The DSMIV: Labeling Mental Illness

The Diagnostic and Statistical Manual of Mental Disorders (DSMIV) is not used to categorize or label people, but rather conditions or disorders that people have. If I said my friend Barbara is breast cancer, you would laugh at me, right? No, silly, you would say, Barbara has breast cancer. Well the same is for another friend. She isn’t a manic-depressive, she has manic depression. While it maybe true that labels may burden a patient with the stigma surrounding it, finally having something concrete to learn about, to understand, to fight against and to conquer can be such a relief. Labels provide patients with a means of communicating about what is going on with their body or psyche with others. It helps them identify and to find support. I found the website “All About Depression” ( echoed my thoughts precisely: “The DSM-IV is not used to categorize people, but to categorize conditions or disorders that people have. This may be a subtle distinction, but it is a very important one. We do not say that a person is cancer, or is heart disease, or is an illness. A person has an illness. Likewise, we should not say that a person is a depressive, but that a person has clinical depression. Along the same lines, the value of diagnostic labels is often debated among mental health professionals and the general public. On the negative side, some people believe that making a diagnosis is simply the act of labeling a person. Once a person is labeled he or she may have difficulty overcoming the label, may lose hope of recovery, or may come to believe that he or she is the label. On the positive side, some people are relieved when they finally learn that the symptoms they are experiencing have a name. This often offers a sense of hope and personal control over the illness as more can be learned about its treatment, causes, and outcome.”

It seems as though the main problem is really not what a label is, but how it is viewed by others in society. In 1940 the terms idiot, imbecile, and moron were actual definitions for types of mental deficiency. (Psychiatry of Nurses by Karnosh and Gage (1940 – p. 237)) Over time, however, these terms have been used by the general public as a means of insult to devalue a person, thus stigma is born. John Ruscio in “A Critical Evaluation of the Labeling Theory of Mental Illness” ( (a very interesting read regarding this subject, by the way) stated “Perhaps most important of all, focusing on other means of alleviating the stigma of mental illness may serve this purpose better than flogging diagnostic labels.” Part of this should be education around mental illness, and how it is an illness a person has, not is, as discussed above. Perhaps another area of reform could be helping to shift the social norm. It is not acceptable in our society to refer to another person as a fagot or nigger. Why should we allow people to use mental illness labels in a derogatory manner?

When people attack the method of labeling, usually they fail to propose a viable alternative. That is the soundest foundation for supporting the continuation of the method. So in conclusion, I would agree that labels continue to serve a purpose and do more good than bad. And until a new viable alternative is found, or people should be focusing on alleviating the stigma, not on attacking and destroying the only established system we have.

I have grown up with the label of being artistic. While it is nice to be noticed for a talent, at times it has been quite the burden. Most annoying is the perception that as a designer, I should have a high sense of style in all areas of my life. I can’t tell you how many times people have criticized my clothing. I have flat out been told that “I would have thought you would have a better sense of style, being a designer and all.” Well, I might be able to dress well if I decided to focus my time, energy and money on it, it is not a pursuit I am interested in. In the end, I suffer a hit to my self-confidence and esteem. I wonder perhaps I should dress a bit better, and am lacking in some way, both as a female and as a designer because I don’t. The second label I have dealt with is being an over-achiever. Jeez, talk about a life long stress. It’s not like being an achiever… no, this is a step beyond. People label you an over achiever and henceforth expect much more than above and beyond in everything that you. There is no break, no rest, no room to breath. If you turn in work that would otherwise be viewed as good, in my case I’ll be met with “This is great… but you could do so much better.” There is no allowance for mediocrity. Every little thing you do must blow them out of the water, and be a life changing experience. What happens? You get a very old 25 year old, who is bordering on burn out.


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