could instead by addressed by eating right and exercising. Or for coping with bad or sad feelings connected with life's difficulties that could instead be worked through (and so learned from) over time. Aren't they missing some of the adventure of feeling alive?  Or are they, instead, wise to avoid feeling bad feelings?

Here's a cosmic statement for a Tuesday morning: Life is hard, and we're all blessedly different. Or at least, I've always thought we considered our differences a blessing. Yet among the proposed revisions to the DSM is one that creates "risk syndromes," meaning that a person who exhibits behavior that might underlay psychotic disorders gets slapped with a diagnosis. So, if one is overly suspicious (what's overly?) or one has disorganized speech patterns (yikes! have they ever listened to me try to tell a story?), one gets labeled pathological.

The revision also proposes reclassifying what we've always taken as the normal grieving process triggered by the death of a loved one as depression.

Personally, I consider myself a pretty odd person who generally enjoys the company of other odd people. I think what I really mean by this is that I don't want the ups and downs of my life evened out pharmaceutically; and I enjoy engaging with other people who don't shy away from their own ups and downs. Are we odd people an endangered species? Should we be an endangered species? Would I be happier, more productive, more engaged in life, and less problematic for others to deal with if I were willing to take more pills?

The revisions to the Diagnostic and Statistical Manual of Mental Disorders are not yet final. There's an open comment period until April 20th. If you have a moment, take a look at the proposed revisions and think about their implications for your future, your family's future, and, most particularly, your children's future.

And, by all means, comment.

1 comment:

  1. Thanks -- had no idea comments were being accepted from us layfolk. I heard about the proposed revisions and that the National Eating Disorder Association (correct title?) is up in arms about the decision not to include the new diagnosis "Orthorexia" (an obsession with healthy eating). Those who oppose including it say it is just a form of OCD and can't be clinically differentiated.

    Well, I sure am "RS" and proud of it. It makes me shudder to think new diagnoses are just going to encourage the pharmaceutical industries and their advertisers and drive up the costs of healthcare. I also don't want my children, who I think are delightfully "odd," to be viewed or described as kids with disorders.

    Now and again I'm attracted to reading the Yahoo news articles that come out with new health and wellness studies, or the Wellness column in the NY Times. Sometimes I can't believe how lacking in common sense and logic they are -- putting the cart before the horse and assuming certain lifestyle norms that themselves should be questioned. As someone who has always cared to stay healthy and in tune with my body, I don't put a lot of stock in the trendy pronouncements of the health industry (and I don't really know where they come from -- doctors, the media, the drug companies, the patients?).