Mental health clinicians, perhaps more than any other healthcare professionals, really struggle when it comes to making a precise diagnosis. Unlike other areas of medicine that largely rely on objective data (i.e. EKG, x-ray), mental health professionals depend exclusively on subjective measures of data collected by asking clients specific questions about their symptoms. As you might imagine, this data is not always valid or reliable, and client answers can be influenced by many factors, including not fully understanding the question, the time of day, the client’s level of tiredness, or even answering questions in a way that the client thinks the clinician wants to hear. Some clients are too afraid to answer truthfully, while other clients may fabricate and exaggerate their condition. None of this is meant to create distrust in mental health, but to instead remind us that mental health diagnostics are far from perfect, and to use caution and critical thinking when assessing our mental distress. When we misdiagnose, the results can be very serious, both in terms of ways in which we treat the condition as well as level of optimism the client has for overcoming his or her condition in the future.
Diagnostic challenges
One of the biggest concerns in mental health is properly diagnosing mental health conditions, but doing so in a way that does not create self-fulfilling prophecies. Put another way, how do we figure out what is going on with someone without leaving them the impression that they are “doomed” and forever helpless to their condition? For example, when a parent comes to my office and announces that her son “has ADHD,” the parent has already created a challenging situation:
- First, nobody “has” ADHD, as it is not a virus that you “catch.” When we state mental health challenges as though they are communicable diseases that we either have or don’t have, we have created a near-impossible situation to overcome as far as having hope for future positive change. Why try if there is nothing you can do to overcome?
- By not understanding ADHD is a man-made disorder comprised of a collection of bothersome behavioral symptoms (and not an organic tumor), any efforts to overcome are replaced with thoughts of victimization, pessimism, and ultimately little chance for future improvement.
- When clients quickly grasp onto a diagnosis (legitimate or not), often psychotropic drugs are prescribed that can lead to a new set of problems by means of side-, interaction-, and withdrawal-effects.
While it is completely understandable that people long for reasons why they struggle with specific issues and situations in life, it is important to not compound matters by being vulnerable to flimsy and misleading diagnoses. Contrast these concerns to other helping professionals to see the stark difference — dentists can see cavities, physicians can observe broken bones, and optometrists can objectively gauge your visual acuity. Mental health clinicians, however, lack these methods of data collection, and as a result have far less precision when diagnosing mental illness.
Final thoughts
Diagnosing a problem is often the first step in repairing something, but with mental health there are unique issues that accompany diagnosing. First, our methods are very subjective and leave a lot of room for error. Second, most people lack the understanding of how one develops a mental health condition, and many assume they are doomed for life as a result (self-fulfilling prophecies). And finally, erroneous diagnostics can lead to unnecessary psychotropic drugs, many that lead to new, unexpected future problems.
drstankovich.com
