People who have fibromyalgia, ME/CFS (chronic fatigue syndrome), chronic pain and any number of other chronic illnesses are in serious danger of being labeled as having a mental disorder.
The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders, commonly known as the DSM-5, is about to go to the printers and is scheduled to be released in May 2013. The DSM is published by the American Psychiatric Association (APA) and contains the diagnostic codes used by doctors for mental disorders.
The problem with the DSM-5 is they have added a new diagnostic category called “Somatic Symptom Disorder.” According to the diagnostic criteria, a person can be diagnosed with Somatic Symptom Disorder (SSD) if for at least six months, they have had one or more symptoms that are distressing and/or disruptive to their daily life, and they have one of the following reactions:
Disproportionate thoughts about the seriousness of their symptom(s).
A high level of anxiety about their symptoms or health.
Devoting excessive time and energy to their symptoms or health concerns.
Are you as shocked as I am? Almost everyone who has fibromyalgia or other chronic pain issues has had at least one of these reactions – especially during the time before they get an accurate diagnosis. Personally, I think it would be abnormal not to have serious concerns about your health when you're experiencing symptoms severe enough to disrupt your daily life and you don't know what is causing them.
According to these criteria, someone diagnosed with cancer could be labeled as having SSD because they have a high level of anxiety about their health. Or someone with diabetes could be diagnosed with SSD because they devote excessive time and energy to their symptoms. Ridiculous!
Basically what this would mean is that if any one doctor at any point in time feels like you're a little too concerned about your symptoms or your health, he can diagnose you with SSD and you will forever after be labeled as having a mental disorder. And once you have that label, how seriously do you think future doctors are going to take your symptoms? How much time do you think doctors will spend trying to identify the physical cause of your pain if they think you have a mental disorder that makes you overly concerned about your health?
I think this new diagnostic category has the potential to be extremely detrimental – not only to fibromyalgia, ME/CFS and chronic pain patients – but to all patients who develop any kind of chronic illness.
What You Can Do
Since the DSM-5 is so close to being released, the options we have to try to stop the inclusion of SSD are very limited. Our best hope is through Allen Frances, MD, who was the chair of the DSM-4 Task Force. He has written an excellent article in Psychology Today on the dangers of adding SSD to the DSM-5: Mislabeling Medical Illness As Mental Disorder. I encourage you to click on the link to his article and make a brief comment supporting his stand. The more page views and comments he has, the better his chance of persuading the editors of the DSM-5 to make a last-minute change.