Mental Health Disorders

The DSM-5 defines a mental health disorder as a behavioral or psychological syndrome or pattern that occurs in an individual.  This indicates that symptoms may be noted via behavioral observations of an individual, or based on the self-report of the individual’s inner experience.  The DSM-5 appears to avoid defining the etiology of mental health disorders, as research in the field has never defined a single pattern of brain or body functioning that can account for all possible presentations of each disorder.  Instead, the DSM-5 states that a psycho-biological dysfunction is responsible for the disorder, and the resulting disorder causes clinically significant distress or impairment in one or more areas of life functioning.  I personally prefer this atheoretical approach to defining mental illness.  Unfortunately, we are not at a place within our field where we can definitely point to the cause of all mental health disorders (and there is definitely not a consensus amongst mental health providers). 

In addition, the DSM-5 states that the causes of mental health disorders cannot be due to common stressors and losses.  Because it is common to experience stress and negative emotional reactions to stressful life situations and losses of friends and loves ones, the DSM-5 advises mental health practitioners not to stigmatize or pathologize these reactions.  Moreover, the DSM-5 states (for most mental health disorders) that substance use or medical illness cannot be the cause for the symptom presentation.  For example, if someone experiences a temporary manic state due to cocaine use, the person should be not diagnosed with Bipolar Disorder.  Or, if someone experiences depression due to hypothyroidism, the person should not be diagnosed with Major Depressive Disorder. 

Mental Health Disorders

There are many different mental health disorders defined within the DSM-5.  The DSM-5 uses categories to group these various disorders according to certain shared features.  I will relay the list of these categories in order to show all of the different disorders/disorder categories we must consider when conceptualizing a diagnosis for an individual. The following is a list of the categories noted in the DSM-5: neurodevelopmental disorders; schizophrenia spectrum and other psychotic disorders; bipolar and related disorders; depressive disorders; anxiety disorders; obsessive-compulsive and related disorders; trauma-and stressor-related disorders; dissociative disorders; somatic symptom and related disorders; feeding and eating disorders; elimination disorders; sleep-wake disorders; sexual dysfunctions; gender dysphoria; disruptive, impulse control, and conduct disorders; substance-related and addictive disorders, neurocognitive disorders; personality disorders; paraphilic disorders; other mental disorders, medication-induced movement disorders and other adverse effects of medication; and other conditions that may be a focus of clinical attention.

In order to arrive at a correct diagnosis, the clinician must gather as much information as possible about the individual.  This usually entails conducting a clinical interview that collects information about symptom presentation and important life domains, disorder specific questionnaires, personality testing, IQ testing (many clinicians use IQ testing during psychological testing, but some clinicians do not use IQ testing if they do not believe low IQ is present and can account for reported symptoms), and many other tests that are designed to detect mental health symptoms or impaired performance characteristic of various disorders.  The clinician that works with you to complete psychological testing will utilize a tailored approach to test selection.  Tests will be selected in order to best answer the question that has led you to pursue a psychological evaluation, as well as to provide accurate diagnosis and treatment recommendations.