As a psychologist, one of the tools I may use to understand and address mental health concerns is the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). This guide provides standardized criteria to help diagnose a wide range of psychological conditions, which may offer clarity and direction for treatment planning. However, while the DSM-V can be an invaluable resource, it’s important to approach it with an awareness of the broader, post-modern perspective that invites us to consider the complex nature of human experiences beyond the confines of a diagnosis.
Psychologists are trained to assess and diagnose mental health conditions using tools like the DSM-V (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition). However, psychologists provide provisional diagnoses, which are tentative conclusions based on the symptoms and assessments they observe. These provisional diagnoses may be used to guide treatment and further exploration.
For a confirmed diagnosis, only a medical doctor or psychiatrist have the authority to prescribe medication and make definitive medical diagnosis.
Provisional or confirmed diagnoses can help validate your experiences and guide treatment, but they are not a complete explanation of who you are.
While a diagnosis should never be the sole way to define a person’s experiences, it can still offer positive outcomes. It can provide a framework to understand and clarify what might be influencing your thoughts, feelings, and actions. For example, if you’re experiencing symptoms of anxiety, a diagnosis could help identify potential underlying factors such as trauma or stress, which can, in turn, help guide treatment options in therapy.
A diagnosis can provide reassurance—it can be validating to know that there are clear reasons for your struggles and that you are not alone. Many people face challenges similar to yours, and knowing this can foster a sense of connection and understanding. The right diagnosis can be the first step towards finding effective treatment that is tailored to your unique needs.
The post-modern position on the growth of the DSM, from its original 130 pages in 1952 to the current 1,100+ pages, critically examines the influence of pharmaceutical companies and other industries on the development and expansion of the manual. Post-modern perspectives often challenge traditional, medical model narratives and question the power dynamics that shape societal norms, including the definition of mental health and illness.
Here’s a breakdown of the post-modern position:
One of the primary criticisms from a post-modern perspective is that the DSM’s expansion reflects the medicalization of increasingly broader aspects of human experience. As the DSM has grown, more behaviours, emotions, and life challenges have been pathologized, leading to a wider definition of what constitutes a mental disorder. The post-modern view suggests that many of these conditions may be normal human variations, influenced by societal pressures, rather than medical illnesses requiring diagnosis and treatment.
A key argument is that the growth of the DSM is partly driven by the influence of pharmaceutical companies and the biotech industry, which stand to gain financially from the expansion of mental health diagnoses. As the DSM introduces more conditions, the market for pharmaceutical treatments for these conditions grows. For example, as more disorders are recognized (like certain anxiety or mood disorders), pharmaceutical companies create and promote medications to address those conditions, thus increasing their market share.
Critics argue that pharmaceutical companies may exert lobbying power, funding research, or influencing the inclusion of certain conditions in the DSM, often in ways that prioritize profit over patient well-being. The post-modern view questions whether these industry influences have led to an over-pathologization of human experiences, with a focus on medication-based treatment rather than non-pharmaceutical interventions.
The post-modern critique also suggests that as the DSM has expanded, it has increasingly pathologized normal life struggles, such as grief, shyness, and stress, by framing them as diagnosable mental disorders. This expansion has opened the door for pharmaceutical companies to market medications for these newly recognized conditions, potentially altering how society views common human emotions and experiences. The post-modern position argues that these expansions may not necessarily reflect a true increase in mental health issues, but rather an artificial widening of the definition of “illness” driven by industry interests.
The post-modern perspective highlights that mental health diagnoses are not purely objective; they are influenced by cultural and societal factors. As societal norms change and industries shape those norms, what is considered “normal” or “abnormal” evolves. For example, behaviours or emotional states that may have once been considered part of the human experience (like grief or intense social anxiety) are now categorized as disorders that require professional intervention. This shift can be influenced by market forces, which push for the medicalization of behaviour to create demand for psychiatric services and pharmaceutical products.
A post-modern perspective also brings attention to the lack of transparency in how the DSM is developed and the potential biases that may affect its evolution. Many DSM revisions have involved collaboration with individuals who have ties to pharmaceutical companies or other stakeholders with vested interests in expanding the scope of mental health diagnoses. These financial and professional connections can create a conflict of interest, leading to a distortion in the way mental health conditions are understood and classified.
As more conditions are recognized and categorized, individuals diagnosed with these conditions may increasingly identify with them, potentially leading to a narrower sense of self. The post-modern view cautions against this, arguing that people are much more than their diagnoses. While a diagnosis can provide clarity and help individuals understand their struggles, it can also lead to the stigma of being labeled with a mental disorder. This process of identity constriction may be fueled, in part, by an over-reliance on labels that come from an expanded DSM driven by industry pressures.
The post-modern critique of the DSM’s growth highlights the complex relationship between medicine, society, and profit. It suggests that while the DSM’s expansion may have helped identify and treat previously overlooked mental health conditions, it has also been influenced by pharmaceutical and other industries that profit from the medicalization of human experiences. The challenge lies in finding a balance between acknowledging the importance of mental health diagnoses while avoiding the risks of over-diagnosis, over-medication, and the erosion of individual identity.
Ultimately, it’s crucial to recognize that mental health is not a one-size-fits-all experience. While provisional diagnoses and labels have their place in understanding and treatment, we always take a holistic approach that goes beyond simply identifying symptoms. Together, we will work to address the emotional, relational, and situational factors that contribute to your current experience. We can explore your strengths, values, and hopes for the future, and move forward with tools that empower you to heal and thrive.
You are much more than your diagnosis—let’s work together to explore who you truly are and how you can create the life you want.
