The 4-5ds of Diagnosing Mental Illness

I have always believed that any mental illness is a continuum ranging from mild to severe and each one of us expresses a certain degree of abnormality at a point in time. Haven’t we all heard voices when we were alone at home? Or seen objects that weren’t necessarily there and did a double take to assure their presence? Does that mean we all suffer from schizophrenia? No!

Taking the human psychology under the microscope, one might realize that majority of the mental illnesses (if not all of them) root back to normal human nature. For example, we all have ancestral fear which helps us protect ourselves from danger. However, when this fear exceeds normality it starts taking the form of a mental illness such as anxiety. This is when fear starts doing the exact opposite of its job and instead of protecting us, it impedes our functionality. Therefore, it is sickening that those who get diagnosed with a mental illness get stigmatized while they are only suffering from heightened, normal emotions and brain activity.

Even though the latter may be true, a good psychiatrist should not mistake a flare here and there to be a mental illness because practically a person suffering from anxiety is not the same as a person feeling simple fear. In brief, mental illnesses are extremely handicapping and can put one’s life on thin ice. This is why the basics of pointing out abnormality in diagnosis is partially based on the interaction of the four Ds-Dysfunction, Distress, Dangerousness and Deviance.

Dysfunction

This is when mental illness starts to hinder the everyday function of the person. One becomes unable to cope and socially interact with other humans. Sufferers usually fail to take care of their own hygiene, nutrition and to a certain extent start lacking self-control. They also fall short of taking care of their loved ones and these include family members and friends.

Distress

In this case the sufferers would feel distraught and uncomfortable dealing with the symptoms of their illness. They also tend to cause anguish to those around them whether at home or at the work place.

Dangerousness

Those who pose a threat on themselves or on people around them are considered abnormal. This danger includes suicidal and homicidal thoughts and attempts.

Deviance

What defines abnormality to a certain extent is being different from the norm. That does not mean that all exceptions are mentally ill though. What defines that a behavior could be an indication that there is a mental illness is the time frame within which the behavior takes place.

The four Ds mentioned above are based on the Diagnostic and Statistical Manual of Mental Disorders. However, in the year 2009, Timothy O. Davis suggested that an extra D should be added to the diagnostic criteria and that would be the ‘Duration’

. Davis believes it is “….important since it can illuminate whether an emotion, cognition or behavior is a fleeting symptom without consequence or is persistent enough for classification.”

On an end note, these identifying tools might help you identify a good psychiatrist from a not-so-good one. If you get a diagnosis in your first session, you got a strong pointer right there that you should go see a different psychiatrist simply because it takes more than one visit for a professional to get to know whether you are really suffering from a mental illness. Imagine you had a really bad day and you go to your therapist crying your eyes out, that doesn’t mean you are depressed, does it?

Mai Elsayed

A Mass Communication alumna from the American University of Sharjah. Loves writing about human related stories and factors that affect our psychological well being such as relationships, love and family.

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