When a person has a cough and a fever, his or her doctor diagnoses pneumonia based on patient history, sounds in the chest, and interpretation of an X-ray. When a person is very sad, the doctor diagnoses depression based on five out of a possible nine symptoms listed under “Depression” in the “Diagnostic and Statistical Manual of Mental Disorders.”
Since 1952, the DSM, produced and periodically revised by the American Psychiatric Association, has been the “bible” of psychiatric diagnosis, studied by every medical student and referenced by every mental health clinician and researcher. The fact that the DSM is more subjective than most other diagnostic tools has seemed an inevitable consequence of the psyche’s complexity. But there have always been questions regarding its scientific validity and potential conflict of interest between the DSM’s authors and pharmaceutical companies. Gary Greenberg takes on the issue in “The Book of Woe: The DSM and the Unmaking of Psychiatry.” A practicing psychotherapist, Greenberg has made his concerns plain in incisive articles for Mother Jones, The New Yorker, and other periodicals. The titles of his two previous books — “The Noble Lie” and “Manufacturing Depression” — broadcast his skepticism.