Frequently Asked Questions About DSM

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My mental health journey started at the tender age of five. I had no recollection of it, but that was the first time I met a child psychologist because my parents were worried about my behavior. They kept getting called by the preschool teacher due to my hyperactivity and inattentiveness in the classroom, which was not normal even for kids my age.

Although Mom and Dad were reluctant to take me to a psychologist initially, it turned out to be the best thing they could do at the time. The psychologist diagnosed me with attention-deficit hyperactivity disorder (ADHD), a condition that practically made it almost impossible for me to stay still unless I was asleep. It took me a couple of years in therapy to tone down my hyperactivity and inability to focus, but it worked.

Life After Diagnosis

Not many people knew about my ADHD except for my teachers and some close friends. I did not want to hide it, but it’s undoubtedly something that I did not need to divulge whenever I talked to new acquaintances. When I tried that when I was younger, I realized that other people could be very judgmental, and some parents of my classmates did not want me around their kids, afraid that I would run amok anytime.

Despite those minor hiccups, my childhood was pretty average. I did not have to get special education, so I worked hard like everybody at school. Often, though, I had to work harder, given that I could not always concentrate on my lessons and assignments. My parents also encouraged me to try different sports to have an outlet for my seemingly never-ending energy. That helped the school football team win a few championships, of course. I genuinely felt like I got everything in the bag, and my ADHD would never hinder me from finding success in life.

Then, Another Diagnosis Came 

I slipped in the bathroom a few weeks before my senior year started and almost broke my back. I was so upset because of two things: 1) I was looking forward to ending my high school football career on a high note, and 2) I probably had the lamest accident in history. That was the first time I did not feel energetic to do anything – not even eat and sleep, which I used to be a champion at. On occasions, though, I would feel like the king of the world and strut around the school, pulling stunts that I was not supposed to do.

My parents got worried about me again, so they brought me to my long-time psychologist. They dragged me to the first consultation, considering I did not want to do that at all. Several consultations later, though, I got diagnosed with bipolar disorder.

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My initial reaction was, “No way!” I mean, an ADHD and a bipolar disorder? It sounded impossible for me for one person to get two mental illnesses in a lifetime.

The psychologist noticed my disbelief, so she asked me, “What do you like to do other than playing football?”

“I love reading,” I replied, though I had no idea where this conversation was leading.

Before the session ended, she handed a heavy book to me.

“This is the DSM. Mental health professionals use it to diagnose people better, but you can read it until our next consultation. You may find something enlightening there,” the psychologist said.

What does DSM mean?

 DSM stands for the Diagnostic and Statistical Manual of Mental Disorders. It comes in the form of a handbook for mental health professionals that the American Psychiatric Association writes and updates every few years. The first edition was published in 1952.

What is the DSM 5 definition of mental disorder?

 According to DSM-5, a mental disorder is a condition that has been proven to affect a person’s cognitive, emotional, and behavioral abilities. It serves as a reflection of psychological, developmental, or biological issues that are perhaps unknown even to the individual.

What is the difference between DSM 4 and DSM 5?

 The primary difference between the fourth and fifth editions of DSM is the number of symptoms that individuals must show before psychologists and psychiatrists can say that they have a specific mental disorder. APA has also changed the chronological order of the categories and removed the multiaxial system and global assessment of functioning (GAF) that professionals have been using for years. They replaced GAF with WHO Diagnostic Assessment Scale (WHODAS), which analyzes the patient’s diagnostic profile besides the other factors.

What are the 5 DSM categories?

 DSM used to have five categories, divided into axes: clinical disorders, personality disorders, medical/physical conditions, environmental factors, and functioning assessment. This is supposed to make it easy for mental health professionals to come up with a diagnosis.

However, the DSM-5 categories are seen in the second section of the handbook. They present various mental disorders that go under neurodevelopmental, psychotic, bipolar, depressive, anxiety, obsessive-compulsive, trauma, dissociative, somatic, eating, sleep-wake, sexual, gender, and addictive disorders. These categories seem less detailed compared to how the mental illnesses have been laid out in DSM-4.

