Sally Satel MD, writes her opinion about the upcoming release of DSM 5. Apparently former President Bill Clinton will announce the release this coming weekend in San Francisco. The book has been fourteen years in the making, and with all due respect to Dr. Satel, I think psychiatrists care a lot about this new publication, attempting to pronounce who has a mental illness. I am not sure how one can care about the mentally ill and not care about the labels which shape patient’s identity. As one of my commenters said recently, in response to my post about distinguishing ADHD from Asperger’s Disorder (now called Autism Spectrum Disorder), she did not understand herself because she was told that she had issues which made no sense to her. This confusion, brought on by clinicians, not meticulous about diagnostic classification, causes harm to patients and their families. DSM 5 is likely to cause more patients to believe they have a mental illness, when, in fact, they are struggling with issues of powerful family dynamics, causing symptoms which potentially disable them. This uptick of diagnosis brings more business to psychiatric facilities, mental health practitioners and disability offices, but it also changes the patient’s understanding of what ails them. Likewise, the promise of quick treatment, can lead patients to feel very discouraged that they are not obtaining symptom relief. It would be as if yoga promised patients flexibility, instead of promising them the journey towards deep breathing. The depth of the problem is often not captured in our diagnostic manual, and as such, patients with means, are left to seek treatment from practitioners willing to take the time and the thoughtfulness to tolerate the messiness and uncertainty of exploring an interior landscape which is varied and constantly changing. DSM 5, like DSM IV, encourages a hastiness which is destructive to training new psychiatrists, and hence destructive to patients understanding the complexity of their experience. Dr. Satel is wrong, in my opinion, that DSM 5 is a non-event to clinicians. DSM 5 dashes our hopes for a field which promotes depth and breath, rather than checklists which look at static experiences. DSM 5 is an outrage. That is the fuss.