Overdiagnosis In Psychiatry

The phenomenon of overdiagnosis in psychiatry is due to the tendency to put a pathological label on certain behaviors, even if they are not. Overdiagnosis is common in psychiatry. Not only does this lead to incorrect diagnoses, but many end up taking medications when they do not really need them.

The subjective nature of the diagnostic process has been a problem in psychiatry for a long time. Psychiatrists should determine if a patient has a mental illness based on their observations and inaccurate diagnostic instruments. Given these conditions, it is easy to make mistakes that lead to overdiagnosis.

The most widely accepted diagnostic reference is the Diagnostic and Statistical Manual of Mental Disorders (DSM). A group of psychiatrists (mostly from the United States) compile the manual. They vote to make decisions about the definition and inclusion of disorders in the manual. The first version of the manual identified 60 disorders. But the most recent versions identify more than 500.

Is there a problem with overdiagnosis in psychiatry?

The data indicate that overdiagnosis in psychiatry is a problem. If you stick to the strict definition of the latest versions of DSM, experts indicate that 70% of the population has some form of mental illness. Not only that, but these individuals would all be candidates for medication.

DSM-5 includes some disorders that even professionals in psychiatry question. For example, there is a disorder in the DSM called “psychotic risk syndrome”, which involves having a characteristic that indicates a high probability of developing psychosis in the future. This diagnosis is a justification enough to medicate with antipsychotics.

If you stop and think about it, almost everyone can be diagnosed with this syndrome at some point in their lives. Have you ever felt that you are “going crazy”, but did not? Treating a disorder that may occur in the future is absurd. It is like prescribing a medicine for high blood pressure to a child with parents with high blood pressure because they are at risk of developing it at some point.

Another example is “dysfunctional personality disorder with dysphoria”. This “disorder” basically describes an unsocial, selfish and unsympathetic person. According to DSM, someone with this “disorder” is also a good candidate for medication. In reality, they have only one unpleasant personality. In DSM-5, feeling extremely sad for more than one month after the death of a loved one is enough to be diagnosed with depression.

The difference between having a disorder and just not feeling well

The boundaries between freshness and illness in the sphere of psychiatry are difficult to define. After all, “normal” is a subjective concept and is related to an individual’s specific context. It is also important to point out that being human will always involve a certain amount of suffering. Living is synonymous with dealing with constant uncertainty. 

You will never have everything you want, or have a perfectly balanced life. Everyone has to deal with suffering because death exists and is brutal. No one can avoid feeling frustrated by circumstances beyond their control and everyone is selfish or “naughty” to some degree.

It makes sense that you have times in life where you feel sad and others where you struggle with anxiety. Some psychoanalysts believe that having three episodes of psychosis during life is completely normal. It all depends on what is going on around you. As we mentioned above, problems that are completely normal are defined as disorders, which leads to overdiagnosis in psychiatry. 

Another approach to disorders

Until recently, grief over the loss of a loved one was dealt with within the individual’s immediate circle. Everyone understood that a certain degree of suffering was normal and necessary. Today, however, these support networks are weakened.

Nowadays, it is difficult to express emotional pain, which is why people who suffer feel lonely. The idea that we should be happy all the time puts a lot of pressure on everyone. Many people do not even let themselves suffer. Thus, their way of dealing with these feelings is a pill prescribed by a psychiatrist.

For better or worse, medication is a way to deal with individual and collective unrest. Overdiagnosis is a double-edged sword. On the one hand, there is Orthodox psychiatry, which works with a very narrow range of diagnoses and interventions. On the other hand, there are people who suffer but refuse to understand their pain. Instead, they ask for a chemical substance to help them suppress it.