(DSM) is published by the American Psychiatric Association (APA). The need for a classification of mental disorders has been developing throughout the history of medicine, which basically is throughout the history of humankind. Until recently there was little agreement on which disorders should be included and the optimal method for their organization. In the United States, the initial stimulus for developing a classification of mental disorders was the need to collect statistical information.
By the 1880 census, seven categories of mental health were distinguished: mania (hysteria), melancholia (depression), monomania (obsession or excessive preoccupation with one thing), paresis (weakened muscle movement), dementia (loss of cognitive thinking), dipsomania (uncontrollable craving for alcohol or drugs, and epilepsy (a central nervous system disorder). In 1917, the American Medico-Psychological Association, together with the National Commission on Mental Hygiene, developed a plan adopted by the Bureau of the Census for gathering uniform health statistics across mental hospitals. In 1921, the American Medico-Psychological Association changed its name to the American Psychological Association (APA). It subsequently collaborated with the New York Academy of Medicine to develop a nationally acceptable psychiatric classification that would be incorporated within the first edition of the American Medical Association’s Standard Classified Nomenclature of Disease. The APA Committee on Nomenclature and Statistics developed a variant of the International Classification of Disease (ICD) that was published in 1952 as the first edition of DSM. The DSM became the first official manual of mental disorders to focus on clinical use.[i]
Several editions have come forth with the latest being the 1999 edition. About 68% of DSM-5 task-force members and 56% of panel members reported having ties to the pharmaceutical industry, such as holding stock in pharmaceutical companies, serving as consultants to the industry, or serving on company boards.[ii] No surprise there. The pharmaceutical industry makes millions from drugs designed to treat conditions defined by the APA, DSM5, and NIMH. Also, most mainstream counselors are paid by their employers to counsel by the DSM5. CSCM does not rely on insurance companies, all services are donation based.
Put simply, the DSM is an attempt to name and sort mental and behavioral trouble into identifiable categories that may then be used as a standard for diagnosis, classification, and billing. That is to say, it’s an attempt to provide a system of naming for all kinds of troubles that people face related to their thinking, emotions, and behaviors, in other words, their souls. The scope of the DSM is immense.
How it Works
A person can be diagnosed with an Acute Stress Disorder, (ASD) 308.F43.0 brought on by Academic or Educational Problem (AEP) V62.3 Z55.9. As stated plainly, this is a student who is experiencing crippling stress because of some academic or educational problem. Granted, there may be some problems that can be related to a medical condition such as acute headaches, or any number of other medical or biological causes. This is why all counselors rule out any biological problems first. With biological problems being ruled out the disorder, acute stress could relate to bullying, a very insidious rampant phenomenon in society, or any number of other reasons. Oppression could be stressing them or making them perform poorly in school, or the child may be a member of a dysfunctional family environment where drugs, gangs, or any number of spiritual stronghold behaviors are present. Additionally, a poorly qualified teacher could also be a reason the person has ASD.
Understanding the DSM from a Biblical Perspective
Using the DSM for diagnosis and treatment goals is not entirely bad. There are qualities of the DSM that Bible-based counselors use as they give care to their clients. There are features of the DSM5 that help in identifying conditions while at the same time there are expressions that contradict the biblical worldview. For instance, anger in adults can be brought on by a multitude of life’s problems, conditions, and circumstances that the Bible speaks to. The DSM5 has several categories that relate to anger such as bipolar disorder, psychotic disorder, disruptive mood disorder, major depressive disorder, anxiety, and personality disorders, each with its own therapeutic remedy. Take bi-polar for example is attributed to an inability to make decisions. This inability to make decisions creates instability.
The Bible speaks to instability: James 1:8 “A double-minded man is unstable in all his ways.” A Bible-based counselor would know the consequences of instability such as what is found in Matthew 5:37 “But let your communication be, Yea, yea; Nay, nay: for whatsoever is more than this cometh of evil.” A Bible-based counselor would know that sometimes communication comes from within which affects our emotions and behavior. True, secular therapy does seek out causes, yet these causes are not related to sin and the fallen nature of humanity. When looking at the core, or root of the problem Bible-based counselors seek cause from a spiritual perspective. We cause the client to become aware of these things.
Anger and Depression
Two of the most prevalent conditions of western society, depression can have a variety of meanings because there are different types of depression. Clinical depression as a disorder is not the same as brief mood fluctuations or the feelings of sadness, disappointment, and frustration that everyone experiences from time to time and that last from minutes to a few days at most. Clinical depression is a more serious condition that lasts weeks to months, and sometimes even years.[iii]
Depression can be caused by many life issues, including anger; failure or rejection; family issues, such as divorce or abuse; fear; feelings of futility, lacking control over one’s life; grief and loss; guilt or shame; loneliness or isolation; negative thinking; destructive misbeliefs; and stress.[iv]
Medical and biological factors can also facilitate depression. This is why a client should not fail to get a medical check-up. Inherited predisposition to depression, thyroid abnormalities, female hormone fluctuations, serotonin or norepinephrine irregularities, diabetes, B-12 or iron deficiencies, lack of sunlight or vitamin D, a recent stroke or heart attack, mitral valve prolapse, exposure to black mold, prescription drugs (antihypertensives, oral contraceptives), and recreational drugs (such as alcohol, marijuana, cocaine) can all be tied to medical and biological factors that can facilitate depression.[v]
Spiritual Factors of Depression
Sin. Does sin cause depression? There are cases where depression appears to be a consequence of sin in a person’s life, although this does not mean that depression is always due to personal sin. Possible sin-related causes of depression include negative attitudes or feelings like bitterness and hatred, guilt, and lack of repentance over sinful behavior or attitudes, turning away from God and His Word, fear of the future, and lack of trust in God as a sufficient Provider, and unbelief in general. [vi]
God-sent trials. Difficult, painful, stressful times of trial or struggle may lead to periods of depression. Such God-sent trials are meant, however, to prune or purify us, so that we can bear more fruit (John 15:2; 1 Pet. 1:6–7). Demonic attacks happen to oppress people where inner healing and prayer are crucial, existential vacuum (feelings of meaningless or emptiness), dark night of the soul (Isaiah 50:10) where the darkness can draw us towards Yahuah’s light. Some people may be prone to depression due to loss in early life, or the death of a parent, they may feel guilty when they have done nothing wrong. These may become trapped in trying to win the approval of others.[vii]
A Bible-based counselor would emphasize that we are complete in Yahuah and fully pleasing to Him. He does not want us to suffer such a negative outlook about ourselves. We would speak on ways to know we are precious to Him such as Ephesians 2:4-5, 10, Psalm 139:13-14. Once again, these verses represent the various keys used for transformation and restoration.