The Diagnostic and Statistical Manual, known as the DSM (in this case, the DSM-V), is a manual that psychologists and therapists are meant to use to guide patient care. It provides therapists and patients with a diagnosis – for example, “Generalized Anxiety Disorder,” that, once identified, helps guide treatment.
But there are issues with the idea of using diagnoses at all.
For one, every person is different. While many conditions present in very similar ways, there are situations where two people experience similar symptoms, but one qualifies for a diagnosis and the other does not, or may qualify for something else. Treatments are also very individual based, and may need to change based on how the person responds to questions.
There are also issues with patients that adopt their diagnosis as an identity. Some clients actually feel their symptoms get worse when someone tells them that they have a specific condition. There are many, many reasons that diagnoses can actually be problematic.
Today, we’re going to talk about another one.
Does a Diagnosis Even Matter?
Most people are familiar with depression. Depression is one of the most common and most challenging mental health conditions. Living with depression can be extremely difficult, and the sooner you seek treatment, the better the outcome will be. There are different forms of depression, such as chronic depression and major depressive disorder, and each one has its own diagnostic criteria.
But what many people do not know is that, to qualify for a diagnosis of chronic depression, a patient has to exhibit clinical symptoms for at least 2 years. This means that, if you’ve only experienced depression for 1.5 years – even if you have all the same symptoms – you do not qualify for a diagnosis.
There are many valid reasons for this, and maybe we can discuss them in a different article. But there are also drawbacks. If a client has all the symptoms of chronic depression, but hasn’t yet hit the criteria, a therapist may still determine that they would benefit from a treatment that targets chronic depression. The diagnosis may not matter.
Similarly, therapy and counseling are designed to make your life better and address areas of concern. They do not require a diagnosis to be helpful, nor are they only designed to treat the diagnostic conditions. Imagine if you have other issues:
Worried About the Future of Your Career in an AI Obsessed World?
Stressed About Parenting?
Feeling Sad About Losing a Pet?
If you are relying on a diagnosis, you may not qualify for a treatment, as these are not necessarily mental health disorders. But these are still issues that affect your quality of life, and therapy is also capable of addressing these very same issues. That is why many people see their therapists for years. It is not just about getting a diagnosis, but, rather, trying to make sure that your overall quality of life is better.
We see this with disordered eating as well. “Orthorexia” is a term that describes an obsession with healthy eating that can actually make a person unhealthy or preoccupied in a way that affects their quality of life. Most eating disorder therapists, including our team here at Flourish Psychology, recognize and understand that it is a very real condition. But it is not currently included in the DSM-V, and would thus not qualify as a condition that can be diagnosed according to that manual.
Treatment Regardless of a Diagnosis
One of the reasons that we’ve chosen to be a cash-only private practice is because we do not believe that diagnoses should be required to seek treatment. Insurance companies frequently require a diagnosis, and may refuse payment if no diagnosis is given or stop treatment if the psychologists believe the patient is no longer struggling. They also require that anything that is diagnosed be reported, and become a part of a person’s permanent medical record.
Diagnoses are extremely helpful. We study them extensively in graduate school, and we learn how to treat them. They are also limiting and cause problems for both patients and practitioners. If you feel like you might benefit from a therapist, it is always beneficial to seek help. Do not worry about if you have a diagnosis. Instead, embrace the idea that you can have someone on your team to help you improve your overall quality of life.
Human beings are social animals. Research quite literally shows that we need interaction with other human beings in order to survive. Our life, our health, and our happiness are all directly connected to our ability to communicate and socialize with others.
Still, many of us also struggle with social anxieties. While not everyone may have social anxiety that qualifies as a mental health diagnosis, we can still have fears, anxiousness, and shyness in social situations.
Motivation for Feeling Social Anxiety and Fear
Social phobia can have many different causes and symptoms, and has been linked to issues like trauma, bullying, and other past experiences. One of the most common symptoms of social anxiety is a fear of being judged, and a fear of making a mistake in a way that hurts their social standing.
