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Over the course of its six decades of evolution, the Diagnostic and Statistical Manual of Mental Disorders (DSM) has spawned an increasing biodiversity of mental disorders, even as it has seen the extinction of a wide range of disorders as well. The most recent edition of the DSM contains a fossil record that attests to the manual’s ongoing evolution, even as it contributes to that evolution in substantial, and arguably accelerated, ways. Long gone is the manual’s original psychoanalytic endoskeleton, seen in its first and second editions, but the enduring “atheoretical interim ” that followed it in subsequent editions is now gone as well. The manual’s newest backbone is a biological one, where the origins of mental disorders are to be found squarely in brain dysfunction and the line between mental illness and what Freud (1896/1957) once referred to as normal human unhappiness is intentionally blurred in a quest for more dimensionalized diagnosis. Whether this newly minted epistemic commitment will turn out to be sufficiently load bearing remains to be seen. What is clear is that it must bear an increasingly ponderous weight, given that the manual has grown from its 130-page origin (with 106 disorders) to a weighty tome of now nearly 1,000 pages and well over three times as many disorders. The manual’s growing girth signals its ongoing appetite for pathologizing normality and its unmistakable optimism regarding its future evolutionary trajectory. But there is a fine line between optimism and audacity, between hopefulness and hubris, and it is no