Who hasn’t played armchair psychologist and made some off-the-cuff diagnosis of themselves or friends and family? In my personal life I have listened to innumerable conversations where someone says “she has depression” or “Oh yeah, he is definitely bipolar.”Our culture promotes the self-diagnosing game and most people are more than happy to play along. But, what are psychological disorders and are people any good at giving diagnosis? I want to give some plain and simple talk about psychological disorders and provide some clarity on common misconceptions as well as a clear view of what sub-clinical vs. clinical looks like.
When a psychological disorder is diagnosed by a professional it can have a profound effect on the client both in positive and negative ways. It’s a label, and the classification is used to help delineate and codify people into the appropriate box.
For the client, the newly acquired dog tag can be a freeing event that enhances understanding and helps them conceptualize their symptoms under a single title. Conversely, a title can also send people into a wormhole of symptom-searching chaos.
The first thing there is to know about psychological disorders is that they are always evolving and changing with the times. The American Psychiatric Association is the entity that has full authority over what counts and what is accepted as a diagnosable disorder.
The holy book of psychological disorders, the Diagnostic Statistical Manual, is currently in its 5th edition (DSM-5). There are currently 297 listed diagnosable disorders. With each new version, some disorders are removed and some are added.
For example, one of the most notable differences in the new DSM-5 is the removal of Asberger’s disorder. So for those people diagnosed with Asperger’s, they are now diagnosed with Autism Spectrum Disorder. This has upset, irritated, pleased, and confused a lot of people.
Most of the changes that happen when a new version is printed tend to have this effect on folks, from mental health workers to the people they serve. Some of the changes are for very simple reasons, for instance, changing Asberger’s to Autism Spectrum Disorder allowed people who had the old diagnosis to be eligible for more comprehensive treatment plans with their insurance companies and mental health programs.
Conversely, homosexuality used to be listed as a mental health disorder, but as attitudes changed so did the diagnosis. The list needs to change and adapt with the times. It would have been inconceivable in the 1990s to comprehend the way the world would change, with the expansive reach of the internet. From social media, online porn, shopping, and the gaming culture; we have changed and evolved and so did our mental health concerns.
It is no surprise that every time we turn on the news we hear something about our kids being affected by anxiety and depression in new and scary ways due to our ever-changing world. So the disorders need to change and adapt to the needs of the people living in it.
So how about the disorders you often hear people diagnosing themselves or others with? Normally, people are pretty well informed when it comes to the symptoms of depression and anxiety. But when it comes to an accurate diagnosis, people often have wildly different views of what qualifies.
Many have never heard of Major Depressive Disorder or Generalized Anxiety Disorder. Furthermore, those are only two of the diverse list of many depressive and anxiety-related disorders.
Each disorder has a subset of varying degrees of severity, episodes, and types within each diagnosis. It’s a complicated business when it comes to diagnosing a mental health disorder. Luckily, there are people much smarter than myself who have created highly complex and reliable mental health assessments and tests that can help positively identify a diagnosis.
Unfortunately, these tests are not the ones you have taken on Facebook to determine what kind of bread you are. As fun as the tests are in Cosmo magazine or online pop quizzes they should not be trusted or be given any validity.
Even if you did happen to stumble upon an empirically supported mental health assessment a professional such as a psychologist needs to administer it for it to be accurate. Sounds like a scam, right? But like I said, diagnosing is a complicated business and the consequences of a false diagnosis or self-given diagnosis can have dangerous and complicated effects.
The dangers of an accurate diagnosis can also be just as detrimental as a self-given one. The problem with psychological disorders is that they can create a self-fulfilling prophecy. If I have a client who believes that she may be bipolar and I diagnose her with Bipolar I Disorder then she might be the type of person to go home and search all of the symptomatology associated with the disorder. During her internet search, she might start shaking and head and say “I can’t believe it, that’s me!”
The next day will be the first day of living her life with the label of being Bipolar and she will give those symptoms a new home to thrive and exist in. Where there was once a person who had one of the symptoms, she now exhibits all the symptoms because of the power of persuasion and self-conversion.
People are easily influenced, and when they are given a diagnosis (either medical and mental health-related) they have the capacity to forge their identity to reflect the symptoms. They become the disorder. Have you ever noticed that when a person is diagnosed with cancer they look sick and unwell almost immediately?
There are folks out there who are resilient in strange and profound ways, but the majority of us become victims of our circumstances and our perception becomes our reality. It’s just human behavior. It can be studied, it can be tested, and it can be diagnosed, but it can’t be escaped.
So what is to be gained from understanding psychological disorders? Similar to medical disorders, understanding can offer answers to questions that people have regarding their health so that when a label is applied, steps can be taken to remediate the problems.
The only problem is that a label is created, and where there is a label you will find a small box for yourself. People are complicated, and more often than not, people don’t fit a diagnosis perfectly and are a mix of two or three disorders melted down into their own special recipe.
It is the therapist’s job to handcraft an individual treatment to address all the unique and specific symptoms that are distressing you. Unlike the medical field, there is no blood test to find out if you have Schizoaffective Disorder or Social Anxiety Disorder.
It is up to the psychological assessments, evaluations, tests, and the clinical judgments of the provider to decide if you have met the criteria necessary for the diagnosis. Psychological disorders serve as a platform for providers to offer the most comprehensive and effective treatments that have been determined by empirical and systematic research.
The question boils down to the insight you have about yourself and asking, “What will I do with this label?” Will you use the label as a word to help you address the symptoms you have been suffering from and begin the process of healing and moving beyond the box? Or will you follow the rabbit hole of your browser’s search bar and let the disorder become you?
The reason that people still read the astrology section of their newspaper is that there is just enough superfluous and ubiquitous information that you can apply to your future. In a similar way when you read down the list of symptoms and criteria of a diagnosis you can easily take small parts of yourself and stretch them into a larger theme that supersedes the reality of your situation.
When a person with sub-clinical symptoms assumes clinical symptoms they have the potential to begin manifesting the criteria of the disorder into their thoughts and behaviors. This is when a person becomes a disorder. This is the danger surrounding psychological disorders.
Psychological disorders offer a list of names that help providers classify and interpret symptoms in a uniform way that offers shape to the treatment they then provide. But the reality is that disorders don’t exist in a vacuum amongst professionals; they are labels that are used in our day-to-day dialogue and are often self-prescribed or distributed to our friends and family with little understanding or awareness of the complexity involved.
At the end of the day, psychological disorders are necessary. labels are necessary. We call milk, milk. That’s the word we have to describe milk. We need words to understand one another. Let’s just be careful that we don’t allow the disorders to engulf us. Let’s use our insight to look beyond the label and see the purpose.
“The Plan,” Courtesy of Startup Stock Photos, Pexels.com, CC0 License; “Books,” Courtesy of Pixabay, Pexels.com, CC0 License; “Map-reading,” Courtesy of Negative Space, Pexels.com, CC0 License; “Light.Bulb.,” Courtesy of Pixabay, Pexels.com, CC0 License