What If Depression Isn’t a Chemical Imbalance?

Sadness, stress, and struggle: when did being human become a disorder?

The DSM: The Psychiatrists’ Bible

A Raffle and a Big Blue Book 📖

A few months ago, I went to an internship fair for my counseling program.

One of the tables featured a chatty man hosting a raffle, and I felt obliged to sign up (as one often does). I didn’t think much about it.

The prize? Nothing other than the Diagnostic and Statistical Manual of Mental Disorders—the infamous “DSM.”

A few weeks later…I got an email: Congratulations, you won the raffle!

…Yay??

Soon after, it arrived on my doorstep.

The DSM is massive. It's considered "the Bible" for psychiatrists because it catalogs every mental disorder perceived to be in existence. The big blue book sat on my shelf for months, collecting dust and silently demanding attention.

Finally, I decided to do some digging. What’s really inside this thing? What does it mean for me and my work as a counselor?

What I found shocked me…

And completely transformed everything I thought I knew about mental health.

The Grief Exception

In the DSM, there used to be a "grief exception,” meaning that the authors created one singular loophole for Major Depressive Disorder (MDD).

The exception stated that if you recently lost a loved one and are experiencing symptoms of grief—depressed mood, decreased interest in pleasure, feelings of worthlessness—you wouldn't be diagnosed with depression

The exception existed for the grieving, and the grieving only.

By making this exception, the authors of the DSM acknowledged that life events and environment factors could play a role in causing someone feelings of persistent sadness or distress.

But if there was one exception, couldn't there two?

Three?

More?

Loss of a loved one is devastating. But so is losing a job. Or a family member going to prison. Or a divorce. Or being diagnosed with cancer. Or surviving a car accident.

Do you understand what I'm getting at?

And HERE'S THE KICKER:

That grief exclusion? It was removed.

What This Means