DSM5 for Laymen

The Devil’s Hole Sinkhole

“The Committee of Doctors appointed by the psychiatric association had attempted to execute a paradigm shift, changing how mental disorders are conceived…” was how the Times described the process of creating the new DSM5, “the so-called bible of mental disorders (“A Tense Compromise On Defining Disorders,” NYT, 12/10/12).  Even without having looked at the new DSM-V, here are some of new redefinitions that might run through the mind of a lay person who has followed some of the controversies surrounding diagnosis. The increasingly popular bipolar disorder would be changed from a shift in the mood of a patient to an environmental problem involving global warming. In short bipolar disorder is now melting of the ice caps at the North and South Poles. Manic depression, a condition that was formerly characterized by feelings of almost unbearable exhilaration tempered by countervailing feelings of worthlessness would be changed to a geological malady. For instance, sinkholes of the kind that effected the city of Berezniki (“A Russian City Always on the Watch of Being Sucked into the Earth,” NYT, April 10, 2012) and quicksand pits would both qualify as examples of manic depression. Borderline personality disorders, which rank amongst the most serious of mental disorders would currently be treated as territorial disputes. An obvious borderline problem would be one in which two countries (and in particular the personalities who occupied them) actually disagreed about their borders. The conflict between China and Japan over the Senkaku Islands and the conflict between Britain and Argentina over the Falklands both qualify as borderline disorders under the new paradigm. In the new DSM5 the symptoms of multiple personality disorder would include the creation of aliases in order  to avoid paying bills and/or alimony.