In psychotherapy treatments for social anxiety, like CBT, one way that we try to help address social phobia is to reframe the way you see and approach different situations. The fear of being judged is a perfect example of this. We often feel like, when we stumble within a conversation, that the person on the other end is making fun of us or thinking about how much we made a mistake.
But, when you leave a conversation, how much time do you spend thinking about all the mistakes *someone else* made? How much time do you spend thinking about and judging other people for their fumbles?
Most likely, you don’t think about other people’s mistakes at all.
The truth is that most people do not spend time thinking about you. Most people do not spend much time thinking about anyone but themselves. We all live very busy lives with our own stresses and distractions. We have our own family to worry about. We have dozens of conversations throughout the day. Most people simply do not have the time and energy to spend thinking about every little mistake you made.
And that’s a good thing.
Part of our social anxieties come from feeling like other people care about us enough to talk about us and think about us all throughout the day. But other people are not thinking about us at all. Even in situations where we do truly and objectively do or say something embarrassing, most people have too much going on in their lives and their own needs/desires to focus on anyone but themselves.
Other People Care About You – But Not That Way
Other people do care about you. They care that you’re happy. They care that you have your needs met. They care if you tell them that you got a new job and they care if you tell them you lost a family member.
But very few people have the time or energy to care about small conversational mistakes or inappropriate verbal responses. They don’t care about your facial tics or your bad jokes. There’s very little that any person can do that can cause someone else to focus and think about them all throughout the day.
So the next time that you find yourself worried about being judged, remember how little energy other people have to spend thinking about your mistakes. We all have our own stresses to worry about.
Yes, men can get postpartum depression. It may not even be uncommon. As many as 10% of new fathers have indicated that they’ve felt some degree of post-partum depression, and there are reasons to believe that this could be a massive undercount.
Postpartum depression is often viewed as a disorder that only affects women and other child bearing adults. It is attributed to many factors, most notably hormonal changes, breastfeeding, and difficulty adjusting to life post-labor. All three of those issues do not typically affect men (and other non-childbearing partners), and so the idea that postpartum depression can occur in men is often ignored.
But the reality is that postpartum depression can absolutely affect men for a variety of reasons, and it may be helpful to know that a therapist can support you as you try to navigate these changes. If you need to talk to someone today, call Flourish Psychology in NYC.
What Causes Postpartum Depression in Men?
Actual Experience:
“When I had my first son, I expected to feel elated. But he just didn’t feel like mine. He didn’t look like me. He didn’t feel familiar. It felt like I was caring for someone else’s child. I loved him, and he was a beautiful baby, but I expected to feel instantly connected and, when I didn’t, I felt extremely low in a way that lasted the first few months after his birth.”
Ppstpartum depression does not have a single cause. It is typically a mix of different issues that can all affect both partners. Some of the many issues that lead to postpartum depression include:
Lack of sleep
Difficulty managing the transitions.
Past trauma about child rearing
Struggles bonding with the baby (also may be a symptom)
Adjustments to life.
Arguments and frustrations in the relationship.
Fears over the baby’s health/wellness.
Confusion over the baby’s needs.
Envision any new parent that is waking up every 2 hours to feed and change diapers, hears a screaming child all night, and is bombarded by phone calls and visitors all while they cannot spend any romantic or calm moments with their partner. Lack of sleep alone has been linked to depression. Combine that with all these other emotions and it’s easy to envision how both partners can develop these PPD symptoms.
In addition, men are less likely to have an immediate bond with the child (likely due to hormonal differences and not carrying the baby for 9 months), are typically not given much support by friends and family, and are not always raised to know how to transition to childcare with ease.
Women have a higher risk for postpartum depression for a variety of very valid reasons, but it is also easy to see how and why PPD can affect men as well.
How is Postpartum Depression in Men Treated?
Postpartum depression is a unique mental health struggle. For many men, PPD goes away on its own over time. But many others experience some of the effects of PPD for weeks, months, or even years. In addition, the behavioral effects of PPD can last for a long time, even without realizing it. Adjusting to parenting a newborn can change how a father acts if he feels disconnected in those early stages.
