Diagnosing Mental Illness

Mental health diagnosis are far from perfect which is why it is not highly unusual for a person to be diagnosed with mental illness A then later on have it changed to mental illness B. There are a number of reasons for this.

(A) The patient on one day may be exhibiting classic symptoms of Mental Illness A but later on show none or a lot fewer of the symptoms in the upcoming weeks or months. Probably the best example is Bi Polar where the person is diagnosed with depression but then they hit a manic state and the doctor/therapist realizes it is more likely to be Bi Polar.

(B) Lack of information – On the surface a mental illness diagnosis seems pretty obvious just by the signs the person is showing but once the doctor has done a full and complete history the real problem comes forward. Again the person could be showing all sorts of signs of depression but after the history is revealed the doctor can be looking at Post Traumatic Stress Disorder. The depression the client is showing is the results of flashbacks and triggers from an old trauma and has little to do with what is going on in their current life.

(C) The Criteria Themselves – To be diagnosed with Borderline Personality Disorder you need to meet at least five of the nine criteria and that means that there is 256 different ways to qualify for this disorder. That is a lot of different ways for one illness. The other part is that one criteria could fit several different disorders which causes more confusion. This is not like diabetes where a lab result points the doctor in the right direction but instead the doctor needs to somehow fit the criteria in to meet the right disorder(s).

(D) Where the information is coming from – Again there is no blood test for mental illness but the doctor basis the diagnosis on what he learns from the patient. Now the patient just knows what is on the surface and is bothering him or her and may leave out crucial details that would cement a diagnosis. This is why I am such a big fan of writing everything out including the smallest detail so the doctor has the information he or she needs to figure out the right diagnosis.

(E) So the doctor has the right diagnosis now what – In a perfect world the right diagnosis dictates the right treatment. If you have diabetes then you take your medication and change your diet. It does not work this way with mental illness as all a diagnosis does is tell the doctor where to start but even that is not guaranteed. Like any other health problem there are variables that make this more difficult such as multiple diagnosis, response to medication and response to therapy

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