What Does my Diagnosis Mean?

You’ve found a therapist, shared your feelings and presented your personal struggles. But, instead of receiving helpful guidance or useful tools, you are met with a confusing diagnosis – a complicated title and perhaps a sterile summary of what it means. Or worse yet, you don’t receive a diagnosis at all and don’t understand how/why/if your treatment is being structured…

Mental health education should be commonplace, but how many times has a provider had an in-depth conversation with you about your diagnosis? Have you ever needed to google what you’ve been told in a session to figure out what it means, outside of therapy-speak? When you try to share your diagnoses with a loved one, have you ever had a tough time pronouncing it, let alone explaining it? Even more importantly, how many times has a provider actually asked how it makes you feel when they refer to your diagnosis? These are important questions to consider when pursuing care for your mental health and advocating for your treatment.

As a therapist, I tend to nerd-out in my diagnostic sessions with clients. I am fascinated with the complexity of diagnoses and the wide-range of presentations they have in different people. In the initial stages of meeting with a client, I take a warm, curious and educational approach. I work very hard to assist clients in gaining an in-depth understanding of the diagnostic process and work to find out what it means to them. The process I take looks a little like this:

STUDY TIME
We open the big blue book (The Diagnostic and Statistical Manual of Mental Disorders or “DSM”) and read through the criteria piece-by-piece to verify whether or not it rings true for the client.

Q & A
I answer any and all questions the client has about their diagnosis, I earnestly admit when I don’t know the answer and I ensure that I will follow up with more information.

FEELINGS TALK
A couple examples of the questions I usually ask after providing the client with their diagnosis are:

• What is it like for you to hear your full diagnosis read out loud?
• Does this feel like you’re being labeled or put into a box?
• Are there any judgements or connotations that you associate with this diagnosis?
• Do you feel ashamed, proud, relieved, angry?

GOALS, GOALS, GOALS
Together we create a plan that encapsulates the client’s goals for treatment and fully represents the changes that they hope to make in therapy.

Although it may come as a surprise, some of the most common responses I receive from clients at the end of the initial diagnostic process are: 

• It’s a relief to know I’m not alone.
• It all makes a lot of sense now. 
• It’s nice to know there’s a name for what I’ve been struggling with.
• I wish someone would have taken the time to explain this sooner.
• The world needs to know more about this.

I AGREE! The world absolutely needs to know more about mental health and how different diagnoses can look for different people. I truly believe that the more mental health clinicians take time to educate their clients about their diagnoses, the less stigma will exist around them. 

**Important Educational Note!** All individuals have a right to their medical records, for both physical as well as mental health. You can request these records from your provider at any time. All providers are required to give you those records, for free, within 30 days of your request. You also have a right to receive education about the information in those records. 

Knowledge is Key to Understanding

I’ve had clients share about the stigma that often exists around certain mental health diagnoses. Stigma is defined as: a mark of disgrace associated with a particular circumstance, quality or person. Some common examples of stigma can sound like this: 

• People with anorexia all look like skeletons and just need to eat.
• People with schizophrenia are just plain crazy and will never get better.
• People with depression stay in bed all day and are lazy, they should get some exercise. 
• People with anxiety are just too worried about what other people think.
• People only really have PTSD if they have been in war or had a near death experience.
• People with OCD are just organized and high strung. 

Any of these sound familiar? These statements are assumptions that are most likely based on a lack of information and an impulse of judgment. Stigma exists when we allow our lack of knowledge to inform our thoughts and opinions of others. These mis-guided assumptions also lead to undiagnosed patients and lack of support for those who are diagnosed.

Unfortunately, stigma is perpetuated and exacerbated when left unaddressed and unchallenged. It’s only when we are brave enough to question our initial judgements and pursue further education with compassion that we can actually end the vicious cycle of stigma. Margaret J. Wheatley put it so simply and beautifully when she stated, “You can’t hate someone whose story you know.”  

As a mental health provider and a fellow human, I find immense joy in helping my clients better understand their diagnoses. It is truly one of my favorite parts about the therapeutic journey. If you are currently meeting with a therapist or looking to meet with one, I hope you feel comfortable enough to advocate for education about your diagnosis – and that maybe something you read here will help inspire you in that process!

Taking this one step further, if you are knowledgeable about your personal mental health diagnosis and feel safe sharing, I encourage you to initiate conversations about it with others. I advise you to use healthy boundaries and careful consideration about who you share your journey with, but there is power in having your story heard. 

You might be the reason someone gets better care for themselves!