Examining lovesickness: DSM vs. Springsteen diagnostics
The Diagnostic and Statistical Manual of Psychiatric Disorders, a.k.a. the "Bible of Psychiatry," is missing a diagnosis: lovesickness. Then again, music offers insights into this condition that psychiatry never will.
Last May the American Psychiatric Association released the 5th edition of the Diagnostic and Statistical Manual of Psychiatric Disorders, known as DSM-V. Sometimes called the “Bible of Psychiatry,” the DSM-V provoked complaints about the diagnostic criteria it included, whether new diagnoses promote overtreatment, and the lack of statistical reliability for some of the disorders it lists.
But what about the missing diagnosis? The one known to poets, singers, artists, and lovers since recorded human history: lovesickness. The symptoms are many, but the cause is singular. It’s that profound and overwhelming sensation of despairing for an absent love. Passion. Obsession. Grief. Longing. That’s the stuff of great suffering and great art.
Popular music offers what the DSM does not, some great insights into the deep feelings of lovesickness. The brilliant country singer Patsy Cline expressed it in her cover of “Walking After Midnight.” Hank Williams, the great country music star, gave us the unforgettable version of “Lovesick Blues.” Singer-songwriter Joni Mitchell captured its essence in the lyrical “A Case of You.”
Shakespeare’s Sonnet 147 begins “My love is as a fever.” And the Boss, Bruce Springsteen, echoing that sensation, gave us the most searing description of the symptoms of agony and desire in “I’m on Fire”:
Sometimes it’s like someone took a knife baby
Edgy and dull and cut a six-inch valley
Through the middle of my soul
At night I wake up with the sheets soaking wet
And a freight train running through the
Middle of my head
Only you can cool my desire.
Honestly, is there any diagnostic manual that can touch the luminous descriptions and profound emotion that our greatest songs and poems can bring to the analysis of lovesickness? Can those feelings be reduced to a numerical billing code to be submitted by your doctor to your insurer for reimbursement?
It’s better to let to let medical professionals define lovesickness with code numbers referring to mania, melancholy, obsession, and depression and any others that fit. Those who suffer deserve help. For individuals who just want to know their experience isn’t unique and who seek a different kind of understanding, let them dive into a poem or song, or write their own.
Lovesickness can inspire the greatest of art.
Janet Golden's previous posts on sickness and medicine: Bed bugs, hookworks, and mosquitoes: A public health playlist for the blues, and From “TB Blues” to “Bacteria”: A musical medical history playbook. And don't forget her cinematic Christmas special: Public health movie stocking stuffers.
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