The DSM (Diagnostic and Statistical Manual) is the list of diagnoses written by and for psychiatrists who dispense FDA approved pharmaceuticals. Insurance decides which medications to cover for which indications. The DSM does not take into consideration all the possible causes of psych disorders, nor allow for the possibility that diet and lifestyle changes might actually bring about resolution. Insurance companies and psychiatrists benefit when patients decide they need a medication for life and are willing to pay for it. The DSM is essentially lists of symptoms used to authorize mental health professionals to dispense psychoactive medications. The conflicts of interest are well documented and the paucity of evidence behind the diagnostic divisions is somewhat appalling.
The National Institute of Mental Health (NIMH) has apparently decided the DSM is not overly relevant to its desire to find out the truth about psychological symptoms and disorders. The NIMH is not using those diagnoses as a foundation for ongoing research. The new Research Domain Criteria (RDoC) project to is intended to transform diagnosis by incorporating genetics, imaging, cognitive science, and more to create a new classification system. The new system of knowledge will be based on biology as well as symptoms, and will consider specific brain circuits, genetics, and experiences without regard for DSM categories. In fact the NIH is looking to support research projects that look across or subdivide current categories.
This is superb and hopeful to everyone who was ever stuck with a diagnosis that didn't fit, or medicated (with side effects) when a simpler solution wasn't even entertained. My congratulations to the NIH for being independent enough to seek the truth. Evidence-based medicine may eventually come to the world of psychiatry.
Teresa Gryder ND is a naturopathic physician with a unique perspective on mental health, and a wide range of evidence-based alternative treatments to consider. Originally from Tennessee, she currently practices in Portland, Oregon.