People who are struggling with mental health might be quite capable of describing their symptoms. They might be able to describe how they’re feeling using metaphors, stories or examples, and they might be quite capable of describing how they felt before the troubles began and how things seem different now. But they might not be able to put a name to the difficulties they’re facing, especially if they have a cluster of symptoms that seem to defy simple explanations.
In general, doctors don’t like to begin treatment programs until they understand exactly what a client is dealing with and how other professionals have dealt with the same problem in the past. Similarly, insurance companies don’t like to provide payments for therapies that aren’t attached to a specific type of diagnosis.
The Diagnostic and Statistical Manual of Mental Disorders (commonly abbreviated as “DSM”) is designed to help doctors put a diagnostic name to the symptoms a person is experiencing.
The DSM was developed and is maintained by a committee formed by the American Psychiatric Association, and it’s in use by doctors and therapists who work in a variety of different settings, including hospitals, public clinics and private facilities. When clinicians need to make a diagnosis of a mental health condition, they reach for this resource to do their work.
The DSM is updated on a regular basis, as
research on mental health conditions is ongoing and new information comes to light on a regular basis. As a result, clinicians often use a numeric designation when they’re discussing the DSM, so they can prove that they’re basing their claims on the latest and greatest research the industry has to offer. In 2013, for example, the DSM was revised, and since it was the fifth revision to this document, it’s commonly referred to as the “DSM-5.”
The DSM is written for medical professionals, so the language can be a little dense, but it’s also designed to provide these clinicians with a significant amount of information about the symptoms they might see in someone who has a specific mental illness. It’s a bit like a rulebook, outlining the signs a clinician must see in order to provide a diagnosis of a specific type of disorder.
But in addition to providing information about symptoms, the DSM also includes other bits of data that can help clinicians understand how a mental illness might play out in a person’s life. According to the American Psychiatric Association, descriptive text that accompanies each disorder might include information about:
Family members might not feel as though they need to read the DSM in order to understand how a mental illness works and how it might impact the person they love. But they will find that the DSM is an important part of the journey they’re taking to get help. After all, as an article in The New Yorker points out, insurance companies require a diagnostic code based on the DSM before they will authorize payments to a provider. Without that code, families might not get coverage for the services the person needs.
Similarly, the updating done to the DSM could impact the course of treatment for people who already have a diagnosis of mental illnesses. For example, a study in Health Canal looked at the DSM revisions made to the criteria for people who drink alcohol. Diagnostic details involving people who drink a bit too much, but who don’t quite qualify for alcoholism, have been strengthened and lengthened, and as a result, these researchers found that people who might have been given a clean bill of health a few years ago might now qualify for therapies for alcoholism. As this example makes clear, people who are currently in the mental health system may see their diagnoses bend and sway, depending on the criteria in use at the time.
The manual might also help providers to explain how the disease a person has might progress and how it might impact a person’s life down the line. Families that really want to know what’s coming and how treatment might help might be soothed to learn more about the details held in the DSM.
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