Hoarding may be funded.

The battle of DSM-V is approaching full-tilt and most people are blissfully oblivious. They aren‘t aware of the impact on their healthcare costs and other facets of life.

In a little over a year, the fifth edition of the “American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders" (DSM-V, for short) will be put to bed. It’s the bible of the profession worldwide and is printed in 13 languages.

What’s in it will determine what gets treated and how. Maybe more importantly, what gets paid for and how. Whose field is hot and whose is not. It goes far beyond that, especially in legal issues. Who gets earmarked benefits or special protection or exemption.

With all this at stake, how much could’ve changed since the last edition? That was 1994, so the field is pretty wide open. No, brains haven’t changed much, but environment and technologies have. And, there’s no end to ambitious individuals and institutions who will lobby to bump up their specialties in the pecking order.

Perhaps the most obvious change will be in the area of gambling, sexual and internet addictions. While once viewed as undesirable habits to be addressed with will power, they are now nominated for mental illness status. Higher volume abetted by additional channels brings them to the fore.

This is not a mere finger exercise. When someone goes from character flaw to illness status, there are resources that become available. And, since resources are not infinite, they’re usually coming out of someone else’s hide. If people have nothing better to do with their lives than to bet the ponies, pay hookers or court affirmation on the web, that’s sad. But, I don’t think it’s worth pulling funding from treating suicidal adolescents, etc.

And, what if the classification is materially pointless or duplicated? For instance, the embittered losers now have a champion who wants them certified as a mental disorder because they can barely function outside of ruminating about the circumstances and people they obsess with. They are further described by their sponsor as angry, pessimistic, aggressive and hopeless haters. Of course, hanging a catchy name on the theorized sickness made it more tangible and quite the cause at last month's APA convention.

That is unfortunate, but even their advocates admit that they won’t seek therapy because of the perception, “the world needs to change, not me.” If offering treatment and/or applying it won’t do any good, why waste time?

And, haven’t we already covering this ground? Let’s see, people who bump heads almost everywhere they go but project the responsibility for it, delude, obsess with issues, sow seeds of hate, etc.? I think we might’ve already made the mental illness call on this about a hundred years ago.

There’s no point in reshuffling the deck now just to create some book contract and grant opportunities. If there’s little hope of successful treatment or it’s already been covered, let’s shift our focus to areas where we can effect the most positive impact.

And then there’s obesity. Not plumpness, obesity. It’s proposed as a symptom or risk factor. This is kind of a chicken and egg argument, as far as I can see

That’s the real question, because it’s already being factored into the medical equation. That is, we do psychiatric evaluations on candidates for bariatric surgery. Why are we going to that trouble and expense if we don’t agree what’s the cause and what’s the symptom? Or, is obesity a cause of mental illness or a sign of it? Or, neither?

I do understand that we’re not fixing computers here and everything is subjective. My concern is that we obfuscate and loose sight of the root problems through an unchecked proliferation of special interest theories.

Are we casting new light or stirring up dust? I don’t know. Ask the guy who’s advocating hoarding as a mental illness.