Mental health diagnoses, such as “Autism”, “major depressive disorder”, “bipolar disorder”, etc., are used in mental healthcare as part of primary treatment. For many people, those labels mean the difference between receiving and not receiving treatment. But, for many of us, they also move that treatment into a box and sometime exclude us from the treatment and help we really need. Why? Doctors and psychologists and mental healthcare workers are people just like the rest of us. Mental health labels can function to stick patients into a box, where any symptoms outside of that box are not seen or treated or are even ignored.
That can go much further, especially with certain heavily stigmatized diagnoses. However, for the most part, mental health labels are a doorway to treatment. When they do go wrong, it’s important to understand why and to try to find workarounds.
Treating Diagnosed Problems Only
In one study assessing results from 78 papers across 13 countries, it was found that patients who received a diagnosis often felt that additional problems they brough to doctors were ignored. Here, doctors and healthcare professionals might focus on the symptoms of the diagnosed disorder only – completely ignoring or dismissing other manifestations of symptoms. This could potentially lead to people with poor diagnoses and with multiple mental illnesses, only one of which has been diagnosed, to be dismissed or left behind. That’s especially true for dual diagnosis patients who might need extra attention and care paid to additional symptoms, or to individuals with a changing pattern of mental illness.
The answer is that mental healthcare professionals must always treat the person and the symptoms rather than just the diagnosed disorder. That’s one reason why personalized treatment and care should always be top priorities. They remove the risk and sometimes the possibility of treating patients like they can only have certain symptoms or problems because of their diagnosis. This is especially dangerous when the person has both a mental health disorder and a substance use disorder, also known as a dual diagnosis.
Of course, this also spills over into personal life. For example, patients with one diagnosis might have friends and family confront them if symptoms leave expected boundaries of the diagnosis. That can result in feeling gaslit, feeling uncertain if symptoms are real, and in avoiding real and potentially dangerous symptoms because they don’t align with a primary mental health diagnosis.
Failing to Make Other Diagnoses
Once you receive a diagnosis, many doctors will simply stop looking for another one. Yet, many people have more than one mental illness. That’s especially true in the case of substance use disorders, autism, and bipolar disorder. Yet, people with dual diagnosis often fall through the cracks and may receive poor or wrong diagnoses, only a partial diagnosis, or receive help for a second diagnosis at too late a stage, after it’s already prevented treatment from helping with the first diagnosis.
That can be a significant barrier to actually getting help. For many, it also means seeking out treatment that is specifically open to assessing and re-assessing symptoms as treatment progresses, to tailoring programs, and to treating underlying problems per person rather than based on the diagnosis.
Many people experience significant stigma after receiving a diagnosis. That’s especially true for people with schizophrenia, bipolar disorder, and borderline disorder. These disorders, which are frequently associated with erratic personalities, poor long-term outcomes, and reliance on drugs and alcohol, receive stigma at home and in some clinician’s offices. That stigma relates to concepts of what a disorder is and how it impacts people, with some believing that BPD and similar disorders are “untreatable”. At home, those disorders can have worse and more impactful outcomes, as stigma can result in social isolation.
Here, it’s important for clinicians to deliver diagnoses in ways that are insightful and informative. Handing someone a diagnosis without also giving them the information and insight into what it means for them and family can backfire. While that often isn’t possible in one sitting, it’s important for clinicians making initial diagnoses to offer sufficient information to patients and to their families. When that doesn’t happen, you can always reach out separately for treatment later – however, that will be a case of undoing harm already done. It’s important that clinicians be open to treating the individual person, to educating and offering family therapy, and to building people up whatever their symptoms and reaction to treatment.
Reliance on Medication
In some cases, mental health labels can result in the patient receiving a prescription for medication and that’s the end of treatment. While this has been the norm for decades, modern research shows that therapy like cognitive behavioral therapy is often significantly more impactful than medication alone. And, while medication is often helpful and even necessary in long-term symptom treatment, it is far from the only option or solution. This reliance on prescription solutions is outdated, but, especially in smaller towns or areas without significant mental health treatment resources in place, might be the only treatment offered.
That can be detrimental to long-term mental health and stability. That’s especially true as treatment and therapy are often built around treating underlying problems, creating coping mechanisms, and helping individuals to live in a way that minimizes symptoms of the disorder. Medication may be required to help your brain to function at a level you find comfortable. That is valuable and there’s no shame in it. However, medication often simply masks symptoms, which can result in failure to get therapy. Eventually, people relying solely on medication often feel the need to quit because they feel fine. Then, symptoms return, and things get worse. Especially when you’re also most likely to be struggling with getting off of a medication, with significant chemical reliance, and possibly even with addiction depending on what the prescription medication was.
Getting treatment for mental health problems often involves more than seeking out a diagnosis. It means going to therapy, getting long-term evaluation of your mental health. And, it means ensuring that your treatment covers more than “just” your symptoms. Eventually, you need mental healthcare professionals who can treat you as an individual with individual problems – so that you receive custom treatment based on those symptoms. And, treatments like cognitive behavioral therapy often means assessing and approaching issues from the point of the underlying problem, which can help you to discover if your diagnosis covers everything or if you need a broader spectrum of treatment.
Eventually, mental health labels are valuable. They help people to get treatment. They allow many of us access to the mental healthcare we need. They enable diagnoses. And, they give us answers and make us feel less alone. But, at the end of the day, a label is just a label, and no mental illness will ever be a list of checkboxes. Every person is unique, so their mental illnesses are unique and must be treated that way.
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