Physical Illnesses May Soon Be Labeled Mental Disorders

Polaris · Jan 20, 2013

http://www.psychologytoday.com/blog...llnesses-may-soon-be-labeled-mental-disorders

This article, published in December 2012, discusses the new DSM 5 (The Diagnostic and Statistical Manual of Mental Disorders) criteria they are adding as of May 2013. Added is a new diagnosis, "Somatic Symptom Disorder" or SSD, which is explained below.

Here is the new DSM’s definition of Somatic Symptom Disorder. (Warning: you may have trouble believing what you’re about to read.)

People can be diagnosed with SSD if, for at least six months, they’ve had one or more symptoms that are distressing and/or disruptive to their daily life, and if they have one of the following three reactions:

Criteria #1: disproportionate thoughts about the seriousness of their symptom(s);

Criteria #2: a high level of anxiety about their symptoms or health; or

Criteria #3: devoting excessive time and energy to their symptoms or health concerns...

What’s the problem with all of this? I recognize that there could be a plus side to being diagnosed based on the DSM. Some health insurance companies won’t cover mental health treatments (from therapy to psychotropic drugs) unless the patient has a diagnosis from the DSM. So if you wished to seek therapy or try these medications to help you adjust to the drastic life changes brought about by chronic pain or illness, it’s possible that this expanded definition of somatic disorders will allow you to get these services paid for by your insurance company.

But the downsides of including Somatic Symptom Disorder in the DSM-5 far outweigh the benefits:

1) Those of us with little-understood illnesses who are “excessively” proactive in trying to get answers could have a psychiatric diagnosis added to our medical charts. Then every specialist we’re referred to would see it. The stigma of mental illness is, unfortunately, alive and well in the twenty-first century. In addition, for many of us, it would become a double stigma because we already have a diagnosis that is disregarded by many health care practitioners—CFS, Fibromyalgia, IBS, to name but three.

2) Once a person is diagnosed with a mental disorder, it increases the likelihood that his or her doctor won’t look further for a physical basis for that person’s symptoms. (And it’s possible that health insurance won’t cover those tests anymore since the person has been labeled as having a mental disorder.) This could even affect the motivation to continue to fund and perform research into little-understood illnesses such as CFS and IBS.

And what about illnesses that can take years to diagnose, such as Lyme Disease, Fibromyalgia, Multiple Sclerosis, Systemic Lupus and other autoimmune diseases? If a patient is given a Somatic Symptom Disorder diagnosis early on after reporting symptoms, it’s highly possible that further testing and investigation into physical causes will be put on hold and a person would never get the proper diagnosis and treatment.

The same author updated her article January 17, 2013 here:
http://www.psychologytoday.com/blog...al-illness-may-now-be-labeled-mental-disorder

Another interesting article written by Allen Frances, who worked on the DSM IV taskforce, and has tried to keep this diagnosis from being included in the DSM 5, if you'd like to read:
http://www.huffingtonpost.com/allen-frances/terrible-news-dsm-5-refus_b_2473321.html

There is a website dedicated to the new DSM 5:
http://www.dsm5.org, but of course, I found little information on anything specific. I'm still researching, so if you have anything to add, please do.

A petition on whitehouse.gov you may sign, in an effort to stop this "diagnosis" from being added to the new DSM:
https://petitions.whitehouse.gov/pe...ased-revised-criteria-dsm-5-may-2013/vDSKX9XT

wildbill_52280 · Jan 21, 2013

i was diagnosed with an anxiety disorder, and it wasnt covered by my insurance, im sure it is in the DSM.

To me, this is a wild out there conspiracy theory perhaps, but this new classification may be a way denying someone medical care for a real illness, that doctors just cant figure out, or dont want to figure out.

its another way of doctors to abuse their positions of authority, when they feel they need to write off someones own concerns about their body, who are underinsured and basically a liability for the business of medicine. now they have better/legal reason to delay the treatment of the underinsured.

this would be the classification for someone who, disagrees with their authoritative judgement of saying, there is nothing wrong with you, when you know in your heart and soul there is. for all the medical dissenters, now their is a classification for them, and they can more legally be determined to be called crazy.

this person was me by the way, this is what happened to me. i disagreed with them and demanded them do more tests, they eventually budged and found a tumor on my liver, then crohn's disease. I really pissed them off, i was right. i had a real reason to be concerned with my health, there was nothing psychosomatic about it.

levi · Jan 21, 2013

To me, this is a wild out there conspiracy theory perhaps, but this new classification may be a way denying someone medical care for a real illness, that doctors just cant figure out, or dont want to figure out.

Let me use your format and posit what came to my mind:

To me, this is a wild out there conspiracy theory perhaps, but this new classification got me thinking about the gun control (now gun safety) legislation/executive orders that would deny you the right of firearm ownership if you have been diagnosed with a mental illness. I sometimes discuss treatment options insistenly with my GI as I am adamently against certain treatments. I also tend to be a pessimistic person by nature and he has picked up on this. I will surely be guarded at my next appointment because I don't want to be forced to choose between my firearms and freedom to have somewhat of a choice in my treatment options.

