Is the diagnosis of mental illness helpful?

Have you ever received a mental health diagnosis?

Do you wonder if you have an undiagnosed issue?

Would or have you benefit(ed) from such a diagnosis?

The idea of mental health labels can be a contentious topic among therapists. Some counsellors believe they’re beneficial, others feel they’re unhelpful, and some like myself sit somewhere in between.

In this blog, I cover topics such as how a diagnosis is made, who can give them and the potential pros and cons of receiving a psychological diagnosis.

What is a psychological diagnosis?

A psychological diagnosis is a label or classification given to a person based on their presenting symptoms. Symptoms taken into account often include an individual’s mood, behaviours, or thinking patterns. Examples of psychological disorders include generalised anxiety, depression, PTSD and Obsessive Compulsive Disorder (OCD).

Who can diagnose mental health issues

Only certain medical professionals can give a formal diagnosis of a psychological disorder.

A GP can diagnose certain conditions, such as anxiety and depression. However, less common or more complex issues, such as psychosis or bipolar disorder, may require a mental health specialist such as a Psychologist or a Psychiatrist.

Whilst therapists are trained to work with human distress, we’re not able to offer a formal diagnosis. As a therapist, I’m interested in people as individuals and understanding their experiences. Therapists are trained to help guide and support people to improve their well-being rather than offer a diagnosis.

How is a psychological diagnosis made

Psychological diagnoses’ are sometimes made from a book called the Diagnostic and Statistical Manual (DSM). The DSM  appears to have been thrown together with little scientific research.  Despite it being in its fifth edition there remains a lot of controversy around it. See the article on Psychology Today’s website for more information on this.

Specific mental health practitioners carry out assessments to formulate a psychological diagnosis. Assessments may include one or more of the following:

• Clinical interviews - Where the clinician will gather information such as an individual’s symptoms, history of mental illness, family background or anything else that seems relevant;

• Observations - This could include noticing a person’s body language, tone of voice, behaviours and how the patient interacts with others;

• Psychological testing - This may involve questionnaires or cognitive tests;

• Information from other sources - This could be interviews or questionnaires completed by friends and family members or notes from other medical professionals;

Physical medical tests or scans are not used to diagnose mental health issues. However, some biological issues can mimic psychological disorders. For example, a urine infection in an older person might cause confusion or hallucinations. Some physical tests to rule out biological causes might include:

• Samples for lab testing - This could involve blood tests or urine samples. For example, a blood test may be used to check for thyroid issues. If there’s a problem with a person’s thyroid it might cause symptoms of depression or anxiety;

• Neuroimaging - This may be things like an EEG, MRI scan or CT Scan. Such tests may be used to rule out a neurological disorder such as epilepsy;

• Sleep study - Some sleep issues might be neurological rather than psychological, such as restless leg syndrome or have a physical cause like obstructive sleep apnea.

Is having a mental health diagnosis helpful?

It’s a complex question to answer as multiple factors are involved. For example, would the diagnosis impact how that person views themself, how others view them, and what help (if any) is available.

For some individuals, a diagnosis will be invaluable, yet for others, they may find it unhelpful or even harmful. Then some people will experience both advantages and disadvantages of having a diagnosis.

The following section discusses some of the pros and cons of a diagnosis.

Advantages

• It may be a relief to be given a name for what you’re experiencing. It may help you to make sense of what you’re going through;

• Work or education settings may be required to make reasonable adjustments to support you;

• It can give you words to describe to trusted friends and family how you feel and possibly receive support;

• A diagnosis may also open up access to mental health support and services. Different conditions may respond better to different therapies or mediation.

• There may be support groups where you can communicate or meet with others who are experiencing similar difficulties. This may foster a sense of belonging, reduce isolation and provide you with practical advice.

Disadvantages

Some of the potential disadvantages are:

• Overidentifying with the diagnosis - It’s easy for a diagnosis to feel as if it’s the whole of who you are. Overshadowing other aspects such as your interests, strengths and capabilities. It could lead to feelings of hopelessness that prevent seeking out coping strategies, engaging in personal development and working to build a more positive future;

• Lead to a negative view of the self - Some people find having a mental health diagnosis feels shameful, or as if they are somehow failing at life. This may lead to low self-esteem, a reluctance to reach out for help and a worsening of their mental health;

• Discrimination and stigma - A person may feel judged or treated differently due to their diagnosis. This could lead to withdrawal, isolation, being overlooked at work and a reluctance to seek help;

• Misdiagnosis - Mental health diagnoses are complex and it’s not an exact science. Receiving the wrong diagnosis may lead to incorrect treatments, being overly medication or delays in getting the appropriate support.

Is receiving a diagnosis a personal choice?

Ideally, it would be. However, sometimes receiving a diagnosis is out of a person’s control due to practical, unexpected or safety reasons. For example:

• Needing a medical letter for work or education;

• Trying to access psychological help;

• A mental health assessment and receiving a different or additional diagnosis than what the person expected;

• Someone needs urgent treatment or a hospital admission as a result of a mental health issue.

I’m not sure whether to get a mental health diagnosis

If you’re in two minds about seeking a mental health diagnosis, you might want to spend some time weighing up the potential pros and cons. You might also find the following questions useful to reflect on:

• What positive difference would a diagnosis make to:

  • How you feel?

  • How you view yourself?

  • Your behaviours?

  • What help or support would you expect to receive from e.g. work, education, friends & family or the medical profession?

  • Any other positives you can think of?

• What negative difference, if any, do you think it will make to:

  • How you feel?

  • How you view yourself?

  • Your behaviours?

  • Any other possible downsides you can think of?

Final thoughts

So is the diagnosis of mental health really helpful?

I don’t feel that I can give a firm answer to this question. Receiving a mental health diagnosis carries the potential to be both beneficial, harmful or somewhere in between.

Receiving a diagnosis may give you access to services, practical help at work or university, the language to describe what’s going on for you and support from those in your social network.

However, a diagnosis carries potential risks such as discrimination, misdiagnosis, low self-esteem, or hopelessness.

Causes of Psychological Disorders

Some Psychological issues are biological or have a genetic component to them and may require specific treatment e.g. Schizophrenia, bipolar disorder or hormonal issues (Postnatal depression, menopause, PCOS).

However, I believe many mental health labels come from normal human responses to unpleasant events from the past or the present. As a therapist, When someone says to me that they’re anxious, depressed, or suffering from some other diagnosis, what I am interested in knowing is what this label means to them, how they experience it, and what happened or is happening in their life that led them to feel this way.

Therapy

If you’ve received a mental health diagnosis it’s important to recognise that it’s just one aspect of who you are. It doesn’t define your entire being, yet it’s easy for it to feel that way.

Mental health should involve a holistic approach and my interest would be working with the whole of who you are, not just the diagnostic label. Therapy can be a useful space to explore your strengths, goals and the wider context of your life, in addition to the difficulties you’re currently experiencing.

Therapy may help if you’re looking to make sense of your past or your present, and build resilience and ways of coping.

However, if you’re currently experiencing serious mental health issues you may require medical intervention instead of therapy (e.g. schizophrenia, or if there are immediate safety concerns).

I offer face-to-face, online and telephone therapy appointments. If you have any questions or would like to book an appointment please contact me.