Understanding the Pros and Cons of Diagnosis in Mental Health
Mental health professionals have long debated the significance of diagnosing mental distress, tracing back to the era of Freud. While these labels can serve as a useful shorthand for clinicians, they often fail to capture the full complexity of the individuals who face these labels in their daily lives. Giving voice to both the pros and cons of diagnosis can add important perspective and dimension to your mental health and wellness journey.
Diagnoses Can Be Restrictive and Arbitrary
Diagnoses, while sometimes helpful as guideposts for treatment, can also be restrictive and arbitrary. Mental health disorders are typically diagnosed based on the presence of a certain number of specific symptoms, a threshold that can often seem random.
To be diagnosed with Major Depressive Disorder (MDD), for instance, someone must exhibit five or more symptoms from a particular list for at least two weeks. Technically, MDD is not diagnosed if someone has 5+ symptoms for 12 days (it's less than 2 weeks!), or only 4 symptoms (less than 5!) for 2 months.
You Are Not a List of Symptoms
Furthermore, thinking about diagnosis tends to focus our attention on a “problem” that needs to be fixed. What we sometimes forget is that we are not equations to be solved. Humans are not perfect. We all have obstacles in our lives and we all have things we would like to change about ourselves. Focusing too much on what might be “wrong with us,” rather than considering our strengths and the resources we have to overcome our challenges, may be creating more obstacles in our daily lives than we recognize.
Instead, we might benefit from shifting our attention to the ways we can use our positive traits to improve our lives. For example, Joe’s Bipolar Disorder does not have to stop him from using his sense of humor, compassion, and sensitivity to support a grieving friend. Betty’s Social Anxiety does not prevent her from excelling at work, as long as she leverages her perseverance, responsibility, and commitment to high-quality performance.
Progress Is Subjective
If diagnosis is inherently flawed, why do we keep diagnosing? Beyond facilitating communication between clinicians, diagnoses are sometimes used to track the outcomes of treatment. This is because some diagnoses are categorized by the frequency or severity of symptoms (e.g., mild, moderate, severe), which can be used as a measure of treatment progress. As most clinicians will recognize, however, measuring long-lasting change is not quite so linear and clear-cut.
Given that mental health improvements are highly individualized, a more effective way to gauge therapeutic progress might be through the quality of the client-therapist relationship. Key questions include:
Do you trust your therapist?
Can they help you experience unsafe emotions in a safe environment?
Are you uncovering new aspects of yourself?
These subjective measures often provide clearer indications of progress than diagnoses or symptom counts.
Diagnosis Can Also Provide Hope, Community, & Intervention
It's important to note that some of us find comfort in having a diagnosis. It can be reassuring to know that we are not alone in our experiences and empowering to have a label that can be addressed. For mental health disorders that benefit from pharmaceutical treatments, special accommodations, or interventions from educational institutions, diagnosis is crucial for effective treatment.
For those of us whose experiences do not neatly fit into diagnostic categories, focusing too much on diagnosis (e.g., “what’s wrong with me?”) and not enough on personal experience (e.g., “how can I live a happier life?”) might not be as beneficial.
By understanding the complexities and limitations of mental health diagnoses, we can shift our perspectives on mental wellness in helpful ways. Emphasizing strengths, building trusting therapeutic relationships, and recognizing individual goals are key to fostering well-being beyond labels.
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