Major Change Coming in Mental Health Diagnoses as Psychiatrists Explore Biomarkers

The American Psychiatric Association (APA) is considering a landmark change to how mental illness is diagnosed, exploring the incorporation of biomarkers into future editions of its Diagnostic and Statistical Manual of Mental Disorders (DSM). Experts are calling it 'the beginning of a revolution' in psychiatric care.

The potential shift was highlighted by the case of Amanda Miller, a 30-year-old neuroscientist who developed depression during pregnancy. After trying four antidepressants and two antipsychotics over two years without improvement, her primary care doctor identified high levels of an autoimmune marker. A specialist diagnosed her with lupus and prescribed a steroid, which alleviated many symptoms including depression.

Most mental illnesses have historically been diagnosed based on symptoms alone. Biomarkers could streamline insurance decisions, improve treatment accuracy, and reduce the trial-and-error approach to prescribing. For example, patients with depression exhibiting elevated C-reactive protein levels may respond better to dopamine-altering drugs than SSRIs.

Jonathan Alpert, an author of the APA paper, called adding biomarkers to the DSM 'a very big deal,' while Andrew Miller, a psychiatrist studying inflammation-related depression, called the APA's embrace of biomarkers 'the beginning of a revolution.'

However, widespread use of biomarkers requires significant coordinated research for validation. The APA's January paper emphasized the need for 'coordinated, well-funded' research efforts, which face challenges due to reduced federal funding. The National Institute of Mental Health had at least 128 grants totaling $173 million canceled in 2025, though some have been restored. Ethical concerns also exist about potential discrimination based on biological profiles.