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Up in arms against mental illness diagnosis

In times of stress, students are accustomed to the familiar feelings of anxiety and mood changes. However, although people encounter stress from exams, work, and life’s challenges, this natural response to the demands placed on the body should not be classified as severe anxiety or depression.

One of the most important references for mental health treatment, the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association (APA), provides a universal standard for identifying mental health disorders, ensuring that a patient in Texas who is diagnosed with anxiety, for example, will receive the same diagnosis across America.

However, the new edition of the manual to be released this May, the DSM-5, is arguably permitting the over-diagnosis of mental disorders by changing the symptoms and descriptions of common occurences. The DSM-5 is also introducing new, classifications of mental illnesses, such as Disruptive Mood Dysregulation Disorder—mood swings in children—and Mild Neurocognitive Disorder—the decline in one’s cognitive ability.

Though the new DSM does not provide suggestions for treatment of these disorders, many health practitioners fear that further over-diagnosis of mental illnesses will exacerbate the already excessive distribution of potentially harmful prescription medications. These new changes to the manual have sparked an incredible amount of protest amongst professionals in the psychiatric fields.

For example, the International DSM-5 Response Committee, “comprised of leaders in the mental health field within the United States, the United Kingdom, and across the globe,” as stated on their website, has posted a petition called “Stop the Insanity” which strongly opposes the DSM-5.

The Stop the Insanity campaign raises many issues with the new DSM, including direct claims that the manual has “many diagnostic categories with questionable reliability,” inadequate scientific justification, and “may compromise patient safety through the implementation of lowered diagnostic thresholds.” They go on to describe the risks of prescribing medications to patients who could likely recover without pills.

“The danger is that people with milder symptoms who are [considered] normal [by previous standards] will be prescribed drugs they don’t need.” Dr. Joel Paris, professor of psychiatry at McGill, said.

As an example, the International DSM-5 Response Committee is raising eyebrows at the Mild Neurocognitive Disorder outlined in the DSM-5, as mild cognitive decline is to be expected in the elderly. Considering the numerous health problems many elderly face, this extra diagnosis, and the medications prescribed for it, is unnecessary.

On a larger scale, the Response Committee argues that “over-diagnosis of psychiatric treatment in the elderly is already a nationwide problem in the U.S. and other countries.”

In response to these protests, the APA has already begun to revise the DSM before its release this May.

The Organization stresses that “news reports and commentators alike are filling the discourse with inaccurate, biased or misinformed criticism of DSM-5… which undermines the important changes that are being made to the manual.” However, with the manual under close examination by professionals worldwide, it is likely that it will align closer to the ideas of the protesters.

In the midst of these vaguely defined psychiatric disorders, it is important to stay open-minded about the classification of milder mental disorders, like anxiety and depression.

“The problem is that we have no biological markers—scans, blood tests—for mental disorders, as other medical specialties have,” said Paris.

Though the diagnostic categorization fluctuates, the most reliable sources, such as the Mayo Clinic and Health Canada, continually emphasize that a positive lifestyle, regular sleep schedule, and healthy diet can make a significant impact on stress and anxiety.

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