The New Face of Depression Diagnosis: DSM-5

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Starting this May with the publication of the new DSM-5, there will be several changes in the way mental health disorders are diagnosed.

In the category of depression the noticeable change is the inclusion of grief (bereavement) in the list of criteria (signs) for depression. Until now, bereavement has been excluded from depression criteria.

The professional mental health community is divided about this change. Anyone who is interested or involved in the depression diagnosis will be hearing and reading more about this. Time will tell whether the bereavement inclusion has a noticeable effect on the diagnosis and treatment of depression, but the debate over its wisdom is likely to continue for now.

To Include or Not To Include

  1. Those who believe bereavement should be in the criteria for depression view grief as a deep psychological stress factor that can trigger a depressive episode in some individuals. They do not view depression and bereavement separately, so it needs to be one of the factors considered when diagnosing.
  2. Those opposed to including bereavement view grief as a necessary and normal emotional response to loss. They believe including grief in depression criteria trivializes a difficult, inevitable experience we all have to face. There is concern that bereavement will be treated too quickly with medication, disrupting the natural healing process involved.

So, should bereavement be considered part of a list of depressive symptoms, or considered a painful but normal part of the human experience? As someone who has experienced both searing grief and the pits of depression, this author’s educated opinion is that the two experiences are not the same.

What is important for you though is being informed enough to make wise choices about your mental health care.

DSM: What’s Good and What’s Questionable

The Diagnostic and Statistical Manual of Mental Disorders (DSM) has undergone its fifth revision which will go live this May. You will see it referred to as the DSM-5. The DSM manual gives an overview of mental health disorders and lists the criteria or symptoms a person must have in order to receive a diagnosis.

  1. What is good about the DSM is that it standardizes mental health diagnoses, making discussion about mental illness between doctors, therapists, patients, and insurance companies easier and more accurate. Everyone in the mental health business is speaking off the same page.
  2. There are also many mental health professionals who believe too many children, adolescents, and adults are mislabeled with a diagnosis. For instance, is a child ADHD, or are they very angry and distracted about how things are at home, or are they eating too many processed foods and sweets, or are they bored with what their school offers them?

Be A Wise Consumer of Mental Health Resources

Three experienced psychiatrists might diagnose the same individual three different ways and none of the doctors will be wrong. They will have interpreted the patient’s words, history, body language, and complaints likely within the same ball park, assigning them to similar but different bases. Criteria lists are black and white, but people are not.

  1. Keep in mind what is good and helpful about the DSM, and educate yourself about a diagnosis if you get one.
  2. Talk to your doctor or therapist about your doubts and concerns. Do not be afraid to challenge a professional; it gives them an opportunity to explain themselves.
  3. As questions arise write them down so you will remember to ask.
  4. Consider any diagnosis as something subject to change, because life is change.

 
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