New Disorders Just Dropped

[DSM-5-TR link party]

Greetings, my sluggies!

This week, I’ve been reading up on the release of psychiatry’s freshly updated sacred text, the DSM-V-TR:

• Prolonged Grief Disorder has been added to the roster, conveniently as we are all enduring a mass grief-making event in the form of global pandemic. Some say it’s a good thing, because people experiencing long periods of grieving were falling through the diagnostic cracks; others (including me) vehemently disagree with treating the natural human reaction to loss like a disease. Death Workers on social media are calling for a National Grief-In-Public Day on April 23 to reject the public denial of grief. (Thanks to Kiki in my patron discord for alerting me to this!)

• There has been some fear on the feeds about changes to the autism criteria, with some claiming it will make it harder for marginalized people to get diagnosed. This can be traced back to one podcast interview with the co-chair of the DSM revision, who did, to be fair, explicitly say autism is being over-diagnosed, lamenting that the phrase “on the spectrum” has made its way into popular culture (as psych terms do!) and that now it’s being applied to “anyone who’s a little weird or awkward”. I find this statement arrogant and annoying, but he goes on to explain that the changes (which are actually just two to three added words) are only clarifying the criteria’s original intentions, not altering them. Some people in r/aspergirls think additions to the explanatory text around the criteria that discuss masking may actually be a good thing. (Personally I do not care very much, because I would like to set all the DSMs on fire!) A petition has been circulating on Twitter to amend the amendments, created by an anonymous “advocacy start-up” called The Center for Neurodivergence, which has a professionally-designed .org site and appears to have only become active on social media recently around this issue. Questions, I have them!

• The new version is striving for what I’m going to call equal opportunity pathologization (inspiration here), enlisting the help of an Ethnoracial Equity and Inclusion Work Group to make the text more culturally sensitive. One of the group’s members said she “gained an even greater respect for DSM through this process” and that racism affects diagnosis not because its baked into the fabric of capitalism, but because some silly psychiatrists aren’t following the directions: “if you follow the manual, you come to a proper diagnosis—because it’s a good manual.” 😬

• They’ve also changed a few terms in the gender dysphoria section: “cross-sex medical procedure” is now “gender-affirming medical procedure”, for instance, and they added the “assigned at birth” language that a lot of the trans internet is moving past already. Keep up, DSM!

• Last but not least: the addition of unspecified mood disorder, which allows clinicians to bill insurance for something mood-related without designating a person bipolar or major depressive. The vagueness is sort of maybe a good thing (not locking someone into a highly stigmatized label) but also a bad thing at the same time (expanding diagnostic reach), and it really speaks to how driven the whole process is by insurance requirements above all.

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Something for your viewing pleasure:

münecat’s deep dive into Gary Vee’s toxic hustle culture is hilarious, and the original song she wrote at the end about class war is high art.

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Something I’m About to Highlight the Shit Out Of:

Thanks to Devon for sending me a copy and also for citing me in it, the highest of honors! Citation is my love language!

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Some extra linkies:

• This interview with Mitchell Gomez, the director of DanceSafe, is a great summary of ongoing harm reduction efforts in the US, which you may have seen right-wingers call “funding for crack pipes” lately, but is actually funding for fentanyl test kits and drop-in sites where people can test their own drugs for adulterants.

• A really good guide on How To Read Any Scientific Paper for Free

• This piece in The Nation on antidepressant withdrawal that cites a few of my favorite researchers and critical psych scholars