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by Garry Cooper, LCSW
DSM-5 has made several changes in the classification of depression. Previously, depression was part of DSM’s Mood Disorders section, along with Bipolar disorders and manias. Bipolar and mania now have a separate section, Bipolar and Related Disorders.
The DSM-5 Depressive Disorders section includes:
Two of these depressive disorders are considered especially controversial.
Disruptive Mood Dysregulation Disorder should be diagnosed only for people between six and 18 years of age. One justification for this new disorder was to stem the tide of children being diagnosed and medicated for bipolar disorder, a trend which significantly increased with the inclusion of Bipolar Disorder II in DSM-IV. Critics of this new disorder, while agreeing that pediatric bipolar disorder has been over–diagnosed, worry that this new diagnosis will result in more children with behavioral disorders being diagnosed and treated with anti-depressants, and that while the net result may be fewer children being treated with mood stabilizers, more children may be treated with antidepressants. Aware of this controversy, DSM-5 includes a long, detailed list of symptoms and guidelines. The concern, however, is that, as with bipolar II, a flood of pharmaceutical advertising will capitalize on this new diagnosis and convince many parents who are exasperated and exhausted by their children’s behavior, to request medication from their physicians, and that many general physicians will prescribe without conducting a thorough psychiatric evaluation.
Pre-menstrual Dysphoric Disorder (PMDD) is not a new diagnosis but it remains controversial, especially among feminist psychologists. Those interested in the feminist perspective on PMDD may wish check out www.paulajcaplan.net.