What Is The DSM? Exploring Psychology’s Diagnostic Guide

In order for an individual to receive a diagnosis of a clinical mental health condition from a qualified provider, their symptoms must generally meet certain criteria. These criteria are outlined in an official publication known as the DSM, or the Diagnostic and Statistical Manual of Mental Disorders. This detailed handbook aims to help practitioners accurately determine the cause of an individual’s symptoms so they can suggest treatment methods that are most likely to help. 

What is the DSM?

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is an international classification handbook designed for use by mental health professionals. It’s widely considered to be the authoritative text for defining and diagnosing various mental health disorders.

The DSM is published by the American Psychiatric Association (APA), which is the largest psychiatric organization in the world. It contains information about all the mental health conditions currently recognized by the broader psychiatric community, along with each one’s classification information and all pertinent details needed by mental health professionals in order to make a diagnosis. The DSM includes this type of information on mental health conditions like personality disorders, obsessive-compulsive disorder, gender dysphoria, anxiety disorders, autism spectrum disorder and related disorders, eating disorders, depressive disorders, bipolar disorder, conduct disorders, and many others.

An example of DSM diagnostic criteria

Let’s look at a brief example to gain a better understanding of what the Diagnostic and Statistical Manual of Mental Disorders contains. The DSM-5 entry for depression notes that this illness is officially known as “major depressive disorder” (MDD) and that it’s categorized as a mood disorder. It then has a list of symptoms, noting that a person experiencing five or more of them must also meet certain criteria in order for a depressive spectrum disorder diagnosis to be considered. For example, the symptoms must:

• Cause “clinically significant distress” and/or impaired functioning

• Not be due to a physical health condition, a medication, or a substance

• Not coexist with other symptoms, such as impulse control problems or significant mood swings, that could point to a diagnosis of bipolar disorder instead

• Not be better explained by another diagnosis, such as schizophrenia

• Not be due to bereavement that occurred within the last two months

As you can see, the information in the DSM is intended to help clinicians identify potential causes of an individual’s symptoms and then narrow them down to arrive at the one that is most likely.

How the DSM changes over time

Changes are made to the Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association when overwhelming, newer research suggests that something in previous versions is no longer accurate. The aim is to make sure that the most recent edition contains clear, accurate information that’s supported by robust, peer-reviewed scientific evidence. When changes are made, information may be kept the same but recategorized, modified slightly, entirely rewritten, or completely removed, depending on the situation. 

For example, one of the many changes that was made between the fourth and fifth editions was to the entry about post-traumatic stress disorder (PTSD). Among others, these included:

• Reclassifying the disorder from “anxiety disorder” to a new category called “trauma and stressor-related disorders”

• Clarifying the definition of trauma to remove the subjective component

• Expanding and rearranging the symptoms list to clarify some somatic symptoms, among other changes

These changes are consistent with new research that emerged between the publishing of the fourth and fifth editions. They’re intended to make the process of diagnosing this condition clearer for clinicians so that those experiencing it can be advised on the appropriate care.

What the DSM is not

The Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association is a thorough and robust resource when it comes to outlining how different mental illnesses can present to help clinicians make accurate diagnoses. However, this is intended to be the limit of its scope. The DSM does not contain treatment advice or information for practitioners. Once they’ve arrived at a diagnosis of, for example, a personality disorder, autism spectrum disorder, anxiety disorder, obsessive-compulsive and related disorder, bipolar and related disorders, depressive disorder, or an intellectual disability with the help of this manual, it’s up to them to decide how to treat it. They’ll need to use their professional expertise and experience, information about the individual’s overall health and circumstances, and the latest research on a particular condition in order to devise an appropriate treatment plan. 

In addition, it’s worth noting that although anyone can read and learn from the DSM, should they wish to, it is written in a technical manner and is intended for the use of trained healthcare professionals. It’s not meant to be used as a substitute for professional evaluation or treatment of any health condition. If you’re experiencing symptoms of a mental health condition, it’s recommended that you seek the support of a qualified healthcare professional.

Online therapy for mental health concerns

As the Diagnostic and Statistical Manual of Mental Disorders (DSM) is a method for classification of diseases/disorders and doesn’t offer treatment information or advice, it doesn’t touch on therapy as a treatment method for any mental health condition. However, it’s standard practice for therapists to use the DSM as a core reference point when evaluating a client. In addition, there’s a robust and growing body of research that supports the efficacy of talk therapy for a variety of mental health conditions, whether it’s practiced face-to-face or virtually. 

For instance, a 2018 review reports that cognitive behavioral therapy—one of the most common types of talk therapy—is considered to be the current “gold standard” of therapy and can be used to reduce symptoms of many mental illnesses, from depression to anxiety. Other studies suggest that online and in-person therapy can be equally effective in many cases, meaning that the average individual can feel confident in choosing whichever format works best for them.

If you’re interested in online therapy for the convenience, affordability, or flexibility it offers relative to the average in-office session, you might consider a platform like BetterHelp. You can get matched with a licensed therapist whom you can meet with via phone, video call, and/or in-app messaging to address the challenges you may be facing. Regardless of the format you might choose, remember that compassionate care for mental health concerns is available.