Therapy can help. But rather than see it as therapy for PPD, it should be viewed as therapy for transitions, parental stress, trauma recovery, relationship health, and more – a more encompassing approach that will help parents throughout the transition to parenthood.
Because postpartum depression is not just about having a baby, men that engage in more ongoing therapy to get a better handle on the issues that can affect parenthood – and just being an adult in today’s world – are more likely to have the long term benefits that many men have been searching for.
It can be difficult to seek help. But if you feel like you are or have been struggling with male postpartum depression in Brooklyn or anywhere in New York City, contact Flourish Psychology.
LGBTQ affirmative therapy is an approach to therapy designed to help those in the LGBTQ+ community feel safe, included, and validated as you navigate some of the social, cultural, and economic challenges that many face with their sexual and gender identity. It is therapy for self-acceptance, empowerment, and wellbeing – teaching you to live a free, truthful, fulfilling life.
Within therapy, one of the things that we might look for is examples of internalized biases – homophobia and transphobia that a person has developed as a result of the culture of American society. Often, we need to address these examples of internalized prejudice in order to fully embrace ourselves.
What Are Some Examples of Internalized Homophobia?
Internalized societal biases can come into play in many different ways, and we’ll explore some of these in our sessions. But examples of internalized homophobia include habits such as:
Self-Devaluation – There is a tendency for those in the LGBTQ community to feel as though their lifestyle is not as valued, or that they should feel shame in themselves.
Need to Adhere to Cis/Heteronormative Expectations – Most of society has an idea of “normal” that is hetero/cis-normative, and puts pressure on LGBTQ+ individuals to not feel themselves.
Body Image Dissatisfaction – Similarly, society’s expectation on body type, body shape, and appearance is also based on cis and heteronormative expectations. This can lead to body image issues, eating disorders, and more.
Judgment of Other LGBTQ+ Individuals – It is also not uncommon for LGBTQ individuals to avoid embracing other LGBTQ people and spaces, feeling like they’re somehow too different and not “for them.” That is often an internalized bias.
Self-Hate – Many in the LGBTQ community have unspoken negativity towards themselves. This may be especially common for those that grew up in religious households.
These are all some of many examples of internalized homophobia and transphobia that hurt your own quality of life.
What Does LGBTQ+ Affirmative Therapy Do?
LGBTQ+ Affirmative Therapy is a way of helping you address those internal biases and start living as a “you” that truly accepts who you are and how you express yourself. It is designed to find where you struggle, and give you a series of actions, feedback, and affirmations that allow you to love both yourself and your community in ways that will help you thrive.
If you’d like to learn more about this approach to mental health, please contact Flourish Psychology today.
We’re in the heart of May, and one reason May is so important to our team here at Flourish Psychology is that it is Mental Health Awareness Month. Since 1949, Mental Health Awareness Month has been just that – an opportunity to:
Spread awareness of different mental health conditions
Show how common it is to struggle with mental health.
Provide wellness tips and information to support mental health recovery.
It’s 2023. Most people now are aware that people struggle with mental health. There are more resources now than ever, and there are entire communities dedicated to understanding anxiety, depression, ADHD, and more. So why is “mental health awareness month” still so important?
Underdiagnosed, Undertreated
Even with all the resources we have available, only a small fraction of the people that struggle with mental health seek treatment. Fewer than 50% of people seek treatment for anxiety, for example, and “seek treatment” means any type of treatment, including those that are not effective or evidence based. The number of people that seek an evidence based treatment, like therapy, is surprisingly small.
Normalizing mental health and normalizing seeking out and treating these conditions is critical, because the more normal it is, the more likely people will feel comfortable and confident getting care. In addition, one of the reasons people seek out ineffective treatments is because some treatment options, like therapy, have stigma that prevent people from getting the care they need.
So Mental Health Awareness Month remains a very important month, and it’s so important that anyone that believes in the importance of mental healthcare feel comfortable and confident in sharing their experiences and the benefits they’ve felt from therapy.
Learn more about Mental Health Awareness Month or contact Flourish Psychology if you’d like to start treating your mental health.
Location: 300 Cadman Plaza West Floor 12 - Brooklyn, NY 11201
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