A diagnosis is a label or name given to a certain set or group of symptoms that a person experiences. To diagnose a mental health problem, doctors will look at various things, including:
- Your experiences (groupings of certain feelings, behaviours and physical symptoms may suggest different diagnoses).
- How long you’ve been experiencing these things
- The impact it’s having on your life.
To do this the doctor may ask you questions about your mood, thoughts and behaviours – sometimes by using questionnaires or forms. Your diagnosis is then based upon what you describe to the doctor. For example, if you share with your doctor that you’ve been feeling low in mood, you have low energy and a lack of motivation, they may diagnose depression. However, over time if your feelings and behaviours change, your doctor may diagnose something different.
Often a GP can give a diagnosis of depression and anxiety, and they may be able to provide your care, such as providing medication, information and support. For other types of diagnosis, people will often be referred to a mental health specialist, such as a psychiatrist.
It’s important to remember that everyone’s experience is different and can change at different times. A diagnosis does not define who you are, and it doesn’t mean that you are experiencing mental health challenges all of the time; many people with a mental health diagnosis are able to live meaningful and fulfilling lives, they go to work or volunteer, socialise, and so on. Equally, you might not have a particular diagnosis, but may still be finding things very difficult.
For some people receiving a diagnosis is a positive step towards making sense of their difficulties. For others, however, it can be problematic particularly when those around them start to only view them through the lens of their diagnosis. The intention of the diagnostic system is not to take away identity through labelling, though this is often how it can feel. Being given a diagnosis doesn’t have to be your entire identity. Over time, your diagnosis may end up being a small part of who you are.
How to explain a diagnosis to family and friends?
Due to stigma around mental health, it can often be difficult to tell family, friends, colleagues and other loved ones about your diagnosis and the challenges you face; you may be worried about what they will say or think, or perhaps you’re worried they may ask questions you don’t know the answers to. Whilst it is true that not everyone will understand and support you, most people will, and choosing who you tell and when you tell them is your decision and in your control. Not everyone needs to know about your mental health challenges, in the same way that if a person had irritable bowel syndrome, they wouldn’t need to share this information with everyone. But sharing it with someone can be a great way to get support.
A lot of the stigma surrounding mental health often stems from a lack of understanding, both other people’s and your own. Before you choose to share with other people your mental health challenges, it may be helpful to better inform yourself about your diagnosis and possible treatment options. You can discuss this with your GP or other mental health professional, as well as using online support sites, such as this website and Mind. This would then help you to answer any questions your family, friends and colleagues may have, but it will also help you to understand yourself better, and help you to make decisions about your next steps. For close support, find relevant articles, stories, etc. that highlight similar difficulties. Write down your diagnosis, what it means to you, how it impacts upon your life, and what the person you’re telling can do to help.
When you do decide to tell someone, try to remember that their reaction to what you tell them may not be a full representation of what they think or feel. For example, some people may react with shock or not take it in at first. This won’t necessarily mean that they think badly or differently about you. It’s perhaps the first time they’ve heard someone talk about mental health and they’re unsure of how to react or what to say. It may also be because they feel worried about you or that your news has struck a chord with something in their own life. Whatever their reaction, try to have a discussion about it at some point and encourage them to ask questions and be open with you about how they feel.
It can be a difficult journey for everyone involved, but sharing and having support from friends, family, loved ones and colleagues can offer so much in helping a person with their recovery.
Controversies about diagnosis
For years there has been debate about whether or not mental health issues are illnesses which can be clearly diagnosed according to the symptoms a person experiences. For some, labelling a person’s distress can make them feel worse. This is because it suggests that there is something ‘wrong’ with them that needs to be ‘cured’. However, some people welcome a diagnosis as they feel it gives them a meaningful explanation for the way they feel. A diagnosis is also sometimes needed for accessing certain benefits or therapies.
There are many people who reject the idea of ‘mental illness’ altogether. This is based on the fact that there is no scientific way to identify it in a similar way to a physical condition. For example, a broken leg is clearly identified as a broken leg by an x-ray.
People are individuals when it comes to their feelings about diagnosis. The key is that people are listened to, believed and given the opportunity to explore what will help them most.
Personal experience
To be a service user for the amount of time I have been, and the slow progress towards recovery when I was in a position to explore a life away from services, seems to be an increasingly no-win situation. It was unfortunate at 16 that I had an episode of psychosis when I was at a critical stage of my education. I was not in a place in my life when I could have reached my possible potential. Regardless of my psychotic episode, the normal emotional and psychological developments of adolescence were debilitated. There was no time invested in promoting my wellbeing, it was only undermined. I feel looking back I was a mobile body that performed as a human, but the qualities that the body needed to feel worthwhile like love, contact, and identity and safe were non-existent.
My earliest memories are of living with an angry, bitter father and being in fear of my own shadow. I could go into some of the things I shouldn’t have experienced and the hurt that I felt, but that would not help my circumstances now. At the point I became ill my family saw me react in a way they could not be expected to understand, but it seemed to make me even less a part of the family. They have all treated me differently and it feels like I am in one way unacceptable, and in another, politely accepted. To say I am not like the others would be a true statement.
For me, my diagnosis was a judgement on my capability. My identity became unstable. But it’s also given me support, financially and emotionally. Beliefs have taken too long, but I have never stopped believing I could work with myself, even if I wasn’t given a platform to work from. The assortment of awful medications I was put on controlled my symptoms or reactions to an extent. But they took a little more of the core of who I could grow with to be well. To be tired, suppressed and intellectually dulled was another way I became segregated, along with the stigma of being mentally ill. The service I received offered very little that represented life and the people running the services put little into running them that promoted any enthusiasm in being alive. In fact they were going through the motions as much I was..!
But 33yrs later, being enabled and supported to do nothing has consequences. My history does not promote confidence and it draws natural assumptions about my capability. However capable I feel and confident I can achieve, I look back at some of the things I have done or allowed myself to be subjected to and doubt I am anything but a gamble. I understand why I made mistakes, because I grew up when I eventually felt able to move forwards, so it was inevitable that people would look at a grown man doing things they would expect an adolescent to be doing.
I am not any different to the majority of service users. I want a relationship, to be connected to someone and to be accepted as part of something. Employment is a dream because I will need to support myself at some point. I would sell my soul for family and someone to love. I am not sure with my experiences I am capable of love but it’s a dream I like to dream.