The most controversial issue at last week’s annual meeting of the American Psychiatric Association in San Francisco was the upcoming publication of the DSM-V, the revised edition of the APA’s Diagnostic and Statistical Manual of Mental Disorder. The bible for the mental-health industry—originally published in 1952 and revised about once a decade—the DSM has been translated into 13 languages and is recognized around the world as the authoritative text on mental health.
Even though the APA asked the psychiatrists working on the manual’s revision to sign a nondisclosure agreement, leaked proposed additions to the new version have already stirred debate. “Psychiatrists manufacture mental diagnoses the way the Vatican manufactures saints,” says Dr. Thomas Szasz, an outspoken critic of modern psychiatry and author of Psychiatry: The Science of Lies. This view may be extreme, but some of the new “mental illnesses” under consideration for the new edition nonetheless sound a little…crazy. Here are eight you may already be suffering from, whether you knew it or not.
1. Binge-Eating Disorder According to the Mayo Clinic, this is “a serious eating disorder in which you frequently consume unusually large amounts of food”—something Americans do with increasing frequency, if obesity statistics are to be believed. Someone suffering from this “may be deeply embarrassed about gorging and vow to stop,” but the compulsion is such “that you can't resist the urges.” Though the fat-acceptance movement might protest such an inclusion, it may nevertheless help Ben & Jerry’s addicts finagle insurance coverage for their problem.
2. Night-Eating Syndrome Similar to Binge-Eating Disorder, this malady is characterized by a compulsion to raid the fridge—but is distinguished by the time it takes place: well past midnight. It affects 1.1%–1.5% of the general population, and people who suffer from it tend to eat at least a quarter of their daily calories in the middle of the night. Scientists believe Night-Eating Syndrome may be a pathway to obesity, partly because people who suffer from it tend to grab for calorie-laden comfort foods.
3. Internet Addiction According to an article in the American Journal of Psychiatry, this is a disorder “that involves online and/or offline computer usage and consists of at least three subtypes: excessive gaming, sexual preoccupations, and email/text messaging.” It has several components, including excessive use, which is “often associated with a loss of sense of time or a neglect of basic drives”; withdrawal, which leads to “feelings of anger, tension, and/or depression when the computer is inaccessible”; tolerance, meaning “the need for better computer equipment, more software, or more hours of use”; and negative repercussions, “including arguments, lying, poor achievement, social isolation, and fatigue.”
4. Sex Addiction What David Duchovny suffered from in Californication was actually included in previous editions of the DSM, but was dropped in 1994 (the year before Bill Clinton’s fling with an intern—right-wing conspiracy theorists take note). It is defined as “distress about a pattern of repeated sexual relationships involving a succession of lovers who are experienced by the individual only as things to be used,” and may well reclaim its position as a full-blown disorder in the new version.
5. Compulsive Shopping Also known as Compulsive Buying Disorder, the need to fill a Medium Brown Bag with blouses is “characterized by excessive shopping cognitions and buying behavior that leads to distress or impairment.” Shopaholics have been a staple of popular culture for years, and have garnered new attention since the recession began. Sufferers “report a preoccupation with shopping, pre-purchase tension or anxiety, and a sense of relief following the purchase.”
6. Embitterment Disorder Feeling bitter? Who isn’t? But if the DSM-V has its way, there might soon be a pill to take care of that. People suffering from Embitterment Disorder “feel the world has treated them unfairly. It's one step more complex than anger. They're angry plus helpless,” according to German psychiatrist Michael Linden. The illness is related to post-traumatic stress disorder, because it is also believed to be the result of some kind of trauma. According to Dr. Linden’s research, embittered people suffer “repeated intrusive memories of the event,” but often hide their true feelings, as “patients can even smile when engaged in thoughts of revenge.”
7. Pathological Hoarding Traditionally considered a symptom of obsessive-compulsive disorder, pathological hoarding may soon be classified as a separate syndrome. People suffering from this illness are stereotypical packrats. According to Dr. George Makari, Director of the Institute for the History of Psychiatry at Cornell University, “it’s a person who has an impulse-control problem; they bring everything in, and can’t throw anything out. You go into their house and they have newspapers from the last 35 years and their house is a scary junk bin.”
8. Pathological Bias In layman’s terms, this is nothing more than an extreme form of racism, homophobia, or other prejudices. Dr. Makari warns that “the idea of making a social ill a pathological mental illness is very dangerous. It misdirects us by biologizing something that is social.” Still, if bigotry makes the cut for the new DSM, it could have profound implications for our justice system, sparking more defense-attorney tactics that begin with, "Your Honor, my client suffers from..."
Constantino Diaz-Duran is a writer living in Manhattan. He has written for the New York Post, the Washington Blade , El Diario NY and the Orange County Register.