PS My pessimistic streak is actually a logical calculation, it prepares you for dissappoint and allows for many unextpected surprises. :thumright:

Polaris · Jan 21, 2013

wildbill_52280 said:
To me, this is a wild out there conspiracy theory perhaps, but this new classification may be a way denying someone medical care for a real illness, that doctors just cant figure out, or dont want to figure out.

its another way of doctors to abuse their positions of authority, when they feel they need to write off someones own concerns about their body, who are underinsured and basically a liability for the business of medicine. now they have better/legal reason to delay the treatment of the underinsured.

this would be the classification for someone who, disagrees with their authoritative judgement of saying, there is nothing wrong with you, when you know in your heart and soul there is. for all the medical dissenters, now their is a classification for them, and they can more legally be determined to be called crazy.

I agree with you completely, wildbill. My mom suffers from gastroparesis, and her doctors have basically given up on her. If she fights them or disagrees, they tend to write her off more. How can we continue to fight with these new "standards"? It's insane.

Niks · Jan 21, 2013

This is scary! It has already been suggested that my daughter is 'making' herself sick! Although they have admitted she is seriously obstructed. Even a barium meal didn't go past her stomach. She has constant rectal bleeding even if she doesn't have a BM.

So frustrating!!

UnXmas · Jan 28, 2013

I was treated along these lines for a long time. Primarily I was treated for anorexia due to weight loss and trouble eating (which were actually due to digestve problems). I experienced so much discrimination from medical professionals. Even if I genuinely had an eating disorder, I would have been devestated by the ways I was treated. Mental illness seemed to be viewed as something the patient was responsible for and eating disorders were something patients could stop doing if they were given enough punishments - taken out of school, forbidden to exercise, prevented from socialising - whatever would make each individual patient miserable. I was in a treatment centre for teenagers, but the punishment system seems to apply to adult eating disorder patients as well.

It was very much the case that my physical symptoms were not investigated because of this. They would not even consider that I might have both a mental and physical illness, let alone that the mental one was misdiagnosed all along.

I was later misdiagnosed with IBS, which seemed to be viewed by medical professionals as primarily a mental disorder - or at least one that's caused by lifestyle rather than anything truly physical.

It took years to get the correct dignosis, and that only happened because my health got so much worse.

I'm in the UK so issues about insurance, etc. aren't relevant. I find it hard to understand why so many doctors are so keen to put illnesses down to stress or psychology, or why they are so quick to write off any digestive problem as IBS. I don't understand where the motivation for these tendencies comes from.

Many medical professionals are prejudiced against people with mental illness. Not all of course, but it does seem to be the most prevailant way of seeing mental illness from everything I've observed and read. I'd love to know whether this is the case since I only have anecdotal evidence to go by, and to know in what ways medical professionals are trained to understand mental illness, especially those from other areas of medicine who come across mental illness patients even when it's not their speciality.

I wonder whether classing physical symptoms/illnesses as psychiatric is a result of the negative associations attached to mental illness.

Ya noy · Jan 28, 2013

Somatic symptom disorder, huh? OMG!

I've never believed there was much sanity in psychiatric professions anyway.

mnsun · Jan 28, 2013

I would echo Levi's concern, at least with respect to MM as well as POSSIBLY Low Dose Naltrexone. If I were you--an LDNer--I probably wouldn't go out of my way to tell random physicians that you take LDN. They're likely to assume you're a heroin addict or something and forget the whole "low dose" part of the equation. Gun rights, among others, could be up for grabs.

levi · Jan 29, 2013

I would echo Levi's concern, at least with respect to MM as well as POSSIBLY Low Dose Naltrexone. If I were you--an LDNer--I probably wouldn't go out of my way to tell random physicians that you take LDN. They're likely to assume you're a heroin addict or something and forget the whole "low dose" part of the equation. Gun rights, among others, could be up for grabs.

Oh God I hadn't thought of that. When I went in and got set up for the inevitable round of Pred last August and we discussed LDN my GI said, and I remember the exact phrase, "I know you're hot for LDN." So he knows I've put serious research and thought into it. Oh well, that cat's out of the bag. I would try MM in a heartbeat if it were legal in North Carolina. Wouln't that be something, me getting put on a substance abuse list and I've never smoked a cigarette, much less a joint in my life. I've never had more than a few sips of beer in my entire life in sum or maybe a tiny glass of wine in any single day every few months. :ysmile:

mnsun · Jan 29, 2013

I wouldn't fret so much with the doctor who knows what it is, mainly the GPs or random doctors seen for infections/physicals. I would maybe voice your concern with the prescribing doc and ask him how to keep such things on the down-low.

I'm probably overthinking it, but I had a run in with a tick and went to a cheap clinic. There I got the impression they were prying for info they had no business asking (spousal/substance abuse etc.). These petty power tripping government minders are to be suspect.

UnXmas · Jan 29, 2013

levi said:
Oh God I hadn't thought of that. When I went in and got set up for the inevitable round of Pred last August and we discussed LDN my GI said, and I remember the exact phrase, "I know you're hot for LDN." So he knows I've put serious research and thought into it. Oh well, that cat's out of the bag. I would try MM in a heartbeat if it were legal in North Carolina. Wouln't that be something, me getting put on a substance abuse list and I've never smoked a cigarette, much less a joint in my life. I've never had more than a few sips of beer in my entire life in sum or maybe a tiny glass of wine in any single day every few months. :ysmile:

I'm the same - don't drink, don't take drugs, never even smoked. I think when doctors label physical disorders as mental illness, stereotypes play a big part in determining the kind of mental illness they go for. I've never once had a problem with doctors suspecting I'm seeking drugs for recreational reasons, even though I have a prescription for opiate pain killers. But as a young, middle class female, I've been diagnosed with anorexia and questioned about anorexia more times than I can count.