How a Diagnosis Can Prevent You from Getting Better
If you’ve been struggling with symptoms of anxiety, depression, or other mental health concerns, you may have tried to diagnose yourself in an effort to understand what’s going on. This can be helpful, but it doesn’t help you understand why you feel this way. In the realm of mental health, a diagnosis fails to provide enough information and can even be misleading.
Psychiatric diagnoses are labels determined by a list of symptoms that are mostly behavioral, meaning, they describe things you’re doing or not doing (like sleeping, or eating). Most diagnoses require a threshold number of symptoms, such as four out of nine. This means a single diagnosis can encompass many – even dozens – of different experiences (American Psychiatric Association 2013).
Is it depression, anxiety, ADHD, or all three?
For example, if you’re depressed, someone could diagnose you with major depressive disorder (MDD) if, for two weeks you’re not engaging in activities you used to do, you’re sleeping or eating more or less than you did before, and you can’t concentrate. But, you’d also qualify for an MDD diagnosis if you have a depressed mood, low energy, feel guilty and thinking about suicide (American Psychiatric Association 2013). These are two very different experiences, but they’re both MDD.
There’s also a great deal of overlap among diagnoses. This is called “comorbidity.” The comorbidity between depression and anxiety is substantial: For instance, let’s say you can’t sleep, can’t concentrate, worry about your future and feel socially anxious. You could be diagnosed with an anxiety disorder, like generalized anxiety or social anxiety, or even ADHD. But did you know that these symptoms could also justify a diagnosis of depression? The difficulties with sleep and concentration are also symptoms of MDD (American Psychiatric Association 2013).
Your social anxiety could be depression
Moreover, social anxiety is more nuanced than it appears. Certain forms of depression can cause social anxiety. Here’s how: One symptom of depression is excessive self-criticism. If you criticize yourself relentlessly, you’re apt to project these negative thoughts about yourself on to others. This means you plant your self-loathing thoughts into other people’s heads, and then “read” their minds. As a result, you become easily convinced that others think the same negative things about you that you think about yourself. These beliefs feel awful. It’s like everyone in the room is ganging up on you in your head! It creates a level of self-consciousness that can be unbearable. So, in this case, do you have depression, social anxiety, or both?
Multiple diagnoses
This brings us to another problem with relying on a diagnosis to make sense of your unhappiness. Comorbidity among psychiatric diagnoses is so prevalent, that if you’re given a diagnosis, it’s likely going to be more than one. And how meaningful can a diagnosis be if it overlaps with a bunch of other ones?
Perhaps most importantly, if you’re diagnosed with five different mental disorders because you experience and manage your emotional pain in multiple ways, the message you receive is, you have five illnesses. This is confusing (and demoralizing). How do you wrap your head around the notion that you’re an otherwise high-functioning person with five psychiatric disorders? What do you tell yourself? And what do you do about it?
What’s really going on?
The biggest question is, How do you explain this? You grew up in a “normal” environment. No one treated you terribly. You might even be the only one in your family who seems to have these problems. What’s wrong with you? Do you have a “chemical imbalance”? No, you don’t. This is a common phrase, but it’s a myth (Moncrieff, Cooper, and Stockmann, et al. 2023). Is it genetic? No. We all have genetic dispositions, but that doesn’t explain why certain genes get expressed, or why you’re in emotional pain. Were you simply born with a defect that makes you depressed or anxious? No!
Tragically, these debunked explanations are often validated by professionals and family members who may be confused about your behavior, don’t question where it comes from, and may be more comfortable with an explanation that involves only you, without implicating anyone else. This doesn’t help you; it hurts you. It leaves you in the dark about what’s really going on, which keeps you feeling depressed, anxious, even addicted, and suffering. There must be a better way. And there is!
I approach therapy from an attachment perspective, which means we look at your symptoms developmentally. We ask, What are your responding to? We always have this question in the back of our minds as we discuss your current experiences. This is the only way to make sense of what you struggle with today. The next several posts will address attachment in more detail. But the only way to understand how your own unique attachment patterns affects every aspect of your life is through individual therapy.
CONTACT US today to get started! Or you can call or text me at 248-219-2548. We see adults, couples, as well as kids and teens in-person at our beautiful Birmingham, MI office.
References
American Psychiatric Association 2013. Diagnostic and statistical manual of mental disorders (5th ed.).
Bowlby, J. 1988. A secure base: Parent-child attachment and healthy human development. London, England: Routledge.
Moncrieff, J., R.E. Cooper, and T. Stockmann, et al. 2023. “The serotonin theory of depression: a systematic umbrella review of the evidence.” Molecular Psychiatry, 28:3243–3256