The New DSM: Abnormal is the New Normal


Cartoon by E. Wagele from “The Happy Introvert”

Under the Diagnostic and Statistical Manuel (DSM), which defines mental illness in the U.S., half of us have a diagnosable mental disorder.

 It should come as no surprise that many who profit financially from mental illnesses would encourage broadening the definitions in the DSM-5. This benefits therapists because insurance covers clients if their diagnosis is in the DSM.

According to Robin S. Rosenberg in his article in Slate,  “Abnormal is the New Normal,” our odds of having a mental disorder in our lifetime are greater than 50%, based on the new DSM-V. “For decades, mental health clinicians, physicians, the U.S. surgeon general’s office, and various state and local agencies have been advocating for better detection of mental illness. If we are better at spotting it, we can treat it. And if we detect it earlier, we can hopefully intervene to reduce the intensity and/or frequency of symptoms. For instance, people who decades ago may have had undiagnosed attention deficit hyperactivity disorder, depression, or substance abuse are now more likely to have their problems recognized and diagnosed. But the increased awareness and detection translates into a higher rate of mental illness.”

Various tests show our population is getting more anxious, more neurotic, and more narcissistic.

We’re more willing to see mental illness in ourselves and others. Many normal problems that were once considered healthy are now classified as mental illness, partly because the DSM keeps increasing the number of disorders, from 106 in 1952 to 297 in DSM IV.

Some of the disorders added are medical, not psychological, such as “breathing-related sleep disorder,” caffeine intoxication, and caffeine withdrawal.

Even shyness, worrying, and grief are now considered pathological.

When insurance pays for treatment, a diagnosis is necessary. So you can see why therapists like it when more problems qualify. The more problems, the more the pharmaceutical companies profit, too. 70% of the DSM-5 task force members have financial ties to the pharmaceutical industry. Also, people want quick fixes to their problems and mental diagnoses enable them to become more eligible for government services.

Rosenberg adds, “…Having a diagnosis gives a name to the suffering we feel and the hope that with a label can come relief… Hope is essential. But I’m not sure that ultimately labeling half of us with a mental disorder is the best way to give people realistic hope. Having a diagnosable mental illness has almost become the new ‘normal.’ As a society, we have an opportunity to think about how we define mental health and illness. It shouldn’t only be up to the authors of the DSM.”

In my blog last May in Psychology Today, “Criticism of the DSM-5 and a Suggestion, II,”  I suggested the DSM completely change the way it diagnoses problems by using the Enneagram as a model for not only mental illness, but also for a comparison with people who are healthy mentally. Each of the 9 Enneagram personality types can be described in stages from healthy to unhealthy. The DSM would be tied to a continuum of these 9 basic features. For example, the 6-Questioner when healthy is alert, often witty, and concerned about safety. This personality descends when unhealthy into paranoia. The healthy 1-Perfectionist wants to do what’s right and is well-organized. People of this type who are unhealthy may suffer from obsessive/compulsive disorder. While most pathologies could be compared to the normal personality, schizophrenia and some other illnesses may lie outside of this model.

Read my Psychology Today blog of 8-6-13, Pessimism and Enneagram Type 6-The Questioner.

Visit to check out my CD, cartoons, essays, Famous Enneagram Types, and books:

“The Enneagram Made Easy,”

“Are You My Type, Am I Yours?”

“The Enneagram of Parenting,”

“The Happy Introvert,”

“Finding the Birthday Cake“ (for teaching the Enneagram to young children),

“The Career Within You,”

and “The Enneagram of Death.”

My CD, “The Beethoven Enneagram,” is available only through My books can be ordered from independent book stores or


One Response to “The New DSM: Abnormal is the New Normal”

  1. Tom Purcell Says:

    Elizabeth,You write with such conciseness,ease and elegance it is always a pleasure to read your articles..I agree with you.I love reading so I am most likely suffering from Excessive Reading Syndrome.or ERS as the pros call it.The cause is curiosity,probablly excessive.There is no known cure.On a related note a personal friend who happens to be a psychiatrist once told me that a huge number of people were diagnosed with Borderline Personality Disorder back in the 80 s,simply because it was a fad among the doctors.It,s like the drawer many people have where things go simply because it doesn’t go anywhere else.I think some Ennneagram enthusiasts who attempt to type every single human they encounter could have their own DSM section under the excessive/compulsive banner called ETS-excessive typing syndrome.
    Keep up the great work!

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