Psychological Disorders: Are We Diagnosing Humanity or Defining It?

Stefan Becker

Is the DSM-5-TR a diagnostic bible or a cultural straitjacket? Renowned psychologist Dr. Gabor Maté once said, “What we call a disorder may just be an adaptation to an abnormal environment.” While we celebrate advancements in mental health care, it’s time we confront an unsettling question: Are we pathologizing human experiences or genuinely addressing mental health issues? Psychological disorders like anxiety, depression, and substance use dominate discussions about mental health, often reducing individuals to diagnostic labels. Despite the intent of resources like the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) and the International Statistical Classification of Diseases (ICD-11), these tools have sparked debates on their benefits — and pitfalls.

At their core, these manuals aim to standardize the identification and classification of mental health disorders. This standardization is invaluable for clinicians, researchers, and policymakers alike. For someone battling a debilitating condition, a diagnosis can serve as a guidepost, offering clarity and directing treatment. However, beneath the surface lies a troubling paradox: Is this “clarity” achieved at the cost of reducing human complexity to checklists and codes?

The Foundations of Psychopathology

The term “psychopathology” encompasses both the scientific study of mental disorders and a synonym for psychological disorders themselves. In essence, it serves as a lens through which abnormal patterns of thoughts, feelings, or behaviors are scrutinized and addressed. But what determines whether these patterns warrant the label of a disorder?

Psychological disorders are distinguished by their negative outcomes: distress, impairment, and danger. Distress manifests as emotional suffering, such as the pervasive sadness seen in depression or the relentless worry in anxiety disorders. Impairment refers to disruptions in daily functioning, whether at work, school, or in relationships. Lastly, danger captures the potential harm to oneself or others, such as suicidal ideation or substance-related risks like overdose. These criteria serve as the bedrock for determining whether an individual’s experiences fall within the domain of psychopathology.

However, not all disorders fit neatly into these categories. Consider substance use disorder: Individuals may initially enjoy the euphoria associated with substance use, experiencing little distress. Yet, the eventual impairment and risk of danger make it undeniably pathological. The nuances of what qualifies as a disorder highlight the complexities — and limitations — of our diagnostic frameworks.

The Stigma of Diagnosis: Language Matters

Language shapes perception, and nowhere is this more evident than in the realm of psychological disorders. Historically, individuals were defined by their conditions: a schizophrenic, a depressive, a manic. Such labels not only reduced individuals to their disorders but perpetuated stigma, reinforcing societal biases against mental health issues. Today, the adoption of person-first language (“a person with schizophrenia” rather than “a schizophrenic”) aims to humanize those with mental health conditions and emphasize their individuality.

Yet, the battle against stigma is far from won. Terms like “crazy” or “nuts” remain ingrained in everyday vernacular, trivializing serious conditions and marginalizing those affected. Even clinical terms like “insane”, though now largely confined to legal contexts, carry a weight of dehumanization. Despite these efforts, the question lingers: Is person-first language enough to dismantle centuries of prejudice? Or are deeper societal shifts required to truly destigmatize mental illness?

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Sources:

• American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).
• World Health Organization. (2019). International Statistical Classification of Diseases and Related Health Problems (11th rev.).
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• Allsopp, K., et al. (2019). “Symptom Overlap and Comorbidity in DSM-5 Disorders.” Journal of Psychiatric Research.