The Art of the Diagnosis - Jessica Hairston, MD
As a psychiatrist discussing a diagnosis, any diagnosis can be a sticky situation. Very few people enjoy speaking about mental illness. Even the term “mental illness” is enough to cause people to visibly cringe. Today, I am here to tell you why the correct diagnosis can be a very powerful tool and to ones’ advantage.
Long ago the wise Greek Philosopher Socrates was quoted to have said “Know Thyself”. What did he mean? What is there to know? What’s the point? In my opinion, to “Know Thyself” is to seek wisdom of the human condition. When we look at our mental challenges and face them, individually and collectively, we can then move beyond them and no longer see them as limitations.
Mental Illness is no laughing matter and the stakes can be high. The wrong diagnosis can be devastating, yet the correct one followed by the appropriate treatment can be fully transformative. Many people may have ‘Diagnoses’, but they may never tell you who they are because of the ridicule they face by people who may judge them for having “mental illness”. Yet their lives are much more powerfully lived because they know how to treat, correct, and manage their conditions instead of living in silence and fear.
For instance, the child with diagnosed Attention Deficit Hyperactivity Disorder (ADHD) at seven years old that was labeled a “problem” or he was “not able to get it together” before his diagnosis. After the diagnosis and proper treatment, he begins to focus well in school. He is more confident in his academic abilities. He’s better able to control his impulses and thereby in more control of his behavior. As a result, not only are his parents happier and satisfied; his father is proud of him. Last but not least, he is now the big brother he is expected to be. This is only one example.
How about the 28 year old diagnosed with Borderline Personality Disorder? Before treatment with Dialectical Behavioral Therapy (DBT), suicidal thoughts were a scary yet daily occurrence for several years. After treatment he gained the ability to push away suicidal thoughts, repair his marriage, and strengthen relationship with his children. His friends and family noticed and appreciated the change. He has been able to tell them what helped him and why. He has learned the triggers for his sad thoughts and feelings and through psychotherapy has accessed the power to change them. Within a year, he has strengthened his self-esteem and is providing for his family and community. And finally, here is an example of how diagnoses can help preventatively.
Consider the person with Major Depressive Disorder, diagnosed in childhood. Now he is 30. He has been on anti-depressants since 12 years old with no plans to stop treatment. Why? His mood has remained stable on a low dose anti-depressant for 18 years now. He has avoided the long range pitfalls of his illness because he was diagnosed and treated correctly as a child. He has had fewer depressed episodes than his peers and through the years, he has witnessed first-hand how his parents and relatives of previous generations have struggled with depression, lost marriages, unemployment, or substance abuse after discontinuing their medications. They did not believe that they had “mental illness” and thought “No pill can fix me”. He has learned instead that his medication works for him and is a small price to pay for enduring mental and economic stability.
As a psychiatrist, I do not have all the answers, or the “panacea”, or the ability to make the correct diagnosis 100% of the time. I do know that seeing a trained mental health specialist such as a social worker, psychologist, psychiatrist, or professional counselor can be the beginning of a journey towards healing and empowerment. To ‘Know Thyself’ is to acknowledge and appreciate all facets of one’s existence, physical, psychological, and spiritual. The goal of life is not to become unflawed and perfect. Growth and maturity is about acknowledging ones’ imperfections, and learning to live life to its fullest regardless of our ‘diagnoses’ which encourages other people to do the same.
