The first Diagnostic and Statistical Manual of Mental Disorders is due for publication in May 2013 and since the fourth edition’s arrival in 2000, there has been a large controversy over what should constitute as a mental disorder and what should not.

Mental disorders bring legal, social and financial ramifications, and for these reason the DSM-IV should limit the number of mental disorders to only those truly warranting treatment.

Approximately one out of four college students are diagnosed with a mental disorder during college or have already been diagnosed with a psychological condition. Many of these students are diagnosed with attention deficit disorder. To fit the DSM-IV definition for ADD, one must fit six out of nine inattention criteria and six out of nine hyperactivity-impulsivity criteria, along with a few other broad criteria regarding length of time of symptoms and intensity.

The inattention criteria consists of vague statements such as, “patients often have difficulty organizing tasks and activities” or “often fail to pay close attention to details or makes careless mistakes in schoolwork, work or other activities.” The hyperactivity criteria consist of equally vague statements, which encompass the behavior of most children. This leads to a growing number of ADD diagnoses, especially for children, and an increased number of medicated children for simply exhibiting normal behavior.

Allen Frances of the Los Angeles Times stated that the DSM-IV contributed to three mental health epidemics—attention deficit disorder, autism and childhood bipolar disorder. ADD does exist, and so does ADHD, bipolar disorder and autism. However, the widening number of those diagnosed with a mental disorder increases the number misdiagnosed with a mental disorder.

The DSM-IV panel is currently debating the addition of premenstrual dysphonic disorder, which is basically an extreme version of PMS. Some women may benefit from these diagnoses, as their symptoms far outstrip the average woman’s each month. However, if the DSM-IV fails to choose extreme criteria, many women previously undiagnosed and untreated each month will find a legitimate excuse to neglect responsibilities and seek a ‘magic pill’ to alleviate all symptoms.

The DSM-IV operates under the guise of identifying a clear boundary between normal and abnormal. But in reality, the normality line is extremely gray and not at all fine. The situation is further complicated because normality is not a scientific construct. It is a social construct that has emerged in a society that favors conformity, and views belonging analogously with success.

The mental health field has come a long way in the past 50 years. Treatment, particularly in the light of biological and neurological advances, has helped many individuals suffering from legitimate disorders to live a normal life. But the pharmaceutical industry has also contributed to a widespread movement to medicate every eccentricity and sedate abnormal urges in the name of achieving society’s normal.

The fact is that many individuals suffering from these disorders do not want a cure. There are people with Asperger’s who are proud to have the syndrome. It is highly doubtful that when homosexuality was viewed as a disorder, all homosexuals desired a cure. Not everyone wants to be normal. Most individuals have a common desire to fit in, but this is more reflective of society than their respective conditions. Fitting in does not always mean treatment or a cure. Sometimes fitting in is just changing society to be a little more accepting.

It is important to realize the differences in people and learn to accept them. The point of diversity is not just to accept people of different cultures and backgrounds, but all people with different ways of life, different perspectives and ways of thinking. That includes people with disorders who do not wish to conform to society but wish to embrace the way they are. The DSM-IV panel should take great care to limit the number and breadth of disorders listed in 2013, because each disorder identified will lead to greater pressure and means to medicate and conform.