He cites three examples of how epidemics of psychiatric childhood disorders have ballooned; attention deficit disorder has tripled, and both autism and childhood bipolar disorders have increased 40 times. Adult bipolar diagnoses have doubled. At least 80 percent of psychiatric medication is given out by non-psychiatric doctors who quickly give it an insurance code. Their pay depends on it.
The newest diagnosis is "sexual addiction." Our 42nd president wasn't a philanderer but the innocent prey of a "sickness." This addiction, however, "requires further research." Frances illustrates it with a cartoon of two women talking at the water fountain. One says to the other: "Evan has a symptom where he cheats on me and does a lot of recreational drugs, but I forget the medical name for it."
Medicalizing bad behavior, however, is no laughing matter. It can be costly to society and damaging to "patients" who are overprescribed. Childhood is on its way to becoming one big disorder, especially for boys, who are diagnosed with attention deficit hyperactivity disorder (ADHD) much more often than girls. A temper tantrum is a "disruptive mood dysregulation disorder." Matching diagnoses with specific school services such as "special learning" classrooms requires an expensive combination based on who can lobby most successfully for public funding.
What is left in their wake is quick labeling by untrained doctors who can dispense drugs. Trained psychiatric doctors doing the heavy lifting for major mental illness are often overworked, underpaid and understaffed.
The DSM should be used as a "dictionary," says Dr. Thomas Insel, the director of the National Institute of Mental Health, so that clinicians share the same descriptions of symptoms, and who understand that symptoms alone rarely indicate the best treatment. He wants to lead the institute to adopt new classifications based on research with biomedical measurable markers, including 'brain circuitry," using innovative technology. Better detection means better prevention.
That doesn't mean, as Dr. Thomas Szaz famously said, "Mental illness is a myth." But root causes are more complex than symptom descriptions. There's a big difference between the "walking wounded" and the "worried well," but you'll not learn what that is in psychiatry's bible. Reading it could bring on a disruptive mood dysregulation disorder.