As the American Psychiatric Association's Diagnostic and Statistical Manual (DSM) has unfolded in recent decades you'll notice that this "psychiatric bible" gets larger and larger with more and more diagnostic categories. You don't want to pick it up if you have back troubles ... use a forklift! So, if you wonder if your concerns about yourself, your loved ones, or perhaps your neighbors and colleagues are diagnosable the answer in 2012 is "you betcha!"
Sadly (and tragically in my view) according to the DSM system everything regarding human behavior has a corresponding diagnosis ... and I do mean everything! But attached to the proliferation of diagnoses is the fact that it leads to potential problematic unintended consequences. For example, one of our neighbors has had a great deal of recent troubles with their middle daughter as she begins her first year of high school. After attending a small, private, and well controlled elementary and middle school she enrolled in a very large (2000+ student body) public high school with a very economically and ethnically diverse student body. Things haven't gone too well there for her. She has gotten involved with peers who struggle with drugs and alcohol, acting out behaviors of all sorts, and hasn't engaged in any productive extracurricular activities (such as sports, music, drama, student government) other than boys, friends, and parties. As her troubles escalated the concerned parents took her to a local psychiatrist who immediately diagnosed her with attention deficit hyperactivity disorder (ADHD), prescribed medication, and offered no counseling, therapy, or suggested interventions of any kind. Sadly, this is a pretty typical story in recent years where problematic behavior is immediately diagnosed with a medical sounding condition, medications are prescribed, and no psychological or psychosocial interventions are considered nor are developmental processes and expectations considered as well. The girl likely feels overwhelmed by her new school environment, lacks adequate structured activities outside of the loose academic environment of a large and diverse school, and the parents are not prepared to adequately manage the volatile adolescent emotions unfolding at home.
Psychiatry has found a way to medicalize all human behavior and offer a pharmaceutical intervention for everything. Yup...everything. Whatever ails you...depression, anxiety, sexual functioning, shyness, inattention, and so forth there is a pill for you! Diagnoses such as ADHD, Bipolar, Depression, Erectile Dysfucntion, and Asberger's have become especially popular in recent years. And guess what? This looks like it will get worse before gettign better with the proposed changes to the new DSM (scheduled to be published next year). The criteria for many diagnoses will be lowered (not raised) which means more people will meetthe diagnostic criteria for illness than they do now. While I do believe that these disorders (and others) certainly do in fact exist they appear to be over diagnosed in contemporary times. The unintended consequence is that non medical interventions are too typically ignored. Take a pill for whatever ails you seems to be the rallying cry of the day. I suppose if your only tool is a hammer you'll see nails everywhere and this seems more and more true for psychiatry where pharmaceuticals are the answer to all troubles.
While better living through chemistry can be indeed true for many we have lost the notion that the integration of biological, psychological, social, cultural, developmental, and spiritual influences has their roles to play as well. Additionally, contemporary research has well demonstrated the validity of biopsychosocial influences in not only psychiatric concerns but medical ones as well. If we use the best available research and practice we'll conclude that life has its challenges and that the influences of multiple factors play a role in them and thus should be treated and considered thoughtfully without over diagnosing everything. Life is complicated for sure but a pill isn't the answer to all troubles.
So, what do you think?