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.