The Right Psychiatric Label Solves Everything

     CNN’s Jen Christensen published a piece last week announcing the American Psychiatric Association’s revamping of their Diagnostic and Statistical Manual of Mental Disorders, which was last updated in 2022. “The critics are loud, so it’s very hard to ignore them,” psychiatrist Maria Oquendo, chair of APA’s Future DSM Strategic Committee, announced.

     One persistent complaint about the DSM is that it is not scientific. There are no medical tests that can be done to determine if anybody has a chemical imbalance or any other biological condition causing their mental disorder. The American Psychiatric Association has the perfect solution for that, though.

     They’ll just change the name of their “bible” to the Diagnostic Scientific Manual of Mental Disorders.
Problem solved. They’re now scientific.

     Psychiatrists are already big on labeling things to make them seem like they have solutions. The three hundred or so mental disorder labels already in the DSM have for the most part been voted on by committees of their peers, but have not been derived from much objective criteria. As long as a “disorder” has a label, psychiatrists suggest, they know what it is.

     While there is no genetic test for any of these mental disorders yet, they hope to make the new DSM flexible enough to incorporate future biomarker technology, even though it does not exist yet. And, of course, may never exist.

     If a mental disorder has a label, a psychiatrist can bill for it, and enough private insurance and Medicare payments can continue being paid to keep psychiatrists driving Mercedes for the foreseeable future. Not to mention the riches Big Pharma can then make from selling their prescriptions of antidepressants and anti-anxiety meds for the DSM “approved” labels.

     “Stigmas” is probably a more accurate term than labels, however.

     Just in case the current three hundred mental disorder labels aren’t enough to catch the average American in their diagnostic net, however, the APA hopes to create new diagnostic categories with less specific labels. After all, if a psychiatrist only has fifteen minutes to choose a mental disorder label for disturbed soul who turns up in an ER, he’ll need to have a flexible enough label so that insurance can be billed and the prescriptions written.

     The APA also hopes the expansion of those labels from the DSM into less exclusive categories can be accomplished by considering the environmental, socioeconomic, cultural, and developmental factors in a person’s life. “…as well as biological factors,” said psychiatrist Jonathon Alpert, vice chair of the Future DSM Strategic Committee. 

     Right. Let’s not forget those “biological factors,” even if none exist behind those labels now or in the known future.

     Just coming up with new labels should solve that problem, too.