I am absolutely fascinated by the study and treatment for mental illness. For several reasons. #1 being that I am a sufferer of mental illness. I struggle with Major Depression and Anxiety. When my husband came home from his nursing program last year telling me he had to write a paper on anxiety disorders, I jumped up & down and said "I can help with that. I've got most of them!"
I also became very interested in it when a friend of mine from high school took her own life in 1999. I felt absolutely awful because I didn't understand her illness and often did not give her the kind treatment that she so desperately needed. I watched her parents cry at her funeral and sitting in the pew 4 months pregnant thought "I pray I never have to go through this".
So today something really significant happened. We got a new diagnostic manual. Today was the 1st day that you could get the DSM-5 (I've written an extremely brief and over-generalized history of the DSM at the bottom if you're interested).
I've been really watching this book and it's development for awhile. I've been uber-curious about it. That was made difficult because those working on it weren't allowed to talk about it, so updates were few & far between.
I've also been very curious because of the tragedies that we've seen that I have felt have come one after another after another. While I'm not a fan of guns and won't have them in my house, I can't shake the feeling that we are completely missing the point when we are focused on guns and not of the mental status of those committing these horrendous acts. I thought for sure that with the new DSM book coming out, it would start more intense dialogue about mental illness.
Yep... I was wrong. We're still not talking very much about it.
So I was cured today of a mental illness. Shyness. Severe forms of Shyness used to be considered an anxiety disorder (medical speak is 'social anxiety disorder'). This wasn't really removed, so to speak, but was revised and additional criteria was added. So now I'm normal.
I find this fascinating, hilarious and infuriating all at the same time.
I have an excellent counselor that has really helped, but my Depression is chronic and today was a bad day. It's hard to describe how painful and crippling major depression can be. I thought I was doing fine and then out of the blue, I feel terrible low confidence, crippling sadness and tears poring out of my eyes. I sit in bed and use my "tools" to talk myself out of the negative thought patterns and focus on my blessings and health.
And as I do this, I become so angry that I truly have no answers for why I go through this and why treatments are so hard to manage. Medications for me always caused me to be worse and suicidal. Meds just don't work for me and there's a lot of evidence that show they don't work for a lot of people.
The reason I feel so angry is because since 1840 when "insanity" was recognized as a mental illness, we are really no closer to effective diagnosis and treatment. So yesterday I was mentally ill and today my anxiety disorder is cured because a bunch of REALLY educated people decided that I was 1 symptom short of ill. huh????
It's great that we keep trying to get a grip of mental illness, but I can't shake the feeling that we are still missing out on:
Prevention
Diagnosis based on biology (not symptoms)
Environment
Deep Research
Social Stigma
Cultural influences
and more...
Why is it that in my very blessed life (healthy body, healthy happy children, amazing husband, mortgage paid, good friends, etc etc), I am still trying to deal with a period of intense sadness and I still break out into tears. What's wrong with my brain? Chemicals? Electricity? Thoughts? Emotions? What??? The DSM 5 doesn't give me that answer. If I had diabetes, I'd have that answer. I'd know exactly what is wrong down to the individual cells involved. I'd know what chemicals are responsible and what organs are malfunctioning. I'd know exactly what to eat and what medicine to take. With my Depression or my parent's addiction or my patient's schizophrenia... I get none of those answers and for someone like me THAT HAS TO KNOW, I feel like all this DSM stuff does is add to my mental illnesses.
So if you see me walking by... would you give me a hug? I'll be doing more research and writing new programs and it's going to be hard for me to get through these changes. Guess it might be time for me to make another appointment and go back in to learn so new 'tools'.
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The DSM (Diagnostic Statistics Manual) is a book of codes and symptoms and resources to help diagnose mental illness.
The history of the DSM book is kind of a funny one. In 1840 "insanity" became an official illness. In 1917 the "Statistical Manual for the Use of Institutions for the Insane" was released and had 22 diagnosis.
The 1st DSM was released in 1952. This included 106 mental disorders and recognized "nervousness" and "personality disturbance" as mental illness.
The 2nd DSM was released in 1968 and had some minor word changes. It had about 180 diagnosis'. There was a reprinting of the DSM-II in 1974. This was really significant because of the emergence of gay rights and gay activism. The term "homosexuality" was replaced with "sexual orientation disturbance".
DSM-III came out in 1980. It included over 280 diagnostic CATEGORIES. Each category having several to many diagnosis'. In 1987 a revision removed "sexual orientation disturbance" and those wanting treatment for homosexuality were lumped into a category called "sexual disorder not otherwise specified." The focus at this time was not on homosexuality itself, but severe anxiety over one's sexual orientation.
The DSM-IV which is the manual we've been referring to up until today was released in 1994 with a revision in 2000. The DSM-IV started using "AXIS" system. Where patients are diagnosed on:
Axis 1 - All mental illnesses except 'mental retardation' (which has received a new name in the DSM5) and personality disorders
Axis 2 - 'mental retardation (again, so glad that name got changed) and personality disorders
Axis 3 - General physical medical condition
Axis 4 - Psychosocial and environmental factors
Axis 5 - Global Assessment functioning (which is a number scale that shows how someone is functioning with their disorder)
So today... We come to the DSM 5. We see a removal of the AXIS system and subsections of Schizophrenia added.
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