The Limits of Diagnosis Labels

"Birdcage" By Marcia Diaz

Let's start with a quick exercise to spice things up: I want to pick a single word to describe yourself to someone who has never met you. Okay, got one? Great, now I want you to reflect on your choice and ask yourself how much this word successfully represents and summarizes you as a person. Does this word tell the stranger about your childhood and family, or about your dreams, or explain anything about your beliefs and opinions?

If you were able to find a single word that is the perfect, all-encompassing summary of your entire being, then congratulations: you have done the impossible.

Now, let's apply this logic to when we meet someone who is suffering from a mental illness (for this example, we will say they are clinically depressed). What does the label of "depression" tell us about the person as a whole? Yup, not very much. Therefore, to say that a person can be defined or fully summarized by their mental disorder is super inaccurate and an unfair box to confine them to. We must remember to see the person, not just the diagnosis.

Things get even more complicated and confusing when we throw in a group of people who all have the same diagnosis. To stick with the label of depression, is it fair or accurate to say that every single clinically depressed individual experiences depression in the same way? Of course not. Most mental illnesses and disorders are not caused by a single thing, nor are they exhibited or dealt with in the same way. It all depends on the specific person.

GRADIENT METAPHOR

Imagine a giant gradient with each end representing a different extreme (to keep the example running, we could say that the left end represents the extremely depressed while the right represents feeling kinda bummed sometimes). Each individual is a single pin point somewhere on the gradient, and yet they are all thrown under the giant umbrella label of being depressed. Seems a little illogical, right?

Perhaps at this point, you are thinking something like "Well, wait a minute, labels have to tell us SOMETHING or we wouldn't be using them," in which case you would be right. But the problem is that it likely doesn't mean what you think it means.

GETTING DIAGNOSED

According to the DSM 5 (the main handbook used by health care professionals to help guide their diagnosis of mental disorders), a person basically has to experience 5 or more out of 8 possible symptoms for at least 2 consecutive weeks to be labelled as depressed. In short, you are labelled based off of the number of boxes you check in a self-questionnaire.

As with many mental disorders, this is really the only way to obtain a diagnosis. There aren't any medical or scientific tests they can run to determine if you are or are not something (that's the rough part about a gradient - there's no definitive rules).

CIRCULAR REASONING

Another common problem with mental disorder labels is that people often fall into the trap of circular reasoning , which is when the conclusion is the exact same as the premise of the argument. Sounds a bit confusing, I know, but this tricky loophole is exactly why it's often hard to detect.

The best way I can explain it is with a conversation example:

Me: Cookie Monster, why are you called the "Cookie Monster"?

Cookie Monster: Because me love cookies !!!

Me: Oh, okay... But why do you love cookies?

Cookie Monster: Because me is Cookie Monster !!!

Me: 😐

Do you see the problem? Ironically enough, this is exactly what it sounds like when we say a person is (mental disorder) because they are experiencing (symptom), and they are experiencing (symptom) because they are (mental disorder).

The worst part of circular reasoning and the resulting labelling is that it stops the search for the true underlying causes of a person's suffering. We as a society have been taught to accept labels as the ultimate finale when it is nowhere close to helping us address what is causing a person pain. The fact is that people experiencing mental illness are experiencing real pain, whether we are effective in our labelling and diagnosing or not.

MAIN TAKE-AWAYS

For all the misleading these labels do, there is still some small benefits to using labels in the field of psychology. One positive aspect is that labels from the DSM are a way to establish a common language for clinicians to communicate efficiently with about their patients. Additionally, for some individuals, labels may serve as a way to help them confront the problem, like the following saying: "The first step in solving any problem is recognizing there is one." That being said, it is critical to recognize that there are an abundance of negatives associated to the misuse of diagnosis labels, including perpetuating stigma and hurting the person being labelled. So in my opinion, the above mentioned benefits are not enough for us to continue relying on our current methods of labelling/diagnosing, and we should strive to find more helpful methods of understanding mental disorders.

The important thing to take away from this is that words can have an impact, and just like any other harmful labels you are struggling to break free of, mental disorder diagnoses are powerful. Labels can only tell us so much, and we must recognize that behind every limited diagnosis is a human person deserving of compassion and respect.

Bonus Article: I found this incredible article where the author talks about her personal battle against labels and how they affected her throughout her life. A quick read I would highly recommend: How Labels Impacted My Mental Health