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What does the DSM 5 stand for?

 DSM-5 Stands for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders that the American Psychiatric Association created in ten years.

Is the DSM IV still used?

 Since the DSM-5 showcases a significant change in how the disorders have been categorized and how the psychiatric disorders should be diagnosed, the DSM-4 may be rendered useless at present. You may still read the latter, for sure, but if you are a new mental health professional who’s about to make a diagnosis, you should follow what’s written in the DSM-5 since it’s the current version.

What is a DSM category?

 A DSM category is practically a general criterion of mental disorder that various conditions fall under. For instance, it’s easy to deduce that anxiety is a sub-category of the same illness. When you have a panic attack, phobia, or selective mutism, it all goes under anxiety too.

What disorders are in the DSM 5?

 There is a wide range of disorders – 157, to be exact – found in the DSM-5. It entails that more than 100 illnesses have been culled from the DSM-4. The new conditions they have added, though, are disruptive mood dysregulation disorder and social communication disorder.

Is the DSM reliable?

 The DSM has been deemed a reliable source of psychiatric information for decades. Most – if not all – mental health professionals can access it and study it front and back before diagnosing patients. However, its reliability had waned since 2013 when the APA released DSM-5, which featured massive changes in the handbook’s overall structure. More importantly, they reduced the number of mental disorders detailed in the manual, removed the multiaxial system, and practically “medicalized” the conditions. The fact that pharmaceutical data have influenced the DSM revision does not help to increase its value.

What are the 5 axes in psychology?

 DSM has taught mental health professionals that there are five axes for every diagnosis. 

Let’s say a person potentially has depression.

  • Clinical Disorders – From the get-go, does the patient show various syndromes? 
  • Personality/Developmental Disorders – Is the person behaving in a non-conventional way? Do they have characteristics that have been present since infancy or childhood?
  • Physical Conditions – Has a doctor diagnosed the individual with a medical condition? If not, are they dealing with physical ailments like a headache, muscle pain, etc.?
  • Environmental/Psychosocial Factors – How is the patient’s life at home, school, or work? Are they always surrounded by bullies or generally negative folks? Do they have money or relationship issues?
  • Global Assessment of Functioning – A scale going from 0 to 100 that mental health professionals give to the patient after assessing the first four factors above. The higher your rating is, the healthier you are. If you get any number from 1 to 10, it entails that you are possibly suicidal or violent.

How many disorders are in DSM IV?

 There are 297 disorders in DSM-4.

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What does multiaxial mean?

 Multiaxial practically means that a mental health professional needs to assess various areas before providing a patient diagnosis. According to DSM-4, the symptoms are visible not only through the individual’s personality but also through physical health. After all, if you talk to a depressed person, they may complain about sleep deprivation, fatigue, and bodily aches, aside from suicidal thoughts. As for the trigger factors, it can be bullying, loss of a loved one, etc.

What is the difference between Axis I and Axis II disorders?

 When you talk about Axis II disorders, you focus on personality disorders, such as narcissism, sociopathy, borderline personality disorder, split personality disorder, and many more. Mental retardation is also a part of it, and its symptoms include:

  • Speech and cognition delays
  • Lack of practical skills
  • Overall slowness
  • Inability to communicate as well as their peers

When it comes to AXIS I disorders, think of every mental illness that is not considered mental retardation or personality disorder. That includes (but is not limited to) depression, anxiety, obsessive-compulsive disorders, addiction, psychotic disorders, gender issues, sexual dysfunctions, etc. 

What does the DSM 5 say about ADHD?

 ADHD refers to a disorder that is characterized by excessive inattentiveness and hyperactivity. This definition is the same for the fourth and fifth editions of DSM. However, what’s changed is that mental health professionals merely need to identify how early and how often the patient has experienced the symptoms over the years. This allows individuals to receive diagnosis faster than usual.

Final Thoughts

The DSM taught me that there were approximately 200 mental disorders on the planet, and I got pretty lucky for not getting more severe conditions. I gave the book back to the psychologist and became more cooperative than ever in dealing with the comorbidity.