A systemic, holistic approach must be taken that requires assessment—not just isolated DSM diagnosis. Triangulation might also make sense, with multiple sources being accessed to help describe the tale of trauma for a specific person or a category of people. Multiple methods could also be used to gain a more complete picture of what the trauma looks like, feels like and is lived with. At least the military-based assumptive world of shell shock and battle fatigue came with full recognition that it is a matter of war and not just personal illness. Furthermore, the descriptions of these war-related ailments often came from many sources (including novelists and movie makers)—not just the medical community
COVID-19
There are many dysfunctional behaviors associated with the COVID-19 outbreak. They range from the benign, but seemingly antisocial hording of medications and supplies (such as toilet paper and disinfectants), to the failure to observe social distancing and the wearing of masks that protect other people from infection. At a more extreme level, there is the anxiety associated with the threat of becoming infected to the profound fear (even paranoia) of contacting other people, resulting in an inability to leave one’s home. In each of these instances, there can be a DSM-based diagnosis and at least in the case of anxiety and social phobias a treatment plan can be formulated based on this diagnosis.
It is important to note, however, that an individual diagnosis in the case of a virus-related pathology is clearly inadequate, for this pathology must be viewed within a much broader context. In these cases, pathology exists in the society, not just in the individual. Diagnoses must be accompanied by (or even superseded by) assessments. We must know more about what is happening in the world if we are to understand and do something about what is happening in the individual.
Thus, at the end of the day, we find that DSM can’t really handle the complex, systemic nature of COVID-19. A sick and anxious child or grandparent is not the disease—rather this person is the symptom of a much bigger and much more challenging disease which is the pandemic virus. We need an assessment rather than a diagnosis to be in any way successful in addressing the mental as well as physical illness created by the virus. Once again, Triangulation might prove useful, with multiple sources and methods being deployed to gain a clearer and more complete perspective on this virus (enabling better preparation for future viruses).
