Why This Becomes Circular
This leads to circular reasoning.
How do we know someone is depressed? Because they have certain symptoms.
Why do they have those symptoms? Because they’re depressed.
The diagnosis explains itself by referring back to the symptoms that define it. Nothing outside the description is being identified as the cause.
How This Differs From Medical Diagnoses
In most areas of medicine, diagnoses are intended to point toward causes. Pneumonia helps explain chest pain, fever, and shortness of breath. Diabetes helps explain elevated blood sugar. These diagnoses function as explanations, not just descriptions.
DSM diagnoses function differently. They are descriptive categories rather than explanatory models. They were never meant to explain why symptoms occur—only to organize and name recurring patterns of experience.
What the DSM Does—and Does Not—Address
Mental health is often discussed in biological, psychological, and social terms. However, the DSM itself does not address any of these domains. It does not specify biological mechanisms, psychological processes, or social conditions.
It identifies patterns. It names them. And it stops there.
