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In the realm of mental health, the topic of diagnosis comes up often. How can having or not having a diagnosis change the way you see yourself? What tends to pique our interest in the labels that are used to describe different mental health experiences? Maybe you’ve been given feedback from a health professional that you “have” or “show symptoms of” a particular mental health-related disorder, or maybe you’ve been trying to understand if the mental health challenges you’re experiencing “fit” within a particular diagnosis? Maybe you’ve heard about problems associated with “over-diagnosing” mental health-related disorders?

It can be helpful to start with an understanding of what a diagnosis means, and some of the purposes and important limitations of diagnostic labels.

Mental Illness Diagnosis - Sleep, Depression, Greed, Happiness, Envy, Lust, Anxiety, ADHD

Diagnosis and Treatment Planning

  • Mental health diagnoses (e.g., major depressive disorder, ADHD, generalized anxiety disorder) are based on groups of symptoms that tend to occur together, known as symptom clusters. Therefore, diagnostic labels are generally best understood as a description of symptoms, rather than an illness or disorder that is innate to a person and part of their identity.
  • Unlike physical illnesses, mental health difficulties aren’t always visible or verifiable with specific medical tests, so symptom clusters create a framework for categorizing and understanding an individual’s challenges. This helps treating clinicians develop appropriately tailored treatment plans.
  • Connecting a specific treatment plan to a diagnosed condition can increase efficiency and contribute to effectively targeting the main concern(s) an individual is wanting to address.

Context Matters

  • Because diagnoses simply represent symptom clusters that can elude direct testing or observation, it is crucial to recognize that they are not definitive markers of a permanent disorder. Rather, they provide a snapshot of an individual’s challenges at a particular point in time.
  • One must always consider the broader context of an individual’s life (e.g., relationships, environment, life experiences) as playing a pivotal role in shaping mental health, and clinicians take this into account when formulating diagnoses.
  • The difficulties identified in a diagnosis are not isolated within the person but are deeply intertwined with the person’s surroundings and history. Importantly, diagnostic labels do not provide information about a person’s ability to function in specific situations. For example, one’s symptoms might make it very difficult to function at work, while they are able to cope adequately in their home life because that environment is different, or vice versa!
Contemplating a diagnosis - OCD, BPD, Anxiety, Depression, ADD, Panic, ADHD

Cultural Considerations

  • Cultural factors can significantly influence what is labeled as a “disorder”. What may be considered a challenge in one society or culture may not hold the same meaning in another, emphasizing the subjective nature of diagnoses.
  • It is crucial to acknowledge that diagnostic labels were developed from the perspective of the dominant, White/Western European culture, and there is strong evidence that they may not accurately reflect the skills and abilities of people from other cultures and backgrounds.
  • Recognizing and respecting cultural diversity is paramount to understanding mental health challenges beyond the confines of Eurocentric perspectives.

Case example: Attention Deficit Hyperactivity Disorder (ADHD)

ADHD is generally considered to be a type of “neurodivergence”, meaning that it is associated with differences in how the brain operates. This categorization implies a more biologically-based and stable condition compared to diagnoses like anxiety, which are more descriptive of current symptoms, and can ebb and flow over time. However, it’s imperative to emphasize that even neurodivergent conditions should be viewed as descriptions of symptoms rather than definitive, static labels. While the challenges may persist over time for someone with ADHD, their functional impact depends on coping strategies and the dynamics of the environment and society at large, thus potentially impacting whether or not they continue to meet diagnostic criteria.

Adult woman, late diagnosis ADHD, addiction

The Process of Receiving a Diagnosis

In general, a mental health-related diagnosis can be assessed and conveyed by a psychiatrist or psychologist. General physicians (e.g., a family doctor) can also diagnose common mental health conditions and refer individuals to specialists if needed. The diagnosis process begins with an assessment, which typically involves the clinician conducting an interview to understand the individual’s personal and family history, symptoms, and their impact on functioning. Sometimes standardized questionnaires or diagnostic tests are part of the assessment. After the assessment, the clinician discusses the results with the individual, explaining any diagnoses that are found and providing treatment recommendations if desired. These recommendations may include therapy and/or medication, or referrals to other specialists. 

Keep in mind that it can still be worthwhile to seek psychological treatment even without a formal diagnosis, as therapy can provide valuable support, coping strategies, and personal growth opportunities. 

Potential benefits of a diagnosis

  • Validation of Experiences: A diagnosis can validate and affirm an individual’s mental health experiences, providing a sense of recognition and understanding. It can help individuals realize that their challenges are real and legitimate.
  • Access to support and resources: Having a diagnosis can open doors to support networks, resources, and communities of individuals facing similar struggles. This sense of belonging can be crucial for emotional well-being.
  • Communication with others: A diagnosis provides a common language for people to communicate their experiences with healthcare professionals, friends, and family. This can facilitate better understanding and support from those around them.

Potential drawbacks of a diagnosis 

  • Stigma and discrimination: Sometimes others may make assumptions about an individual based on a diagnosis. Very unfortunately, in some societies/communities this can contribute to stigma and discrimination. This experience can lead to isolation, reduced opportunities, and negative stereotypes affecting individuals’ personal and professional lives. 
  • Self-identity and self-esteem: Receiving a mental health-related diagnosis (especially without adequate explanation, psychoeducation and support) can negatively impact an individual’s self-identity and self-esteem, potentially leading to feelings of inadequacy, self-doubt, and a diminished sense of self-worth. 
  • Labeling and overgeneralization: Having a diagnosis can lead to being labeled in ways that overshadow the person’s unique qualities and experiences. This can result in others, even the individual themselves, overgeneralizing their behaviours and attributing unrelated actions or traits to the diagnosis. In this way seeing ourselves through the lens of a diagnosis can feel limiting (e.g., “I’ll never be able to do [insert activity / behaviour / accomplishment, etc.] because of my diagnosis”), especially if we make assumptions about what the label means based on others’ experiences or information we’ve consumed that may or may not personally apply.
Freedom from diagnosis label

In Conclusion: Moving Beyond Labels

To conclude, mental health diagnoses should be approached as dynamic descriptions of symptoms rather than rigid classifications. They are tools to guide treatment, not boxes to confine people. Understanding mental health requires a holistic perspective that considers the intricate interplay of factors, including cultural variability and the evolving and fluctuating nature of symptoms. By fostering a nuanced and compassionate approach, we can better support individuals on their mental health journey, moving beyond labels to recognize the resilience and potential within each person.

Ms. Rachel Jewett

Ms. Rachel Jewett

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Dr. Alexa Kane

crop Headshot of Dr. Susan Sergeant

Dr. Susan Sergeant

Please note: this article is for informational purposes only, and is not intended as a substitute for therapy or advice from a qualified professional.