The APA’s DSM 5: What’s Up With That? by Dr. Margaret Cochran, author of “What Are You Afraid Of?”

Dr. Margaret Cochran

Save the date folks, the new DSM 5, aka DSM V, until the American Psychiatric Association (better known as the APA) decided to drop the Roman numerals (it’s my suspicion that they did it because they can’t count higher than that in Roman numerals, I’m just saying…) is due to be released in May 2013.

So far there’s been lots of ‘hoo-hah’ and ‘folderol’ about this momentous occasion, but you know the APA, any excuse for a party! The DSM is an amalgam of sorts, a bureaucratic zebra, you know, a horse made by a committee. I want to offer my apologies to zebra lovers everywhere for that last comment. I’m really a zebra enthusiast myself but when it comes to color choices, they’ve got commitment issues, if you know what I mean.

Anyway, let’s backtrack a moment and I’ll explain a little bit about what the DSM is and is not. The letters DSM stand for the Diagnostic and Statistical Manual of Mental Disorders and it’s been around since 1952. The volume due out in spring 2013 is, as its numerical moniker indicates, the fifth revision of the document.

Now, there are groups who pretend they are part of a religion instead of a cult, and/or unscrupulous individuals who like to make a buck or two on scary videos, that jump up and down and flush like toilets in fact or on film, about the reality that the newest DSM has more diagnostic categories in it than the last one did. And, these individuals and groups contend that all these new diagnostic categories were created solely for the benefit of the pharmaceutical industry so that they can more easily and conveniently sell ‘chemical enhancements’ to an unbalanced and easily led ‘lay’ public. And to that I say, “Good gravy Edna, come in from the barn, the manure fumes have gone to your head!”

The DSM is nothing more than a nomenclature, a language, a ‘shorthand’ if you will, for mental health professionals to use to communicate as clearly and concisely as possible with one another about people’s problems. There have been, I’m sad to say, many unspecific, generalized, ‘wastebasket’ categories that people have gotten thrown into, and that is a bad thing. As science, medicine and diagnostic specificity have improved the names of people’s problems have become more descriptive, and that is a good thing.

Has the DSM been used to cause harm? Yes, and an example of this is that at one time it pathologized homosexuality. This was a dark and regrettable period in the world of mental health, most notably because pathologizing homosexuality was not only wrong, it created a great deal of mental and emotional illness in our society that we are still suffering from today, I’m sorry to say.

Can the DSM be used unethically in an attempt to justify certain treatments and medications? Absolutely, like any important document, the US constitution, the Bible, the Geneva Conventions, anything can be manipulated by unethical people. And are there unethical mental health professionals? There are indeed, just as there are unethical journalists, lawyers, dentists, bankers and stockbrokers (who knew), as well. No matter what the profession, government or religion, in practice it can only be as good and helpful as the people in it.

The truth is that two people with the same diagnosis don’t necessarily warrant the same treatment, and it’s the job of your mental health professional(s) to keep abreast of, and understand, the treatment options available and to work with you to find your ‘secret formula’ for optimal health: mental, emotional, physical and spiritual.

OK, “So where do I get one of these brilliant doctors?” you might ask. An excellent question, and the honest answer is ‘caveat emptor’, let the buyer beware. You have to do your homework on who is available in your area. However, I can tell you what kinds of things to look for. You need to seek out mental health professionals who will take a thorough history of both yourself and your family of origin. They need to ask you detailed questions about your diet, exercise habits, medications, any physical ailments you might have, your job, your romantic relationships and your support system. You also need to have labs done and have a complete physical examination. Why? Because there are many physical ailments that can cause or masquerade as mental illness and some that can make existing mental illness worse. The bottom line is that there are certain problems you can ‘cure’ without medication and there are certain problems that you can’t. It is the job of your mental health professional(s) to know the difference.

Oh, and by the way while we’re on the subject, your best and most powerful defense against mental or physical illness is love, and living a joyful life. Without love and joy, no matter what pills you take, recreational drugs you use, or food you eat, life just isn’t worth living. So engage in joyful behavior every day, and if you’re not, ask yourself why not. And please be sure to tell the people you love, that you love them (and just thinking about it doesn’t count) you’ve got to say it, sing it, Twitter it, email it, nowadays the communication options are almost endless. So do it, come on! You’ll feel better, and as a result we’ll feel better too. Because here it is in a nutshell: when any one of us is ailing we are all ill, and when any one of us is restored to health, we are all made better!

Join Dr. Cochran on November 5th, 2011in Los Angeles for  A JOURNEY THOUGH ROMANTIC LOVE: What it is. What it is not. How to get it. How to keep it, workshop where she focuses on techniques for how to manage, and what to expect from one of the most challenging developmental tasks of adulthood: the many faces of romantic love. For more details email or visit

Dr. Cochran is a transpersonal psychologist, licensed clinical social worker, educator and author with more than 30 years of experience. Dr. Cochran works with her partner, board certified family physician David J. Waggoner, MD, at Saratoga Family Health Center, where she takes a whole person approach to health and wellness, treating the individual, not the symptoms.

Dr. Cochran is the author of “What Are You Afraid Of” and a columnist for The Huffington Post and a contributor to Psychology Today.

Dr. Cochran hosts the radio program; Whole Brain Thinking: Wisdom, Love, Magic Visit: and