Using Diagnoses and Labels in Mental Health

            Lisa was referred to my office, and I had the chance to see her.  After a few sessions, her teacher contacted me and asked me what diagnosis I had of her condition.  I then asked myself: “What would a diagnosis do to help this young lady?”  I was not sure.  I also thought:  “What would a diagnosis do to help the teacher?”  I then thought that maybe this would help her have a handle as to what might be going on with this student.  It is a succinct way of labeling the various behaviors they have been noticing with the student.  It is true that for many of us, having a name for a condition help us put into context what a person might be going through.  In a way, the diagnosis has become an explanation for all the behaviors we cannot seem to make sense. 

            This is particularly true of many medical issues.  When I am suffering from a particular skin disorder, for instance, having a specialist identify what this skin disorder is—having a name for it—can actually result to the necessary actions to take in order to know how to treat it.  In fact, this is the true purpose of having a diagnosis.  When we know what the medical issue is, given its symptoms and presentation, medical professionals have a clear idea of its usual presentation, its course, the recommended treatment, and the prognosis of the outcome. 

            Using diagnostic labels is also a convenient way for medical and allied professionals to communicate.  It enables these practitioners to speak to each other and assume a common basic  knowledge, or lack thereof, about the specific and relevant diagnostic label. 

            In the specialization of mental health, there is no laboratory test, no blood test or brain scan, can actually be used to diagnose any disorder.  The current measures of the symptoms are essentially behavioral, meaning that actual observations and reports from people who know that person well are used as a basis of making a diagnostic decision.  And so, some level of subjectivity happens. 

            I must admit that having a diagnosis of a particular set of behaviors can be quite helpful.  When a person suffers from a Major Depressive Disorder, this can signal the need for some kind of intervention.  Similarly, when a person is becoming Dependent on certain substances, having a label can push that person to seek relevant help. 

            Despite the benefits of using diagnostic labels, there are some drawbacks in relying on it too much.  One is the effect that the stigma of mental illness can bring about.  Being diagnosed can stigmatize a person, and may have effects in future employment and limiting other opportunities.  Another is the tendency of diagnostic label being used to identify a person, rather than just an aspect of that person.  The person can be called “Autistic,” instead of a person with Autism, which connotes that first and foremost the person is of this sort, rather than being an individual first before having such a condition.  Yet another concern is the blurring of an individual’s personal circumstances when a diagnosis is used.  The person then just conforms to the diagnostic criteria, rather than the criteria fitting the presentation of the individual.  In many specific instances, individual nuances further define the presentation of symptoms and there are often no two cases that are exactly alike. 

            As a practicing clinical psychologist, I struggle with being able to identify and declare a diagnostic label, and seeing each person as an individual with their unique nuances.  I want to maximize the benefits of both, and not short changing my clients.   This is a tough scenario to balance with no single answer for all the clients.  In the end, I make my judgment in the best interest of each individual client.  With that foremost in my mind, I know I cannot go wrong. 

            In the case of Lisa, I provided a diagnostic label.  Afterwards, I qualified what behaviors were explained by this label, and which ones were not part of the disorder.  More importantly, I made recommendations of how teachers and staff members can best interact with Lisa so that she is provided the help that will assist her in her special needs.