I’ll be the first to say that, as a mental health professional, I understand the importance of a diagnosis for some people: it can lead them to resources they may not have otherwise had access to.
“A diagnosis may come as a relief—with finally being able to put a name to the symptoms you’ve been experiencing. That can be empowering for some, while a diagnosis may feel confining and like a detrimentally defining label to others. Thoughts and feelings about diagnosis are such a personal and individual experience.”
But what happens when you receive a label that you don’t think fits for you?
Or, in my case, no one term seems to fully capture your experience? That can be hugely frustrating, especially when well-meaning people may throw out clinical and diagnostic terms at you that you’ve already pondered for yourself, and you’ve thought: “Um thanks, but no.”
Diagnosis as a Provider
Any mindful and conscientious practitioner doesn’t take diagnosing their clients lightly. Diagnoses can provide a lot of ethical dilemmas for mental health treatment providers—sometimes a diagnosis needs to be provided in order to be reimbursed by insurances, but maybe your client doesn’t fit neatly into any one diagnostic category and an “adjustment” disorder doesn’t quite fit either. What are you to do?
“Any mindful and conscientious practitioner doesn’t take diagnosing their clients lightly.”
I try to be really mindful when I assign diagnoses to my clients. When people meet criteria for any diagnosis, I process that with them. Keep in mind that scores on a measure, and even a diagnosis, are just pieces of information— pieces that makes up the entirety of the individual and their context, not the whole of them.
Another thing to remember is that measures aren’t perfect. If someone scores just below a threshold on a measure to meet the criteria for depression, are they suffering any less than the person who scored just one point more? Probably not.
Measures can be a helpful tool, but they’re just that: a tool to provide more information, not the holy grail that defines what an individual’s experience or identity is.
Personal Experience with Diagnosis
I’ve had a few different diagnoses over the years, none of which actually captured the essence of my experience. For me, a diagnosis isn’t important. I know what my experience is and I don’t necessarily feel like it has to fit into any standard category.
I understand that diagnoses represent clusters of symptoms in order to be helpful, and practitioners need a benchmark from which to operate, but people are complex. I manage my uncomfortable symptoms very well without any medication and have for years. I usually only have one, maybe two significant flare ups a year. If I had to explain what I experience, it would likely be some anxiety symptoms, but in very specific situations.
I have dissociated in the past if I become too activated and feel trapped. Even an anxiety diagnosis doesn’t fit for me though, because I think it all boils down to relational trauma and emotional regulation. So I would say my diagnosis (I’m making this up) is the management of chronic trauma activation? I would bet that this underlies much of the psychological dysfunction in the world. Anyway…
My first experience with a psychiatrist was atrocious. I was given the Beck Depression Inventory and then was labeled as depressed. If the psychiatrist had spoken to my therapist (like I signed the release for her to do), she would have known that I wouldn’t be depressed if not for anxiety. We focused so heavily on that and I ended up on medication that I didn’t need.
At the time, I didn’t feel like I could really articulate what I was experiencing. I dissociated so frequently and didn’t understand how that was happening, how to explain it, or why it was happening.
“Essentially, a diagnosis never helped me: Therapy, persistence, listening to myself, and never giving up did.”
I want to emphasize here that there are amazing psychiatrists out there and I am by no means anti-medication, I just wish more doctors would take the time to really talk to and get to know their clients so that they can make informed decisions. It would have saved me so much time.
Recommendations
I don’t want to speak as if I know what is best for anyone reading this, because I don’t know you personally and I’m not treating you. And even if those criteria were true, we would work collaboratively for a solution. But generally, if you think you need assistance with your mental health, a diagnosis may or may not be helpful to you.
“Sometimes, for more serious and impairing conditions, a diagnosis can be helpful and may lead you toward useful medications so that daily functioning becomes easier. For moderate and less severe cases, what I would recommend is to pay attention to your gut. Find a provider that you trust (which may take time and a few tries), whether that’s a licensed counseling professional, psychologist, or psychiatrist.
I, personally, would say start outside of the medical field with a good therapist if you are mostly able to function day-to-day. And if something doesn’t sit well with you, you can always go to someone else for a different opinion, and consult doctors to see if medications may be of use for you.”
Disclaimer: If you are in danger of hurting yourself or someone else, please seek local emergency/crisis services immediately, and do not wait to schedule an appointment with a therapist.
At the same time, counseling can reveal to you some painful things that you may not want to face. Make sure you are prepared for that as best as you can be. Remember, a diagnosis only defines you as much as you let it. It doesn’t have to be any more meaningful than acknowledging that you have high blood pressure, for example. If you work to have that attitude about it, the stigma surrounding mental health concerns can be shattered.
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