29/10/2026
“While formally modest in its claims, the DSM can operate in practice as a system that powerfully shapes self-understanding [2].
Across high-income countries, DSM-based systems now classify roughly 25% of the population as having a mental disorder each year, with notably high rises among young people [3]. For people who are suffering, DSM-classifications can feel both alleviating and explanatory, even when they are not intended to be. At the same time, when such descriptions are internalized as explanations for one’s suffering, they can profoundly shape who a person becomes, since people in distress often strongly desire to understand what is happening and to relieve their suffering [4]. This mechanism can affect people’s self-understanding because it assigns meaning and coherence to complex context-dependent human experiences at a moment of heightened receptivity and subsequently becomes embedded in the context of a person’s entire life. In this way, living with the understanding that a DSM-classification accounts for one’s suffering, and interacting with others and one’s environment through its lens, can give rise to new kinds of experiences that may ultimately feed back into diagnostic descriptions themselves.”
Do we understand the real-world consequences of a future DSM?
PLOS Mental Health is an inclusive journal addressing challenges and gaps in the field of mental health research, treatment, and care in ways that put the lived experience of individuals and communities first.