The American Psychiatric Association has made a late draft of the upcoming DSM V (the fifth edition of the book psychiatrists use to make diagnoses or rule out diagnoses of everything from autism to panic disorder) available for the general public to comment on. When I went to explore, I realized that I had never actually looked up my primary diagnoses–Generalized Anxiety Disorder–in the DSM IV, the book currently in use. So I don’t know what they changed, but I do know that the criteria I found… well… they kind of sum up exactly how what I’ve been dealing with all my life. Here’s what the DSM V says (so far–it’s still being revised) about GAD:
A. Excessive anxiety and worry (apprehensive expectation) about two (or more) domains of activities or events (e.g., family, health, finances, and school/work difficulties).
B. The excessive anxiety and worry occurs on more days than not, for 3 months or more
C. The anxiety and worry are associated with one or more of the following symptoms:
1. restlessness or feeling keyed up or on edge
2. muscle tension
D. The anxiety and worry are associated with one (or more) of the following behaviors:
1. marked avoidance of activities or events with possible negative outcomes
2. marked time and effort preparing for activities or events with possible negative outcomes
3. marked procrastination in behavior or decision-making due to worries
4. repeatedly seeking reassurance due to worries
E. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
F. The disturbance is not attributable to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism).
G. The disturbance is not better accounted for by another mental disorder (e.g., anxiety about Panic Attacks in Panic Disorder, negative evaluation in Social Anxiety Disorder, contamination or other obsessions in Obsessive-Compulsive Disorder, separation from attachment figures in Separation Anxiety Disorder, reminders of traumatic events in Posttraumatic Stress Disorder, gaining weight in Anorexia Nervosa, physical complaints in Somatic Symptom Disorder, perceived appearance flaws in Body Dysmorphic Disorder, or having a serious illness in Illness Anxiety Disorder).
When they say “disturbance,” by the way, they mean the disturbance in, you know, normal functioning. In life.
When they say “one (or more)” turns out, I fall into the “or more” category. Specifically, all of the above.
I like this stuff, because it makes me feel normal. This might seem weird at first, I know. But in the middle of an anxiety attack, I feel like the world’s biggest freak show. “Why am I the only person on the planet who can’t just get up and go to work?!” I tell myself. And then I see something like this and I think “Hey! Look at that! I must not be the only person to freak out about this!”
Some people feel that diagnoses put them in boxes. That’s valid–I’ve just never felt boxed-in or labeled. I attribute this positive history to the fact that I’ve always been under the care of exceptionally talented care professionals. No one has ever said to me “Oh, well obviously you did that because of the GAD.” If anything, my behavior fitting the description above seems to serve only as a confirmation that we’re on a good treatment path. In fact, my care providers almost never mention my diagnoses. And that, friends, is why I feel like this DSM chapter (draft of a chapter?) makes me part of a community of people who struggle with exactly the same stuff I find so difficult. There have to be quite a few people displaying these symptoms before those symptoms make it into a DSM chapter. It’s not a fun club, but it’s better than feeling alone.