Does Receiving a Diagnosis From a Therapist Cause Mental Health Stigma?
“How do you feel about receiving a diagnosis?” That is a question I almost always ask when doing an intake with a new client. Although diagnoses are something therapists deal with on a daily basis, everyone may have different feelings, thoughts, and experiences around diagnoses, especially when they receive one from a professional during the intake meeting.
What does it mean to have “depression?”
Take depression as an example. Also known as MDD (Major Depressive Disorder), depression is one of the most commonly given diagnoses in mental health services. According to the World Health Organization (WHO), an estimated 3.8% of the worldwide population are affected by depression. However, what does it mean to receive a diagnosis of MDD? What is the difference between feeling depressed and having Major Depressive Disorder (MDD).
To answer those questions is both easy and hard.
The easy route is to open a DSM (The Diagnostic and Statistical Manual of Mental Disorders, created by American Psychiatric Association) or ICD (International Classification of Diseases, created by WHO) manual and refer to the criteria of MDD. The intensity, frequency, and duration of symptoms, and their impact on daily functioning differentiate a diagnosable MDD from occasional depressive mood.
However, it is also hard to answer those questions because diagnoses are social constructs. For example, to meet the criteria for MDD, one has to have experienced more than 5 of the listed symptoms for two weeks. Why not 4 or 6 symptoms? Why not 1 or 3 weeks? More importantly, why do I have to “fix” my functioning when the competitive workplace is constantly forcing inhumane expectations on me?
Indeed, what is normal and what is not? Who gets to define “normal?” For example, American society seems to strive enthusiastically toward happiness. In comparison, growing up in Chinese culture, traditionally, the teaching of inner growth that I received was more focused on a peaceful mind. Does that indicate that in American society, depression is less tolerated?
Similar questions can be asked when discussing anxiety, ADHD, social anxiety, etc. In a society that praises productivity, social skills, and excellency, inability to be productive, to speak in public, to progress, become a “functioning” problem. Even hallucinations in some cultures are considered a superpower, not a problem.
Limitations of diagnoses
Diagnoses have limitations.
First, as mentioned above, society’s tolerance for certain feelings, thoughts, and behaviors dictate normality. The power of social norms forces individuals to “fix” themselves to fit in the majority. In that sense, diagnosis can painfully isolate and stigmatize the individual and their family. Seeing diagnoses as the absolute truth can lead to power abuse and hamper meaningful societal change.
Second, diagnoses cannot thoroughly reflect individual differences and the development of the presenting concerns. Trying to “fit” a client into a “diagnosis,” we run the risk of being blinded by our assumptions, missing the nuances of clients’ unique experiences and the specific context of their concerns.
Last, diagnoses can direct the attention to the person as the “problem” and ignore the fact that they have done their best given the circumstances they went through.
How can diagnoses serve us?
Considering their limitations, why do we still use diagnoses? Although some professionals choose not to use diagnoses in their services, most still find diagnosis an imperfect but easy tool to use when communicating with other professionals, clients, and insurance companies.
For clients, diagnoses validate and normalize their concerns. “At least I know what I’m experiencing now.” For some, knowing that they are not the only person in the world that is going through similar struggles is a big relief. Getting a diagnosis also gives people hope once they learn that there are already numerous studies, evidence-based treatments, workbooks and other resources out there specifically focusing on the diagnosis they just received.
Moving forward, the debate over pros and cons of diagnoses might go on and on. Nevertheless, I find it always helpful to explore ways to take advantage of diagnoses and stay cautious against using them to stigmatize individual struggles. For clients, starting with a discussion with your therapist on your diagnoses might be a good first step.
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Written by: Si Meng, LGPC
Si is a licensed therapist at LifeSpring Counseling Services in Maryland who specializes in trauma, depression, anxiety, life transitions, and mood disorders. She offers multicultural and bilingual services in both English and Mandarin.
Photo Credit: cottonbro, Alex Green, Sora Shimazaki, & Antoni Shkraba
Date of download: 11/3/2022
