There's a New 'Bible' on the Bestseller List

Mental illness is on the minds of many, who are apparently looking to diagnose themselves. Long known as psychiatry's bible, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders has become a surprise bestseller since its fifth version—the first in a decade—was released in March, reports Axios. Dubbed DSM-5-TR, the book, which lists criteria for various conditions, had made its way to the Wall Street Journal's e-book best-seller list by May. It's also the top-selling psychiatry book on Amazon. "I think what really caught the imagination was that we're sitting at home now and looking to say, 'Boy, I'm feeling depressed—let me now go and find out more about it,'" APA CEO and medical director Saul Levin tells Axios.

That's good and bad. Psychiatrist Ralph Lewis, who describes a trend of young people self-diagnosing mental disorders even years before the pandemic, notes a diagnosis "provides validation and legitimacy to one’s struggles," per Psychology Today. It also provides practical benefits such as sick leave and disability benefits. But self-diagnosis—triggered in part by what Axios describes as "a record shortage of mental health providers"—leads to over-diagnosis, which in turn "leads to over-prescribing of medications," Lewis writes. This can also mean "severe mental illness becomes trivialized … It becomes harder for the people most in need of psychiatric services to access the already overloaded system."

It may also "lead to an unrealistic loss of acceptance that stress and distress are inherent features of life," not problems for a psychiatrist to solve, Lewis writes. Author and activist Sarah Fay, who describes her six "misdiagnoses" in the book Pathological, has also made this argument, noting a person might assume they are depressed when they are actually sad. DSM diagnoses, which are not scientifically proven but "lists of symptoms created by mental health professionals," have "led to false epidemics, like ADHD, autism, et cetera," she told Salon earlier this year. Indeed, she has noted there is little reliability to DSM diagnoses, which "shouldn't be taken as the gospel truth—particularly in milder cases where the level of dysfunction is difficult to gauge." (More mental health stories.)