It is certainly true that the Diagnostic and Statistical Manual of Mental Disorders [DSM] overpathologizes the human condition and that psychiatrists and other mental-health professionals may feel obligated to diagnose a patient with something. There is one diagnosis in the DSM, however, that is not given often enough, due to the biases of the clinicians, patients, and insurance and pharmaceutical companies. That diagnosis is alcohol abuse. Other diagnoses, such as depression, anxiety disorder, social phobia, or bipolar disorder, are often given to patients along with the message that they are abusing alcohol to “self-medicate” for their underlying condition. In my opinion the opposite is more often true: The real underlying condition is alcoholism, and the symptoms presented by the patients are largely a response to alcohol abuse – and, to a lesser extent, drug abuse.
I believe that this problem is more deeply entrenched in our society than we like to acknowledge, and it often ends up in the lap of mental-health professionals, masquerading as anything other than itself.
– Stephen Pittelli, MD, letter to the editor in The Sun