Diagnosis: Important, But Not All-Important
“What do I have?” I have heard that quite a few times in counseling sessions from clients who are interested and/or worried about their mental health diagnosis. While in a medical doctor’s office this question is often asked with little preconceived knowledge of what condition may be suspected, in a counseling office most people have at least a general framework for conditions like anxiety, depression, OCD, bipolar disorder, etc. Knowing one’s diagnosis seems more and more popular and accepted in our society, which is mostly a good thing in my opinion. However, it has some drawbacks that need to be addressed as, like almost all information, if it is applied incorrectly than it can have negative impacts on a person’s life. Mental health diagnoses and the process that goes into them have a very long and wild history. It is both comical and tragic when you read about how people were diagnosed and with what conditions even just 50 years ago, let alone 150 years ago. While our process has improved drastically and the diagnoses, and typically leads to correct applications of treatment, they still have some glaring holes. Let’s take a look into the reasons having a proper diagnosis is important, and then some ways we can avoid putting too much energy into our diagnosis and misinterpreting its value in us feeling better.
Why Do We Need Diagnoses?
There are three main reasons I find diagnoses to be necessary, 2 of them being very important and one other being a simple fact of life. Starting with the least important on a mental health level, diagnoses allow us to tell those involved in our treatment what they are dealing with. Therapists, primary care doctors, psychiatrists, psychologists, and other professionals involved in mental health treatment need to be able to communicate with one another in a shared language. Diagnoses allow this to occur. This combined with the ability to bill insurance is the fact of life and a reason we need diagnoses. We have to be able to at least share a general understanding of what a person is going through and needs when suffering from depression, anxiety, or other conditions. Diagnoses allow people to receive the proper services without there having to be a complete examination and workup every time they see a therapist or doctor.
Now on to the two more important reasons regarding diagnoses in terms of our mental health. First is a diagnosis allows a person to understand that they are dealing with a mental condition that has an understood process of playing out and being treated. Think of the chaos we would all live in if a doctor told us we needed to manage a sore throat, runny nose, cough, headache, and possibly a fever. That’s too long of a list for our minds to really wrap around how we need to combat these problems. Luckily, we wrap them all together and doctors say, “you have a cold”. It is much easier to conceptualize and deal with the idea of having a cold as opposed to each individual symptom. The same applies for mental health issues. If I told a client they need to work on sleep issues, appetite problems, the inability to feel pleasure, crying spells, low productivity, and negative self-thoughts in every session they would likely run for the door after being overwhelmed. Wrapping these symptoms up in the diagnosis of depression makes it much more manageable for us to understand and know that dealing with the depression will assist in all of these areas.
The other important reason for diagnosis is the reduction in stigma and misinformation. Having a mental health diagnosis is far more accepted now in society, but we have a lot more work to do in eliminating this stigma. Still, a proper diagnosis allows a person to speak to the world in the context of their issue in a away that most people are more understanding of. In terms of misinformation, we have a long way to go to understand exactly what things like depressive disorders, personality disorders, or anxiety disorders are. But we at least have been able to use diagnostic procedures to eliminate some old misconceptions as to what they are: character flaws, spiritual/demonic influence, overreactions to normal stress, or caused by other illnesses. Hypothyroidism, which creates depression like symptoms is a good example of why proper diagnosis helps with misinformation. Way back in the past, these symptoms would have been blamed on demons or character flaws in one’s soul. Then, medical knowledge showed that there are chemicals in the blood that are lower in those with hypothyroidism. After this, mental health knowledge lumped depression together as a disease of the brain. Now, just in the last 40 years we know that hypothyroidism is treated by a pill, and usually all depressive symptoms go away. So this condition has been destigmatized and now is properly understood for what it is. Diagnosis is important without a doubt, but now let’s see where it can have major limits.
A Diagnosis Is Not An Exact Map
If you have been diagnosed with anxiety, depression, bipolar disorder, personality disorders, even schizophrenia, you can find a lot of information about how these conditions progress and present. Many clients will take a diagnosis and run with it and do as much research as they can about what to expect. This is where diagnosis in the mental health world differs greatly from the medical field. Diseases of the body mostly follow progressions that a doctor can predict to a decent level of certainty. If you have the flu, you will start mildly sick, get sicker as the virus spreads around the body and the immune system fights it, then have lingering symptoms for a couple weeks max. A vast majority of people with the flu can count on this process being accurate for them. Mental health diagnoses are not as useful in predicting daily/weekly experiences. I have written in the past about how depression particularly frustrates clients with its seemingly random process of good days, bad days, followed by great days, horrible days, more bad days, medium days, then eventually seeming to fade away. If you take your diagnosis to be a way to know the future of how you will be feeling every day, you are in for a tough realization that the brain is far too complex for that.
A diagnosis is also not a predictive tool for your symptoms in an exact way. It is true you won’t receive a diagnosis if you are not experiencing certain symptoms, but the brain is again so complex that your exactly symptomatology of any mental health condition cannot be totally predicted by a diagnosis. Many clients have similarities in symptoms like sleep disturbance and low mood, but other symptoms like the inability to feel pleasure or negative self-talk are far too individualistic to be fully encapsulated in a diagnosis. I am a big fan of people reading stories of others with the same mental conditions they have but falling into a trap of believing their experience is going to be exactly the same is a big problem. The depth of you, the complexity of you as a person, is beyond any diagnosis to define and predict with accuracy what you will think and feel. There is another related problem with knowing diagnosis, when clients will then relate everything, they experience to their diagnosis. A bad day becomes a depressive symptom, feeling high energy automatically means mania, nervousness before a big presentation is a part of panic disorder. These are not necessarily signs of one’s mental health condition causing problems and are normal experiences for all people. It is a balancing act to stay vigilant in tracking one’s mental health status when having been given a diagnosis, but not attributing every emotion to being part of the illness. Try to avoid letting your diagnosis become the defining factor in your life.
If you are dealing with a mental health diagnosis and want to know what it means for you, please contact Life Enhancement Counseling Services today at 407-443-8862 to schedule an appointment with one of our experienced Orlando mental health counselors.