Why Mental Illness Self-Diagnosis Doesn't Work
No matter how tempting it might be
It's not all that uncommon to hear people self-diagnose a mental illness or suggest a diagnosis for someone else. It's certainly something that seems tempting, but is it accurate?
Sometimes you'll hear people will toss around diagnostic labels to describe themselves.
"I'm a little OCD."
"I'm a little ADHD."
Often, in cases like these, the person using the term probably doesn't have even much of an idea what the illness associated with the label actually is.
Then there are the people that overgeneralize, suggesting that mental illness happens to everyone at some point or another.
"Everyone gets depressed sometimes."
"Everyone has a little PTSD."
By blurring the distinction between illness and "normal" statements like these detract from the serious of these illnesses as faced by the people actually living with them.
A popular diagnosis that people will attribute to emotionally abusive exes or family members is narcissistic personality disorder. Yet does someone who's abusive necessarily have a mental illness?
The DSM is not a cookbook
The Diagnostic and Statistical Manual of Mental Disorders, currently in its 5th edition (the DSM-5) is one of the major diagnostic systems for diagnosis of mental illness—the other is the World Health Organization's International Classification of Diseases (ICD-11). The DSM lays out diagnostic criteria that must be met in order to give someone a diagnosis.
To the casual reader, it may seem like most people meet the diagnostic criteria for some type of mental illness; if you tick enough depression boxes, you've got yourself a depression diagnosis. However, the DSM explicitly states that it was never intended to be used that way.
The boundary between normal and pathological
Many of the symptoms in the DSM represent extreme examples of things that do occur normally (anxious mood, for example). To count as a symptom, something must have crossed over from "normal" territory into pathological.
To be diagnosed with a condition, there must be a clinically significant impairment in social, occupational, or other levels of functioning. This also involves distinguishing between "normal" and pathological experience.
In order to have a good sense of where the boundary lies between "normal" and pathological, it's important to have broad experience seeing individuals with different illness symptoms ranging from mild to severe.
The broad experience that comes with clinical training gives a frame of reference to evaluate severity and distinguish between "normal" and illness. Most people don't have that, which makes it pretty difficult to accurately determine whether or not someone has a given illness.
Talk to a professional
If you're concerned that something's not right and you might have a particular illness, talk to a mental health professional. Reaching out for help isn't always easy, but getting a diagnosis can be a huge step towards finding treatment that's likely to be effective.
If it's someone you know who appears to be having symptoms of mental illness, it's not up to you to diagnose them, nor is it up to you to make them get help. Listening goes a long way. If you want to talk to them about your concerns, try keeping the focus on what's objectively visible rather than on what your interpretation is.
What self-diagnosis can do
Attempts to self-diagnose are least helpful when they are used as the only source of information. If you try to self-diagnose and then decide how you should manage the problem on your own based on that self-diagnosis, you're probably not doing yourself any favours.
If, however, looking into a potential diagnosis on your own is used as the starting point for a conversation with your health care provider, that's a much healthier way of channelling your concerns.
If you already have a diagnosis and you think there's another diagnosis that's a better fit for what you're experiencing, track your symptoms very closely so you can give your health care provider the clearest possible picture of what's going on.
And finally, try to avoid assumptions and approach the issue of diagnosis with openness and flexibility.
Making Sense of Psychiatric Diagnosis
Want to know more about how psychiatric diagnosis works? My new book Making Sense of Psychiatric Diagnosis breaks down the diagnostic criteria for a variety of mental illnesses, and includes firsthand narratives of what it's like to live with each disorder. It won't help to diagnose someone, but it can certainly aid in understanding.