Are We All Crazy? What Psychiatrists Say is Abnormal Now

Rats. Just when you thought you might escape being labelled crazy. A new edition of the psychiatrists' "bible" has been published and it seems the American Psychiatric Association has been very busy.

Busy, that is, medicalising just about every type of human behavior you can think of.

The new Diagnostic and Statistical Manual of Mental Disorders (DSM 5) lists far more mental illnesses than the previous edition in 1994.

"Sorry about my dad ogling you. He can't help it. He's got hypersexual disorder."

Where a shrink might once have said "He's a heavy gambler," he can now say "He's suffering from a gambling addiction," and prescribe a drug. Where he might once have said "You're pre-menstrual," he can now say "You have pre-menstrual dysphoric disorder," and prescribe a drug. Pop will no longer be a randy old goat. He'll be suffering from "hypersexual disorder." Yes, there's a drug for that too.

Be careful who you talk to and what you say. If it turns out you scoffed a whole pizza last night you could be in line for a "binge-eating disorder" diagnosis. Spend too much time on the internet? Dodgy. You've probably got "internet addiction." Feel a bit shy sometimes in a large gathering? That'll be social phobia then. In fact, pretty much anything you do a lot of can get you labelled an addict or an -aholic.

Here are the symptoms of the new psychiatric disorder of binge-eating, for example: recurrent episodes of binge-eating, eating more than most people would consume, eating rapidly, lacking control, eating till uncomfortably full and with subsequent feelings of guilt. Well, duh. What happened to greedy and undisciplined?

Notice also that the symptoms are pretty vague, as they often are with the new "illnesses." 'Eating more than most' is pretty hard to define.

"Minor neurocognitive disorder" has equally vague and undeniably minor 'symptoms'. It's a 'minor cognitive decline from a previous level of performance.' You mean you sometimes lose your keys and you never used to? That would cover just about everyone who's older than they used to be then. Pass the pills, would you?

Bringing a bit of common sense to the table is the mission of Professor Peter Tyrer of Imperial College London. He chairs the working group leading revision of the International Classification of Diseases (ICD), DSM's European equivalent.

Here's how he responded to the new DSM:

"The joke about the DSM is that it doubles in size each time it is revised so everyone is pathologised in time. I call hypersexual disorder the Bill Clinton Syndrome. If you're really going to pathologise men who can't stop thinking about sex, that is going to be an awful lot of men. Similarly with pre-menstrual dysphoric disorder - it's likely to affect 50 percent of women of child-bearing age."

He added that the psychiatrists revising the DSM "promised to include only disorders with a proper basis in biology. They have abandoned that entirely now. The scope has widened further than ever despite concern that we are medicalising far too many conditions."

Abnormal is the new normal

There are several problems with the relentless tendency of the psychiatric profession to pathologise our behavior. One is the dishonesty, or call it greed. It's perfectly clear how the profession and the drug companies benefit from persuading people they need drugs or therapy, or both, for a habit or an idiosyncrasy. Another is that it's corrosive on an individual level to pathologise common, imperfect human behavior. And it's also corrosive on a social level to spread the fiction that almost everyone has some mental illness. Treating ever growing numbers of people with drugs, and often powerful psychotropic drugs, is also a disservice to society.

One of the most sinister aspects of the new "everyone's sick" culture is its extension to children. "Psychosis-risk syndrome," for example, will be applied to kids who are in general a little suspicious (who wouldn't be with all these crazy people around?) or hold irrational beliefs. That could affect an awful lot of children and an awful lot of teenagers. ("I'm NOT pretty, mum. I look like a dork. Everyone thinks so.")

The drug companies, and some academics, are naturally rubbing their hands in glee. If you're going to develop a drug to treat adults, it's a great spin-off if you can get kids to take it, too.

DSM 5 was still in draft form in early February 2010, and subject to review. Pressure should be applied to the psychiatric profession, and drug companies, to stop them labelling everything we do. It's getting to the point where one has to wonder if the psychiatric profession itself has become deranged. Perhaps they're suffering from pathologising-everything-that-moves addiction. Or must-get-into-the-deep-pockets-of-the-drug-companies disorder.