The discussion about mental health diagnosis wages on. Many find them punitive and question their need. Arguing they increase stigma; especially when it comes to more severe diagnoses such as psychosis. Others argue the need for them. They can have their uses in certain situations. For some people, perhaps those who have struggled with understanding what they’re experiencing. It can be reassuring or helpful. For others, their diagnosis may compound their feelings of anxiety or fears of stigma.
Find Your Tribe…A Diagnosis!
For those of you who are unfamiliar with Crazy Ex Girlfriend. There’s a song called A Diagnosis. It captures the essence of why a diagnosis could be grounding or comforting. In the song, our protagonist Rebecca becomes excited about the prospect of a new diagnosis. After many that didn’t fit, and stigmatizing comments equating mental illness with weakness. Rebecca hopes the new diagnosis will finally provide a reason for the symptoms she’s experienced for so long. Likewise, she feels like a diagnosis with open a whole new world of people to her. Those with similar lived experience who are in a better position to understand her.
A Path to Better Treatment?
But, if we pay attention to the lyrics, there’s another undercurrent here. Rachel mentions the stigma that she’s faced. And feels it is worth the burden if she is correctly diagnosed. We know that some people may receive multiple diagnoses in their lives. Some fitting better than others. Perhaps, some no longer fitting us as our lives and selves evolve.
With the hope of a correct diagnosis comes the anticipation of a more fitting treatment plan. Hopefully one made with the direct involvement of the person experiencing said diagnosis. For those who have been misdiagnosed or prescribed treatment which wasn’t the right fit. The need for accurate diagnostic tools. And a full range of effective treatments tailored to the individual are vital. Although, of course they are important to us all. And the hope of finally getting the right treatment cannot be underestimated
And yet, the accuracy of diagnosis, range of treatments and their accessibility continue to be an issue. So, whilst a new and hopefully correct diagnosis should be what we expect. And we shouldn’t settle for less. We do need to acknowledge it’s not a panacea. Even when the system works, there is no magic pill for mental illness. As with many physical health illnesses. Recovery takes time and is an individualised path built from a variety of building blocks. One step forward may be followed by two steps back. It can’t be rushed and it won’t be solved by a diagnosis.
For What Mental Health Recovery Means read here.
For How to Understand Fear of Mental Health Recovery read here.
As above, getting the correct diagnosis can be a bit of a minefield. And understandably people may be hesitant to receive one. With a diagnosis may come better understanding of what is happening to you. A group of people who understand and the possibility of peer support. As well as, a more robust or helpful treatment plan.
But there’s also stigma associated with many diagnoses; if not all. People may fear what diagnosis they may receive. What treatments may be offered or even available. How others may react. And the impact of keeping their diagnosis private if they choose not to tell others. After all, it is our right what we do and don’t disclose. And then there is wider society to consider. Whilst education and awareness of mental health and mental health illnesses are improving. We are not quite as open-minded as we should be. And so, kindness and understanding is not always a given.
Does Diagnosis Have a Place?
Some people may argue, and indeed do argue, that diagnosis has a place. For example, to promote understanding of symptoms. To help medical professionals liaise with each other. And to ensure correct access to treatment. To a certain degree, I agree. To a panicked parent, a diagnosis for their child might be a relief. Or like Rebecca for herself. A diagnosis can explain symptoms they’ve found difficult to experience or manage. It might be the light at the end of the tunnel leading to better treatment. It may be helpful to provide your diagnosis when speaking to friends, family and employers. A short hand for your experience when you don’t wish to re-live or delve in to it. This can all be helpful provided it is met with empathy and understanding.
Diagnosis in the Hands of the Professionals
Likewise, among professionals, a diagnosis can be helpful. They’re low on time so it can be a short-hand. Giving a rough guide of what to expect with a patient. And, of course, guide the medical professional or even community member to more accurate signposting to statutory and voluntary sector organisations. But, again, we have to be aware of the impact of stigma.
Whilst diagnoses like anxiety and depression have gained more understanding. And are, arguably, less stigmatized. This isn’t true of other diagnoses or behaviours. And even among medical professionals they continue to be stigmatized. For example, self-harm as a behaviour (not a diagnosis) continues to be misunderstood. And people have often been met with misunderstanding and a lack of compassion. Or more severe conditions like schizophrenia which still carries a burden of stigma. Or Borderline Personality Disorder where patients can still be viewed as difficult. Although we know this is an unfair label. And then there’s the language around mental illness and treatment. Words like ‘non-compliance’ which suggest someone resisting their treatment. Rather than a nuanced conversation about what the obstacles are.
The Importance of Person-Centred Care
And even when diagnoses aren’t met with stigma. There’s still the need to acknowledge individualized experience. Whether we’re talking about the more understood diagnoses of anxiety and depression. Or the more misunderstood diagnoses such as schizophrenia or bipolar disorder. My experience and sets of symptoms, the reasons why I experience the condition and my triggers. Will all be different to someone else. Whether or not we have similar life experiences, genetic make up or socio-economic and familial set ups.
So, whilst a diagnosis may suggest a set of symptoms which can signpost possible areas of treatment and support. It can also lead all of us, healthcare professionals, friends, family and community members to make assumptions. And the media doesn’t help with this. Sensationalizing certain diagnoses or people’s experiences of them. It’s a key reason why people still continue to associate mental ill health with violence. Although we know you’re more likely to be a victim of a crime than a perpetrator if you’ve got a diagnosis.
For The Crucial Difference Between Sympathy and Empathy (When Providing Support) read here.
For The 11 Tips You Need for Effective Listening read here.
So, Where Are We?
The argument over diagnoses and when they are appropriate or helpful is far from done. Which is just as well as I don’t think we’re nearer a conclusion. In certain situations they do seem to have a place. And can aid treatment and recovery. But if we want to reap the full benefits of using diagnostic terminology. Then we need the empathy and compassion to go with it. Among us all.
Receiving a diagnosis and knowing that your friends, family and peers will be supportive is a far cry to worrying about their reactions. Knowing that your doctor will diagnose you, but not make assumptions about what it means for you. Will aim to take a nuanced, person-centred and holistic approach to your treatment. And include you in the decision making and ensure you are informed. That’s a world away from a medical professional assuming that a list of symptoms or a label tells them all they need to know to treat you. Or a friend or family member reduces you to that same list. Forgetting the years of friendship and experiences you’ve had previously.
What are your thoughts about the place of diagnosis in mental ill health? Is it a help or a hindrance? As always, let us know below!