x165 (diagnosis: helpful or hurtful?)

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Image by JD Hancock. No changes were made. CC BY 2.0

Learning about your diagnosis can help you advocate for yourself and help you get the best treatment possible, but it can also remind you that your mental health condition is not the sole basis of your identity. Most people with a mental health diagnosis do not fit perfectly into all the boxes that the Diagnostic Manual lists. Many people with a mental health diagnosis have co-morbid conditions that blur the lines between the individual disorders. Just because someone you know has a brother whose cousin’s father-in-law is “completely crazy and unreliable” because of their diagnosis does not mean you will struggle with the same things they do (nor does it mean that said person is, in actuality, “crazy” or “unreliable”). You may have experienced some confusion when you were diagnosed. This confusion may carry over into your current sense of self and your ability to manage your condition. And with the new, much revised version of the diagnostic manual now published, even your medical practitioner may be confused! We know that it is important to be knowledgeable about your condition while not crossing the fine line of self-diagnosing. But what does a diagnosis mean outside of your treatment in regards to your identity?

Misdiagnoses may occur for a variety of reasons. Often times, a mental health diagnosis comes during a time of crisis. In this scenario you are often meeting a provider for the first and last time. Certain symptoms are difficult to track if you do not know what you are looking for (such as hypomania, where you may be overly energetic and motivated but are not necessarily experiencing the more severe and noticeable symptoms of a full blown mania). Age is also a factor – one of the reasons I doubt some of my diagnoses at times is because they came at such a young age, and due to hormonal reactions and natural teenage mood swings, it can be very difficult to accurately diagnose a mood or personality disorder during the teen years. Some disorders also show different symptoms depending on your age, and often operate on a continuum. For these reasons, it is often important to re-evaluate a diagnosis after a certain period of time, and to be aware of what your diagnosis entails. Outside of a psychiatric hospitalization or a respite center stay, therapists and medication providers often operate on our self-reported symptoms. Being aware of the symptoms associated with your mental health condition and being able to recognize whether or not the symptoms you are actually experiencing match up with those assigned to you is an important form of self-care and self-advocacy. The symptoms you report to your medication provider often influence what medications you will be placed on, and therefore will influence whether or not the medications are actually helpful in treating your condition. You are your own best advocate, and you know yourself best.

Knowledge of your diagnosis is not just about advocating for your health care. Often times, our diagnosis becomes an intrinsic part of our identity – whether or not this is a good or a bad thing. Certain conditions come with a heavy stigma in the “neurotypical” (or without diagnoses) world we live in, while others are treated differently by mental health professionals. Oftentimes, we internalize these stigmas as well as a heavy sense of shame and believe we are lesser-than because we carry a diagnosis. I often find myself thinking the world would be a better place without me because my diagnosis of bipolar disorder means (in my mind) that I am damaged and worthless. I hate the fact that (not unlike someone who is diabetic) I need daily medication to function. I recall going through a phase in my late teen years where I tried to develop a “bipolar pride” mentality – if I couldn’t change the fact that I have bipolar disorder, I may as well be proud of my condition and embrace the positive things that come with it, such as enhanced creativity and a heightened sense of empathy and understanding toward others. Taking on this mindset only furthered the discrimination I faced from my neurotypical peers. Even now, I try to embrace the fact that I am disabled and use that label to connect with others who are experiencing similar things. I also embrace the label of disabled to prove that people who are not neurotypical are valuable and can contribute things to society.

Whether or not my diagnosis is an integral part of my identity, the outside world often assumes that it is. I saw a therapist for the first time when I was nine. I was placed on psychiatric medication at the age of twelve; at the age of fourteen, I was diagnosed with bipolar disorder, a generalized anxiety disorder, and an eating disorder not otherwise specified. In the past year I was also diagnosed with posttraumatic stress disorder. When I was first seeking treatment, I did not know what most of those diagnoses entailed, what the healing process was like, or what kind of stigma was attached to these conditions. Once someone finds out about one of my diagnoses, I am often known first as “the woman with bipolar/PTSD/GAD/EDNOS”. Sadly, many people who are neurotypical, and many who are not but who struggle with seeking help to treat their conditions, know little about mental health concerns and what they do know often carries negative connotations. These two factors often influence the development of our sense of identity concerning our disability or condition. We must remember that we are a whole person, both because of and in spite of our mental health concerns.

Learning about our conditions helps us remember that they are simply conditions, and that everyone must exercise proper mental health hygiene, regardless of whether or not they carry a diagnosis or are considered “neurotypical”. When we utilize our diagnosis as part of our identity, we need to remember a few things: it may or may not be accurate or it may change over time; the negative aspects of a diagnosis are not the sole things that define us; our identity as a disabled or disordered person should be one that comes from a place of advocacy and pride and not one of shame. Labels such as “disabled” or “disordered” should provide opportunities for community, not backlash and stigma. Being knowledgeable about your diagnosis can help with your treatment, but hyper-focusing on what conditions you may or may not have and the stigmas associated with them is unhealthy. Learning to love your whole self is an important part of your healing process, and whether or not you choose to heavily incorporate your diagnosis into your identity (or disclose it at all) is up to you. But just as race or sexual orientation are not the sole components of one’s sense of identity, neither is a mental health condition. Your identity is made up of a myriad of wonderful aspects and no one facet of that defines you. Learning about your diagnosis should enhance the knowledge that you are a whole, worthwhile, and loveable person, and it should help you take care of yourself – never should it make you feel guilty or ashamed.

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