Mental health is big business — very big business. I know — I'm an active client of the industry.
Mental health thrives on a classification system spelt out in the Diagnostic and Statistical Manual, now in its fifth edition (DSM5). Unlike guides to diagnosis in other specialties, the DSM5 is completely focused on the symptoms experienced by the patient — two people could have a consultation with a psychiatrist and be diagnosed with precisely the same illness, irrespective of whether the underlying causes of their illness were poles apart.
As a handbook for clustering like symptoms with like symptoms, the DSM5 is unrivalled. As a manual that gives us insight into the etiology of specific mental illnesses the manual is severely underdone.
What is amazing is that few among the experts seem nonplussed about this. The DSM5, introduced earlier this year, is primarily a diagnostic tool to ensure that like is treated as like, at least when it comes to symptoms. This is a critical part of the legitimacy of the psychiatric profession — we can't have psychiatrists disagreeing all the time on what illness a patient suffers — as well as being the bible for determining the appropriate bounds of medicinal, speaking therapy and other interventions.
In the 1970s the DSM listed homosexuality as a mental illness — something that both much of the research community and all the gay community disagreed with. In the stroke of an editorial pen hundreds of thousands, perhaps millions, were cured by the declassification of homosexuality as an illness in the DSM. The DSM is a socially constructed manual, put together by those with a vested interest in mental health.
But what of the current DSM? Asperger's syndrome no longer exists, but is part of a spectrum of autism. Depression is expanded to include those down in the dumps for an extended time because of a death of a loved one. This is by and large good news for anyone who wants to match a client with a treatment — don't be too fazed by what is going on, simply look at the symptoms, get a classification and treat accordingly.
The truth is that our society is amazingly ignorant of the underlying causes of mental illness, and would seem not too interested in finding out more. I've been diagnosed with a major depressive disorder, melancholia — you can find it in the DSM. But my treating psychiatrist and I