Problems with the DSM-5

"The new volume is an 'absolute disaster,' it could cause a seismic shift in the way mental health care is practiced in this country."

I've heard a lot of buzzing lately about the DSM-5 (Diagnostic and Statistical Manual) and all the issues it is having. According to this article in Wired, there are some people close to the DSM that are having second thoughts. Allen Frances, the man who "wrote" the DSM-IV, has an op-ed, too, on what he sees is wrong with the new version.

He recommends an abstract by a colleague, John Livesley, which says "The proposal (for DSM-5) totally reformulates the way personality disorders are classified so that there is virtually no continuity with the previous system.... Implementation of the proposal would have serious adverse consequences for patients, treatment, research, and administrative and legal applications, especially in the area of psychological injury and law."

Ouch. So what's really wrong with this DSM? From what I can gather, they're changing the way they define mental illness, and the way they diagnose. I've heard mumblings that soon no one will be "normal," and everything is a disease. One thing that's worrying a lot of people is the severity criteria. They're going to use the new criteria to put people on a scale of illness; kind of like saying you only sort of have the flu. I'm not sure what they think the purpose of that is. I can see a lot of problems, though.

Imagine, you meet the criteria for bipolar - you've been manic, you've been depressed - but you've never been psychotic on either end of the spectrum. You've maintained relationships and jobs, you've been ok. So you're probably a on the low end of the crazy spectrum, right? Well, does that mean your health insurance doesn't have to cover meds? I mean, you're doing fine, right? Or therapy. Can you get by with less? It all seems like a slippery slope to me. By any sort of scale system I'm just suffering, not sick. I can manage to work and interact with people. So does that exclude me from the right to services?

I'm not sure I understand all of it, but there is some interesting dissension amongst the rank and file.

Here's what they're doing with bipolar disorder.